Vol 4 Issue 2 October 2016-March 2017

Abstract: Fungi, once considered non-pathogenic microbiological curiosities have emerged as an important cause of community acquired and health care associated infections.Invasive fungal infections are important cause of morbidity and mortality in cancer patients. Among various pathogenic species of fungi, Candida is the most prominent cause of fungal infections Candidiasis is an infection of Candida albicans causing disseminated disease invariably when host defences are compromised. Here we report a case of invasive mycoses in which Candida albicans was isolated from urine sample of 60 year old male. Patient was diagnosed with cancer in penis. A major obstacle to control this infection is inadequate diagnostic techniques. Although major advances in the case of cancer patients over past several decades have resulted in improved survival Keywords: Fungi, candidiasis, cancer, pathogen, infections, disseminated. Title: ISOLATION OF INVASIVE CANDIDIASIS IN CANCER PATIENT: CASE REPORT Author: Parnavi Arya, Varsha Aglawe, Megha Tiwari, Shraddha Patel, Sushma Jaget International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Background: Women health in premenopausal age is still a matter of neglect. Current scenario reveals that they are not spared of coronary artery disease in spite of the hormonal protection. Although several clinical trials of lipid lowering prevention of coronary artery disease have been conducted, women have always been involved in some number or have not had their result analyzed separately. Hence the present effort tries to find out the prevalence of dyslipidemia in premenopausal women. Objective: To study prevalence of dyslipidaemia in study group of female medical students of Padmashree Dr. D.Y. Patil Medical Hospital And Research Centre, Pimpri ,Pune. Secondly to find out the individual prevalence of abnormal levels of serum cholesterol, triglycerides, LDL and HDL .Materials and methods: The study group (n=200) comprised of female premenopausal medical students (Age: 20 to 40yrs) from a medical Centre was selected by random selection from 3rd year, final year undergraduates and students attending postgraduate courses. They were screened for lipid profile which includes Total cholesterol, Triglyceride, HDL cholesterol and LDL cholesterol by Enzymatic End Point method after 12-14 hrs fasting. The quantitative data was analyzed using MS Excel. Result: The prevalence of dyslipidemia was found out to be 10.5% with LDