Vol 3 Issue 2 October 2015-March 2016

Abstract: Background: The mortality trends of coronary artery diseases (CAD) among women were increasing and despite the old stipulations that heart disease are men’s problems; and women are relatively immune against it; more women than men die as a result of heart disease. (CAD) risk among women is under-recognized and women usually do not perceive CAD as the greatest threat to their health. Misdiagnosis as a result of uniqueness of symptoms, and postmenopausal drop of estrogen level pose women at a higher risk for developing cardiovascular disease. There is paucity of studies on middle-aged women in low- and middle-income countries who are more likely to develop CAD and die from it in comparison to women in industrialized countries. Aim: To describe CAD risk profile and predict ten years coronary heart disease risk using global risk score among women in a rural community, Minia, Egypt. Method: Cross sectional community based study carried out in a rural area and included 124 women aged 35-75 years. An interview questionnaire included socio demographic data, history. Medical and lifestyle risk factors. BMI was calculated, blood pressure was measured. Fasting blood glucose and fasting lipid profile were carried out for each participant. Assessment of the ten years risk for developing heart disease using Framingham risk score was undertaken. Results: 124 rural women with mean of 51.69±10.49 year participated in the study. Nearly one -quarter (27.4%) of them were significantly having a high risk for developing coronary heart disease in the next ten years, and 40.3% of them was located in the intermediate risk zone. The most significant risk factors are diabetes (P=0.001), hypertension (P=0.001), smoking (P=0.001), physical inactivity (P=0.03) and dyslipidemia (0.001). Conclusion: Moderate –to- high risk score for coronary heart disease were prevalent among study participants. Obesity, hypertension, diabetes, dyslipidemia, smoking behavior and physical inactivity contribute significantly with a varying degrees to the global cardiac risk score which is found to be an alarm and useful tool for screening and early detection of those at risk in order to follow an intensive risk factor modification strategy. There is a need to increase awareness about modifiable risk factors of CHD among women. Keywords: Women, Cardiac risk profile, scoring, hypertension, diabetes, cholesterol, obesity, BMI. Title: Coronary Artery Disease Risk Among Middle-Aged Women, Minia, Egypt: An Epidemiological Study Author: Eman Mohamed Mahfouz, Ebtesam Esmail Hassan, Nashaat Nabil kamal, Eman Fathi Abd Elrazik International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The aim of this study is to describe sleep hygiene and habits among, and to investigate the relationships between sleep habits sleep quality and the academic performance among Saudi medical students in eastern province, Saudi Arabia. The study population consisted of male undergraduate medical students at King Faisal University. Target population was found to be 451 students, as follow:Year 1(55), Year 2 (73), Year 3 (78), Year 4 (86), Year 5 (90), and Year 6 (69). Frequency scores are calculated for each item, and higher frequency scores indicate worse sleep hygiene. Analysis of variance (ANOVA) and t-test were used to test significance between continuous variables, while a Chi-square test was used to test independency between categorical data. In this study, a p-value of less than 0.05 was considered as significant in all .Results: A total of 370 out 451 male medical students registered at college of medicine, King Faisal University, Al Ahsaa have returned the questionnaire. Out of which, 14 were excluded due to history of chronic diseases, namely sickle cell anemia, systemic hypertension, gastro-esophageal reflux disease and bronchial asthma. The overall response rate was 78.5 % (table 4). Target population was found to be 451 students, as follow:Year 1(55), Year 2 (73), Year 3 (78), Year 4 (86), Year 5 (90), and Year 6 (69). , the results indicate that sleep hygiene practices were generally good among 4 out of the 5 categories of the sleep hygiene, namely, in the use of sleep-disturbing products, engaging in activating or arousing activities close to bedtime, the use of the bed for activities other than sleep, and maintaining a comfortable sleeping environment. This is consistence with a US study published in 2009 [61]. In the other hand, adherence to proper sleep scheduling was low. Notably, variable sleep schedule among university students is generally high, this finding has been shown in many studies. Keywords: prevalence, Hygiene, academic performance, Medical students. Title: Prevalence of Inadequate Sleep and Poor Sleep Hygiene and Its Association with Academic Performance in Male Medical Students in Eastern Province, Saudi Arabia Author: Adel Nasser Al Bargi, Ammar Abdulfattah Al Kkubaish, Abdullah Khaled Al Maqhawi, Ahmed Al Zubair, Saleh Al Mogairen, Abdulsattar Khan, SayedIbrahim Ali International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Satisfaction with care is an important influence determining whether a person seeks medical advice, complies with treatment, and maintains a relationship with the practitioner. Consistent with this idea, studies have shown the importance of both identifying and addressing patient expectations. Objective: In our paper, we will be assessing patient satisfaction among people in the region of Alhasa city and we will be primarily compare between public and private hospitals. The comparing criteria are, the satisfaction based on, gender, age, family income, education level, hospital sections, medical facilities and the reason why people of Alhasa would pick any hospital on the other one. Method and tools: It is a cross-sectional study conducted between March-May 2015 and our target population are only the adults (17 -55 years old). A self-administered questionnaire and the questions were obtained from the study of St. Joseph general hospital questionnaire. Results: The main significant factor that determines satisfaction and the hospital choice is the family income. There is no significant relationship between the education level and gender in hospital choice. Keywords: patient satisfaction, Alhasa, Private & Governmental hospitals. Title: Patient Satisfaction on Hospital Services in Private and Governmental Hospitals in KSA, ALHASA Region Author: Mohammed Al Mulhim, Majed Al Omair, Falah Al Otaibe, Abdulaziz AlOtaibe, Abdullah Alshakes, Zaenb Al-Salman, Sayed Ibrahim Ali, Ansari Mukhtar Aleem International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: In perioperative medicine, fluid management is a crucial role as it can lead to one of the causes of perioperative morbidity and mortality. The aim of fluid therapy is to maintain fluid homeostasis and it can provide adequate hydration, blood volume and oxygen delivery to tissues. Perioperative fluid therapy is a medical prescription which consists of three categories such as maintenance therapy, deficit therapy and replacement therapy. To achieve a correct fluid management plan, it is necessary to understand normal fluid distribution, features of commonly used intravenous fluids, hydration status of the patient and nature of surgery. As body fluid composition is different between adults and children, fluid therapy must be based on individual patients to avoid fluid overload or underload. Fluid losses can be replaced with crystalloids or colloids until transfusion point is reached and it also depends on individual patient. Based on different case scenarios, a well-structured fluid regime should be planned after taking into account physiology, preoperative losses, intraoperative and postoperative factors. Keywords: fluid therapy; crystalloid; colloid; fluid physiology; hydration. Title: Perioperative Fluid Therapy Author: Dr. Aye Thandar Htun International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Surgical defects resulting from maxillectomy vary in size from small perforations of hard and soft palate to complete removal of these structures. Squamous cell carcinoma with a exophytic growing lesion presenting with limited mouth opening further results in difficulties in rehabilitation of such patients producing functional disabilities, with compromised esthetics, mastication and deglutition. This article presents a technique for fabrication of surgical obturator for such patients by modification of impression tray, which provides support to soft tissues after surgery and minimizes scar contracture and disfigurement. Keywords: Limited mouth opening, Maxillectomy, surgical obturator. Title: Fabrication of a Surgical Obturator in a Patient of Squamous Cell Carcinoma with Reduced Mouth Opening Author: Dr. R.P. Luthra, Dr. Renu Gupta, Dr. Shikha Gupta International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: To assess the effect of female body mass index (BMI) on IVF outcomes in Saudi women undergoing IVF with or without intracytoplasmic sperm injection (ICSI). Design: Retrospective cohort analysis. Setting: University-affiliated IVF Unit. Patient(s): Patients undergoing fresh IVF cycle with or without ICSI treatment, 2011-2013. Intervention(s): subjects divided into 4 subgroups according to their BMI: normoweight with BMI 18.5- 24.9 kg/m2 (n = 93) overweight with BMI 25.0 - 29.9 kg/m2 (n = 99), moderately obese (class I) with BMI 30.0 - 34.9 kg/m2 (n = 93) and severely obese (class II/III) with BMI ≥ 35.0 kg/m2 (n = 73). Main outcome Measure(s): The primary outcome was biochemical pregnancy which was defined as the detection of a positive β- hCG concentration 2 weeks after embryo transfer. Ovarian stimulation parameters and IVF/ICSI cycle outcomes were compared. Other factors associated with BMI were demographic, clinical, and IVF lab data. Association between BMI and biochemical pregnancy was done by multivariate analyses to control for confounding. Result(s): In our study, BMI was not found to be significantly associated with biochemical pregnancy. Compared to the normal BMI subgroup, the adjusted OR (95% CI) for the overweight, moderately obese and severely obese subgroups were 0.93 (0.43 – 2.00), 0.83 (0.38 – 1.84), and 1.67 (0.76 – 3.69), respectively. Conclusion(s): Female BMI does not appear to have an adverse effect on biochemical pregnancy rates in women undergoing IVF/ICSI treatment. However, counseling women on the increased obstetric and neonatal complications associated with increased maternal BMI prior to undergoing this treatment is mandatory Keywords: Obesity, body mass index, in vitro fertilization, biochemical pregnancy, infertility. Title: Effect of Female Body Mass Index on the Outcome of IVF / ICSI Treatment Cycles in Saudi Women Author: Saleh AlAssiri, Hadeel AlMadany, Khawlah Ateeq, Hani Tamim International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Grand multiparous women [Para ≥5] have been considered to be at a higher risk to develop maternal, fetal and neonatal complications compared to women of lesser parity. However, this relationship between grand multiparity and obstetrical complications has been controversial. Saudi population has been found to have a fertility rate high enough to stigmatize it as a high risk population. There hasn’t been any previous study targeting the Saudi population. OBJECTIVE: To identify the association between different feto-maternal and neonatal outcomes and presence of maternal grand multiparity. METHODS: The medical records of 151 grand multiparous women [parity >5] and 212 women with parity of 2 to 4 was chosen were reviewed. RESULTS: Grand Multipara group tended to have a significant higher age [P<0.001], a significant higher tendency to abortions [P=0.02], a significant higher tendency to iron deficiency anemia with [P=0.03] and a boarderline significant higher tendency to hypertension [P=0.07], more multiple pregnancies [P=0.005]. Multipara women neonates tended to require more initial resuscitation effort with P=0.001. CONCLUSION: This study suggests that grand multiparity had only a significantly higher incidence of multiple pregnancies. Taking into account past medical history and fair antenatal care, grand multiparity should not be considered as an individual risk factor. Keywords: Grandmultiparity, maternal, neonatal, fetal, complications, Saudi Arabia, abortions, hypertension. Title: Grandmultiparity, Fetomaternal and Neonatal Outcome Author: Hanan Al Kadri, Rami Akkielah, Layan Akkielah, Yara AlSaif, Ageel AlMahdaly International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Colostrum has been known for long time to play an important role in the development, growth and immunity of the newly newborns. In Saudi Arabia, there are cultural differences based on the region of the country, regarding the importance of colostrum and/or breastfeeding on the overall well-being of the newly born. Objective: The objective of this study was to evaluate the knowledge of women about the importance of colostrum for the newly newborn(s). Material and Methods: A questionnaire was used as a tool for collecting information concerning colostrum feeding among women in Western region of the kingdom of Saudi Arabia. The data was entered and analyzed using SPSS version 21. Different demographic information was associated with knowledge and attitude related questions using one way ANOVA. A P-value of less than 0.05 was considered as a criteria to reject the null hypothesis. Results: Five hundred and fifty participants were included in this study. All were married Saudi housewives with an average age of 31 years, with a bachelor degree and an income between 6000-9000 SAR and residing in apartments. Around ninety eight percent of them have heard about colostrums. The source of information varied based on age, monthly income and educational level. Conclusion: The data emphasized the need for more information about the importance of colostrum and breast feeding among the Saudi women. Recommendations: It is recommended to conduct nationwide studies that would represent the view of women from rural areas of the kingdom to provide a deeper understanding of women attitude towards colostrum. More educational campaigns need to be organized to, better educate women about the importance of colostrum for the overall well-being of the newly born. This could be achieved through leaflets, internet websites and other sources of information. Title: Knowledge, Attitude and Practice among Saudi Mothers towards Colostrum Feeding in the Western Region of Saudi Arabia Author: Dalia Hashem, Deemah Tashkandi, Duaa Abdullah, Lama Basuni, Lujain Halawani, Musab Almatrafi, Njoud Aldardeir, Rahma Bukhari, Sunil Joshi, Zahra Othman, Steve Harakeh International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The usage of cerebral spinal shunts is considered the most common way of surgical treatment in hydrocephalus patients. There have been many complications associated with shunts. Infection is considereed the most common complication. S.epidermis is generally accepted as the most common pathogen. This study is intended shed light on pathogens found in our institution among patients who needed shunt reviewing secondary to confirmed infection. Methods: This is a cross-sectional single institution study. Patients who needed shunt review from 2008 until 2012 (68 patients) were included initially. 27 patients had positive lab results for shunt infections. Results: Males constituted the majority of study subjects (63%) compared to females (37%). Pediatric patients were 85.2% of our study sample. Congenital hydrocephalus (44.4%) was the main etiology. Staphylococcus epidermidis was the main organism where it was found in 33.3% of patients. Staphylococcus aureus was found in 18.5% of patients. Conclusion: The Prevalence of shunt infection is higher in our population compared to worldwide numbers. The results of our study are consistent with published research in terms of organism prevalence. Keywords: TH prevalence, Staphylococcus epidermidis, main etiology. Title: TH Prevalence of Ventriculoperitoneal Shunt Infection, One Hospital Experience Author: Dr. Mohand Alzughaibi, Dr. Yasser Babgi, Dr. Nayf alshammari, Dr. Neville Russell International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The aim of our study was to determine the prevalence of irritable bowel syndrome (IBS) according to the Rome III criteria and its subtypes among King Saud University (KSU) undergraduate male students and to describe correlation of symptoms with multiple variables such as exercise, body mass index, family history and others. Material and methods: A hard copy questionnaire was constructed by our team in February-march 2013 and 600 questionnaires were handled to undergraduate students of the different colleges at KSU (5 humanitarian colleges, 6 science colleges and 5 health colleges. IBS was estimated by the Rome III criteria. Results: A total of 509 responders were obtained with mean age 21.4 years (19–25 years range).169 of them (33.2%) fulfilled the Rome III criteria for IBS and had no organic diagnosis to explain their symptoms and 340 (66.8%) did not fulfil the criteria. Subtypes were: mixed IBS 68%, IBS with diarrhea 17%, IBS with constipation 7%, and unsubtyped IBS 8%. The prevalence of IBS among the different colleges was variable, the highest being in faculty of medicine (48%) and the lowest prevalence was in the faculty of business and administration (10.7%).The full description of results in all colleges will be presented. The prevalence of IBS was higher in those who are more than 22 years old, in slim subjects than in obese ones, people with chronic diseases, those with family history of IBS and those who eat more frequent fast food. Those who exercised regularly were less affected; however, there were some variables with no significant association like smoking. Conclusion: The prevalence of IBS according to Rome III in undergraduate students at KSU was 33.2% and was higher in medical students compared to other colleges. Multiple factors may contribute to these findings. Keywords: Irritable Bowel Syndrome (IBS), Undergraduate Male Students. Title: The Prevalence of Irritable Bowel Syndrome among King Saud University Undergraduate Male Students Author: Mohammed Al-Karbi, Naif Al-Sulaiman, Basel Al-Sugair, Ahmed Al-Thukair, Akeel Al-Mahdaly, Saleh Othman International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The study aims to determine the perceptions, attitudes, and behavior of wives toward exposure to passive smoking at home. Methodology: A questionnaire was designed based on focus group discussion results. A Cross sectional study was done on 250 women attending primary health care centers in Buraidah, Onaizah and Riyadh Alkabra within the Qassim Province who live in a house with at least one smoker. The study was done from January 2012 until July 2013. Results: The data was analyzed using the statistical package for the social sciences (SPSS). This study has shown Low knowledge is The only significant determinant of non active behavior of wives to stop smoking (P = 0.006). Conclusion: It is highly important to educate wives about the side effect of the passive smoking and the importance of preventing smoking at home and smoking in company of others especially children, and to emphasize the importance of strict implementation and follow up of anti smoking regulations especially at home. Keywords: passive smoking – at home – housewives- KAP. Title: Perceptions and Behaviors of wives toward the Exposure of Passive Smoking at Home in AL-Qassim Region Author: Nora Abdulmohsen Alyousif, Badriah Abdulaziz Al Raawji, Areej Solaiman Alqarzaie , Rafif Hamdan Al Motairi , Hala saleh Azzieaidy International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The objective of this study was to find out the outcome and benefits of Research Day. Data Sources / Data Collection: Questionnaires were given to participants at the end of the Research Day. Study Design: Cross sectional survey Principal Findings: Participants were satisfied with the objectives of Research Day-they gained knowledge and got new ideas, received good exposure. They were also satisfied with the seating, food and beverages and the audio-visuals. Satisfaction of programme with objectives fulfilled and between assist researchers with objectives fulfilled (P<0.001; rank correlation coefficient > 0.7). Conclusion: Research day is beneficial to researchers as they gain new knowledge and get good exposure to Research. Keywords: Research Day Outcome. Title: Outcome of Research Day-Is It Beneficial? Author: Dr. Thanigasalam Thevi, Prof Dr. Adinegara Lutfi Abas International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: MTG16, MTGR1 and ETO are nuclear transcriptional corepressors of the human ETO protein gang. MTG16 is ensnared in hematopoietic improvement and in controlling megakaryopoiesis. Moreover, ETO homologue qualities are 3'participants in leukemia combinations created by chromosomal translocations mindful of hematopoietic dysregulation. The proposed cooperations of the ETO homologues may have suggestions for the onset of leukemia, since it opens up for an AML1-ETO interceded aggravation of ETO homologue capacity and a regulation of AML1-ETO capacity by the ETO homologues. In this review we tried to identify the outcomes of several reviews that are discussing Characterisation of the leukaemia-associated ETO homologous. Keywords: Leukaemia-Associated ETO Homologous, AML1-ETO. Title: Characterization of the Leukaemia-Associated ETO Homologous Author: Khaled Rhafiq Shabrawy, Raghad Yaser Shawoosh, Abdulkader Mahmoud Dadou, Sally Shaker Alkhonizi, Rawan Alqurashi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Chronic osteomyelitis, or bone infection, is a major worldwide cause of morbidity and mortality, as it is exceptionally hard to treat due to patient and pathogen-associated factors. The pathophysiology of chronic osteomyelitis is multifactorial and starts with spread of microscopic organisms. Microscopic organisms might achieve the bone by hematogenous seeding, direct immunization, or airborne sullying. The effective use of local antibiotic treatment of osteomyelitis requires a detailed understanding of the characteristics and pathophysiology of this disease. The most common pathogens responsible for osteomyelitis in humans are Staphylococcus species, followed by Enterobacteriaceae and Pseudomonas species. Objective: the aim of this paper is to review the complication and outcomes of antibiotics treatment of osteomyelitis, based on evidence of previous studies. Methodology: we conducted systemic search through several databases mostly Midline (pubmed) up to 2015, and we have included all those studies that discussed the treatment of osteomyelitis, and we finally exclude some of studies based on their validity in this field, then we finally analysis the different outcomes of antibiotics methods treatments, and their complications, from each study that were included. Results: An antibiotic is generally begun at the earliest opportunity. The introductory antibiotic picked is one that is prone to murder the germs (microscopic organisms) which regularly cause osteomyelitis. Be that as it may, the antibiotic is here and there changed to an alternate one when the aftereffects of the tests affirm which bacterium is bringing about the contamination. So the complication depending missing the right antibiotic for the right type of bacteria that is causing OM. Conclusion: Acute hematogenous osteomyelitis is typically requires a much shorter course of antibiotic therapy than in chronic osteomyelitis in adults. And usually the short term therapy has better outcome and less complication adverse. Keywords: Antibiotics Treatment, Outcomes and Complications, Acute hematogenous osteomyelitis. Title: Outcomes and Complications of Antibiotics Treatment of Osteomyelitis Author: Majed mohammed albaqami, Mohammad Abdullah Albogami, Rami abdullah alsuwat, Ahmed Eidhah Aloufi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Anemia is a global public health problem affecting both developing and developed countries with major consequences for human health as well as social and economic development. It is defined as a decrease in the level of hemoglobin in the blood below the reference level for the age and sex of individual. There are many types, but globally, the most significant contributor to the onset of anaemia is iron deficiency. Children, pregnant and non-pregnant women are the most susceptible groups for Iron deficiency anemia. Although iron deficiency may be due to physiological demands in growing children, adolescents and pregnant women, the underlying cause(s) should be sought. .There is a great variation in the clinical picture of the disease and its consequences. IDA may be effectively diagnosed in most cases by full blood examination and serum ferritin level. Serum iron levels should not be used to diagnose iron deficiency. This paper aims to identify the prevalence of IDA in KSA and comparing this with other countries, to study the IDA by means of descriptive epidemiology , to identify the possible risk factors and causes , To give an account of the methods of prevention of this problem , To identify the steps by which the main strategies improved food consumption and dietary practices, food fortification, supplementation, and public health measures,To identify appropriate indicators for monitoring programme implementation, To identify high-priority, action-oriented, and operational research needed to enable and accelerate effective programme implementation. Keywords: Anemia, global public health problem, IDA, Children, pregnant women, public health. Title: Iron Deficiency Anemia Author: Nasser H. altarjami, Waleed k. alraddadi, Mohammed s. alrehaily, Hail A. mufti International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals