Vol 4 Issue 2 October 2016-March 2017

Abstract: Rheumatic heart disease (RHD) is cardiac inflammation and scarring activated by an autoimmune response to infection with group A streptococci. In the intense phase, this condition consists of pancarditis, including inflammation of the myocardium, endocardium, and epicardium. Chronic disease is manifested by valvular fibrosis, leading to stenosis and/or insufficiency. This review provides an overview of the current evidence of pathogenesis of RHD, and we also intended to discuss the treatment approaches and prevention that can be taken in advances to avoid RHD. Very detailed search of the literature about Rheumatic heart disease was performed among following databases; PubMed/MIDLINE, and Embase for all relevant articles which were published until December, 2016. We specifically search for studies that are discussing the management and pathogenesis of RHD, we restricted our search for only English language publish articles with human subject.Cytokines play an essential role in inflammation and regulation of immune reaction in RF/RHD and IL-10 gene polymorphism might explain genetic predisposition in RHD patients. Specific medical treatment to manage or prevent heart damage and main prevention of RF continue to be evasive. Main prevention has to depend upon creating a vaccine to prevent GAS infection related suppurative as well as non-suppurative disease manifestations. Keywords: Rheumatic heart disease. Title: Overview of Pathogenesis Rheumatic Heart Disease and its Proper Management Author: Mohammed Hussain fatani, Mohammed Ghazi Humud Alharbi, Hussain Ali Alaidarous, Jawzaa saleh allehyani, Abdalrhman Hussain Fatani, Marwan Hussain Alhazmi, Abdullah Mohammed Alasiri, Nuha Hazem Bukhari International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Pneumonia is a leading cause of mortality amongst kids under the age of 5 years internationally. The purpose of this study was to determine the risk factors associated to acquired pneumonia among children aged under 5 years old, and also to demonstrate the therapeutic optional procedures that could be used in management of this condition. We conducted a Systematic review study through the literature to identify studies with pneumonia Risk factors, and treatment data. All searches were conducted in November 2016 using the PubMed database and entering search terms that were key words, MeSH terms, synonyms or truncations. different search strategies were conducted. Acquired pneumonia in children is a significant contributor to death in children under 5 years of age. There suffices data to show that S. pneumonia and H. influenzae contribute to > 50% cases of acquired pneumonia. There need to be phased and urgent introduction into the UIP because effective vaccines against both of them are offered. A number of avoidable risk aspects of acquired pneumonia like lack of special breast feeding for the very first 6 months of life, improper complimentary feeding, iron deficiency anemia, poor nutrition, and indoor air contamination must be properly resolved. Keywords: pneumonia. Title: Overview of Risk Factors and Management of Acquired Pneumonia among Children, Systemic Review Author: Fahad Alhazmi, Ayman Alshehri, Ziad Alruwaithi, Hanof Bakri, Rayan Bakri, Haitham Alhazmi, Samah Alamoodi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Inflammatory bowel disease (IBD) has been an international health care problem with a sustained increasing incidence. It includes two significant kinds, Crohn's disease (CD) and ulcerative colitis (UC), which are distinct chronic bowel-relapsing inflammatory conditions. The aim of this review was to discuss and overview the roles of environment and diet in altering inflammatory bowel disease (IBD), also to review the etiological factors that contribute in IBD from different aspects. Electronic comprehensive search was performed through medical databases; PubMed/ MIDLINE, Embase, and science-direct, for relevant articles discussing the pathogenesis and etiology of inflammatory bowel disease (IBD), as well as studies showing the roles of environment and diet in the pathogenesis of IBD, search was to identified studies that were published through past period to December,2016, in English and containing only human subjects. The key factors responsible for IBD consist of hereditary parts, environmental elements, microbial flora and immune reactions. It is tough to dispute the common belief that IBD emerges from an extremely intricate interaction among genetic and environmental elements, dysregulated immune reactions and changes of the microbiome, and that none of these factors alone is likely to trigger the disease. Numerous patient-targeted dietary suggestions from the internet and specified diets parallel those of irritable bowel syndrome and functional food poisonings. Keywords: IBD, Crohn's disease, ulcerative colitis. Title: Inflammatory Bowel Disease, Etiological Factors and Role of Diet and Environment Author: Manal Salem Alsaiari, Felwah mohammed yamani, Maram Mohammed Alyami, Wed Ahmed Al Asiri, Tagreed Hussin balhareth International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Biliary atresia (BA) is the most common pediatric cause of cirrhosis, end-stage liver disease, and sign for liver transplantation in children. It takes place in 1 in 5000 to 1 in 18,000 live births. The aim of this review was to overview and discuss the evidence of diagnosis and treatment options for Biliary atresia (BA) in pediatric, we intended to discuss the etiological factors associated with this disease. Relevant studies were identified by a search of electronic databases, including MEDLINE, EMBASE, for all these articles published from time of instance up to December 2016, in English language and discussing Biliary atresia (BA) in pediatric management and diagnostic approaches, containing human subjects only.Early diagnosis is plainly connected with better results for infants with biliary atresia. Outcomes after the Kasai operation in the United States could possibly be enhanced with early diagnosis. Stool color cards distributed to mothers on discharge would not just operate as a screening tool but likewise for educating primary care physicians and moms and dads, engendering awareness that there is an irregular color to infant stool. Newborn screening for conjugated hyperbilirubinemia requires additional analysis. Keywords: Biliary atresia (BA), disease, pediatric, diagnostic approaches, biliary atresia. Title: Diagnosis and Proper Treatment Approaches for Biliary Atresia in Newborns: Review Author: Yusra Mohammed Abdullah Alahmari International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: This review study was aimed to focus on the pathophysiology, and management approaches of asthma in general, its aimed to highlight the most common interactions between the pathophysiology and the proper treatment. An electronic literature search was conducted using Medline (PubMed), Scopus, and EMBASE in December 2016 (all studies published to the mentioned period). The terms used to search titles and abstracts were (asthma OR wheezing OR wheeze OR lung function) AND (pathophysiology OR diagnosis OR treatment OR therapeutic options OR breathing therapy). Only original studies with human subjects and published in English were included. Asthma is a disease of the respiratory tracts, characterized by inflammation and connected with respiratory tract hyper-responsiveness, which can lead to episodes of shortness of breath, chest tightness, wheezing and cough. Genetic factors, environmental impacts and specific trigger factors are implicated in the advancement of the disease. A thorough scientific history and objective measurement of lung function are very important in establishing a reasonably specific medical diagnosis of asthma A series of drugs is used in the management of the disease, and clinical guidelines promote a stepwise technique to drug therapy, where treatment is stepped up when needed and stepped down when control is good. Keywords: pathophysiology, asthma, proper treatment, Medline (PubMed), diagnosis, drug therapy. Title: PAHTHOPHYSIOLOGY AND PROPER MANAGEMENT OF ASTHMA: REVIEW Author: Rayed Saleh A Aldhafeeri, Omar mousa alshamrani, faruq abdullah hassan shaflout alghamdi, Abdullah mosfer Abdullah Alelyani, Mohammad Ahmed Alshamrani, Hatim Ali Saad Alqarni, Sultan Moraya Alqahtani International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Gastric volvulus (GV) is recognized to be a lethal condition, thus timely medical diagnosis and treatment is imperative. This review was aiming to discuss the laparoscopic surgical procedure in treatment of Gastric volvulus (GV), we also indented in this study to evaluate the complications following this procedure and the prognosis throughout the follow up of patients. A comprehensive detailed search was performed through the PubMed/Midline, science-direct. and Embase databases to find a related articles published up to December 2016, and relevant to our study purpose,” laparoscopic management of Gastric volvulus” we restricted our study to only English language published studies with human subjects. then we also searched the references list of each identified article to find more evidence to be included in our studies. Laparoscopic surgical approach has been shown to be reliable for treating both chronic and intense gastric volvulus, while providing the benefits of minimized morbidity provided by laparoscopy. In emergency situations, in patients with high surgical risk and in cases of primary volvulus, laparoscopic anterior gastropexy is sufficient, although research studies of long-term results are required. Keywords: Gastric volvulus (GV), medical diagnosis, treatment, emergency situations, surgical risk. Title: Gastric Volvulus Management by Laparoscopic Surgical Procedure, Prognosis: Review Author: Messedah Awad Rajab Al Daya, Manal Ahmad Ali Assiri International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The Epilepsies are persistent neurological disorders identified by a predisposition for frequent epileptic seizures. Epilepsy/seizure disorder is the most common youth neurologic condition, disorders in children, impacting 4-10 children per 1,000. We aimed by this study to overview the epilepsy in pediatric from different perspective, epidemiological evaluation, diagnosis approaches, and treatment options. MIDLINE, Google Scholar, and EMBASE databases were comprehensively searched for childhood epilepsy related articles published before to December 2016, the literature searched included most of studies that are evidence based supported, and discussing the diagnosis and treatment approaches for pediatric epilepsy, moreover references list of each identified study were searched for more relevant articles.The spectrum of epilepsy syndromes in childhood is large. Diagnosis of an epilepsy syndrome provides insight into the scientific course, assists forecast outcome, and directs the best treatment plan. EEG medical diagnosis, and much better aetiological diagnosis, specifically supported by neuroimaging, has assisted to clarify the diversity of epilepsy in children, and has actually enhanced management. Keywords: Childhood Epilepsy, epilepsy syndromes, Classification, Diagnosis. Title: An Overview of Childhood Epilepsy, Classification, Diagnosis, and Treatment Approaches Author: Rayed Saleh A Aldhafeeri, Omar mousa alshamrani, faruq abdullah hassan shaflout alghamdi, Abdullah mosfer Abdullah Alelyani, Mohammad Ahmed Alshamrani, Hatim Ali Saad Alqarni, Mohammad Siraj Ahmad International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Diabetes foot complication is a life time risk to the diabetes patients that increases the morbidity and mortality. Objective: To assess the prevalence and predictors of amputations among patients with diabetic foot complications followed up at a diabetic foot center (DFC), in Jeddah, Saudi Arabia. Methods: The current study was a retrospective analysis of diabetes patients registered at the DFC between Jan 2012 and Dec 2013, and were followed up for ≥ 3 month for diabetic foot ulcer. Data collected includes demographics, lifestyle, clinical factors, Wagner grade, accompanying clinical signs, associated factors (neuropathy, peripheral arterial disease [PAD], and foot trauma), management strategy, ulcer healing or amputation and mortality. Appropriate statistical tests were applied to identify the risk factors associated with amputation and binary logistic regression was used to analyze its predictors. Results: In total 147 diabetic patients, 73.5% males, mean age (SD) 53.90(16.43) years, mean (SD) duration of diabetes 11.33 (7.53) years, 57.8% had right foot ulcer, 32.2% had high Wagner grade (grade 4-5). Prevalence of amputation was observed in 40.1% (95%CI=32.6- 48.2). Predictors of amputation were age, low income or educational level, long diabetes duration, irregular follow-up, hypertension or visual impairment, existence of two or more comorbidities. Ulcer-related predictors were higher Wagner grade, associated neurovascular abnormalities, and infections. Conclusion: The current study suggests Wagner stage and association of co-morbidities as the major risk factors that predispose to amputation. Thus, enhance the need to recourse to specific therapeutic measures such as revascularization and surgical drainage. Keywords: Diabetic Foot, Complications, Ulcer, Gangrene, Amputation Title: Prevalence and Predictors of Amputation in Diabetic Foot Complications in Western Region of Saudi Arabia: A Retrospective Study Author: Basem AL Shareef, Mohammed Musfer Algamdi, Turki GhalebAlahmadi, Hatan Adnan Mohamad Khan, Muhanad Khalid Kondarji, Yazeed Fahad Altemani, Ayman Abdullah Alshehri, Rayan Tareq Jameel Alrefai International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: A cross-sectional study was conducted to investigate factors and predictors of psychological distress in the bio-social and spiritual model, among 182 patients attending primary healthcare centers in Western Saudi Arabia. A comprehensive questionnaire collected socio-demographic and economic data; biological dimension factors; social dimension factors; and spiritual dimension factors. Psychological distress was assessed using the Depression, Anxiety and Stress Scale (DASS) 21 questionnaire. Assessment of psychological distress using DASS questionnaire showed 10.4% of mild, 6.6% of moderate, 6.6% of severe and 3.3% of extremely severe depressive symptoms. Biological determinants of mental health were overweight, irregular exercise, smoking, history of illicit substance use, and chronic disease all associated with psychological distress. Social determinants were poor social relationships, major family conflict, over-indebtedness, social isolation, and poor intimate life satisfaction all associated with psychological distress; whereas social activities, hobbies, and volunteering in charitable actions were protective factor. Spiritual determinants were compliance with religious duties, diligence with elective religious activities, living satisfactorily in accordance with own beliefs, resilient attitude towards bad life events and regular reliance to spiritual resources in case of stress all being protective factors against psychological distress. The bio-psychosocial and spiritual model showed great significance in application to metal health in the study population. Spirituality and religiousness constituted the most significant dimension, followed by social and biological factors. Keywords: Psychological distress, Depression, Bio-psychosocial, Spiritual, Mental Health. Title: Bio-Psychosocial and Spiritual Determinants of Mental Health among Patients Attending a Primary Healthcare Center in Saudi Arabia: Part One - The Case of Depression Author: Salem Mohammed Barabie, Mohammed Musfer Algamdi, Eida Mohammed S Alharthi, Abdullah Ghazzai G Alotaibi, Mohammed Anwar AlAlwani, Hend Mohammed Al-sheheri, Hassan Ibrahim alasmari, Ahmed Amer M Alalawi, Ali Hussein Mohammed ALASMRI International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Postpartum depression (PPD) is common, reported to be experienced by 15% or more of women during the 12 months after they giving birth to their infants. This review was aim to discuss the role of primary care (Family physicians) in the psychological management of postpartum depression, to be able to evaluate this point we need to overview the diagnostic approaches of PPD in primary care and the awareness general physicians (GPs) about the symptoms and how to approach the treatment of women with PPD. We conducted this review by searching published literature in the following databases: MEDLINE/PubMed, and the Cochrane Central Register of Controlled Trials through “December, 2016”. Reference lists of other relevant publications were screened to identify additional potentially relevant studies that were not identified by the first method of literature searches. The evidence we consisted of in this analysis targeted mainly postpartum women depression management and diagnosis in medical care and the functions of family doctor in management of PPD. The little proof found concerning pregnant females suggested equivalent effects with postpartum ladies for advantages of screening, accuracy of the EPDS, the indirect evidence revealed that screening instruments can identify pregnant and postpartum ladies who require additional evaluation and may require treatment. Keywords: Postpartum depression (PPD), postpartum depression. Title: Efficiency of Psychological Approaches in Case of Postpartum Depression in Primary Care Author: Mastoor Abdulhadi Mastoor Alshahrani, Ebrahim Hussni A Nooh, Qussai Ali Alzahrani, Osama Hassan Alsubhi, Muslih Hayyas H Alzahrani, Moataz Saeed M Hantoush, Ahmed Awad Shamlan International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: We conducted this pilot study to evaluate the effect of HD on IOP in patients with chronic renal failure (CRF) at King Abdulaziz University Hospital (KAUH). Method: A prospective, cross sectional observational study, was conducted on patients on HD at KAUH during the month of September 2016. IOP was measured with a Tonopen in both eyes, before, during, and after HD session. Demographic data were collected from patients’ files. Body weight, systolic and diastolic arterial pressure were also measured before and after HD. Results: 31 patients with a mean age and standard deviation of 48.58 ± 18.16 years were studied. Patients had been on HD for a mean period of 63.29 ± 57.07 months. The main causes of CRF were diabetes mellitus (DM), renal dis-eases, and hypertension. No significant effect of HD on IOP in 29 patients during and post HD (P= 0.776). 7 patients were on systemic B-blocker for hypertension, and one patient was on anti-glaucoma eye drop xalatan for glaucoma. 2 patients had significant increase of IOP during and post HD (P < 0.045). Body Weight and arterial pressure significantly decreased during HD (p=0.001, p=0.002) respectively. Conclusion: No significant effect of HD on IOP in most patients, however, only 2 patients had significant increase of IOP. 8 patients were on systemic B-blocker and topical anti glaucoma eye drop, which may under estimate the effect of HD on IOP. HD significantly decrease body weight and blood pressure. Keywords: HD session, diabetes mellitus (DM), IOP. Title: The Effect of Hemodialysis on Intraocular Pressure Author: Osama Badeeb, Reem A. Alasiri, Ismail Nemri, Lamees Aldoobie, Alaa Alsam-mahi, Yara Fayoumi, Bhaa Simbawa, Abdulaziz Bahamdain International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Surgical treatment is the only alleviative treatment for main cutaneous cancer malignancy, for that reason it is necessary to determine excision margins that reduce risk of regional reoccurrence, far-off reoccurrence and death.6 RCTs with 4233 patients were included. Narrow margins were defined as 1 or 2 cm of medically regular skin around the melanoma; large margins as 3, 4 or 5 cm. Risk ratios (HR) were as follows (HR > 1 shows broad margin better): overall survival 1.09 (95% CI 0.98-- 1.22; p = 0.1); melanoma-specific survival 1.17 (CI 1.03-- 1.34; p = 0.02); recurrence-free survival 1.08 (CI 0.97-- 1.20; p = 0.2); loco-regional reoccurrence 1.10 (CI 0.96-- 1.26; p = 0.2), with no evidence of heterogeneity in between trials for any endpoint or within subgroup analyses. There was an 94% probability that overall survival was even worse with a narrow margin and a 43% likelihood that it was more than 10% even worse in proportional terms (i.e. HR > 1.1). Possibilities that narrow margins were even worse were 99%, 92% and 92% for melanoma-specific survival, recurrence-free survival and loco-regional re-occurrence respectively.The main aim of this systematic review is to provide an updated review of cutaneous melanoma surgical margins We have used standard meta-analysis methods, and for the first time, a probability-based analysis of the data. Keywords: Surgical treatment, melanoma, systematic review, methods. Title: Epidemiological and Etiology Review of Melanoma Worldwide: Systematic Review Author: Wafaa Abdullkareem M Abdullghaffar, Mishael Tariq Saleh Alghamdi, Fawaz Numan Abdulaziz Almulhim, Mohammed Saeed M Alghamdi, Hussein Ali M Fitaihi, Raed Tlaat Abdullah Miralam, Hussain Khalid H Kaaki, Mohammed Rabah A Alkhateeb International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: This review was aiming to overview the urinary tract tuberculosis or as it’s called in many studies urogenital TB (UGTB) from many different aspects, and we intended to more discuss the diagnostic and treatment approaches for this urological infectious disease. An electronic search was performed through Midline, and Embase databases for relevant subject to urinary tract tuberculosis that was published up to December 2016 in English language and contain only human subject, we used Mesh terms in searching the Pubmed database which are; “urogenital TB” Or “UGTB” Or “urinary tract tuberculosis” Or “extrapulmonary TB” combined with “diagnosis” AND “screening” Or “therapy” Or “management”. We have included most of evidence based trails which were discussing the diagnosis and treatment of UGTB in every population stages. Tuberculosis has a high incidence in developing countries. he insidious beginning and non-specific constitutional symptoms of genitourinary tuberculosis (GUTB) often lead to postponed diagnosis and quick development to a non-functioning kidney. Due to hematogenous dissemination of TB, there is a potential risk of participation of the contralateral kidney too. Imaging plays a crucial function in the making of a prompt medical diagnosis and in the planning of treatment, and therefore helps to prevent complications such as kidney failure. Imaging of GUTB still remains a difficulty, primarily on account of the dearth of literature, especially related to the use of the newer modalities such as magnetic resonance imaging (MRI). Keywords: urinary tract tuberculosis, extrapulmonary TB, diagnosis, screening, therapy, urogenital TB, UGTB. Title: Overview of Diagnosis and Treatment of Urinary Tract Tuberculosis Author: Salman Assal Hanif Melhem, Saud mohammad altowerqi, Abdulsalam rashed alshehri, Assaf Nahar Alsulami, Nasser Abdulaziz Almohaya, Hamdan Ahmed ALFaer, osama abdulaziz albaqqar International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Acute mesenteric ischemia (AMI) is an unusual however highly lethal vascular emergency situation, in which intense intestinal ischemia or even infarction may take place if efficient treatment is not supplied immediately. High mortality rates of 30% to 65% have been reported in a number of big scientific series in the past years. The aim of this study was to discuss the surgical management of AMI, also we intended to overview the diagnostic procedures, and mortality and morbidity associated with surgical treatment outcomes. A comprehensive search was conducted through: PubMed/Midline, of the English-language published literature containing human subject, using the terms ‘‘acute’’ and ‘‘mesenteric’’ or ‘‘mesentery,’’ AND “surgical management” or treatment” was performed to identify all articles reporting AMI treated surgical procedures between up to December 2016. Our evaluation of relevant literature found that the conventional management of AMI was open surgical technique, particularly for those presenting emergently with an intense abdominal area. However, the mortality and intestinal resection rate of OS stays high, despite improvements in medical diagnosis and surgical strategy. Endovascular treatment appears to have a higher rate of bowel conservation as well as increased survival and lower problem rate compared with OS, and as such is a good option for treating AMI. Keywords: Acute mesenteric ischemia (AMI), mesentery, surgical management, treatment, surgical technique. Title: Surgical Management Approaches of Acute Mesenteric Ischemia: A Review Author: Ahmed sultan almekhlafi, Nawaf hassan fatani, Abdulaziz aiman neazy, Abrar jamal tawakoul, Tariq faruq kurdi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: TKA is typically carried out to deal with advanced inflammatory and degenerative knee arthritis. With increasing use in younger patients, it is essential to define the best practices to boost clinical performance and implant longevity.The crucial findings of this study were that, comparing to the basic parapatellar method, the midvastus technique supplied significant advantages in short-term pain and ROM, and the subvastus method offered much better outcomes in short-term ROM, earlier straight leg raise and less lateral retinacular release. The main aim of this study is to quantitatively compare the midvastus and subvastus approaches to the medial parapatellar approach in TKA. Keywords: TKA (Total Knee Arthroplasty), short-term ROM. Title: Updated Review of Total Knee Arthroplasty: Systematic Review Author: Raed Tlaat Abdullah Miralam, Hussain Khalid H Kaaki, Mohammed Rabah A Alkhateeb, Mohammed Saeed M Alghamdi, Wafaa Abdullkareem M Abdullghaffar, Hussein Ali M Fitaihi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals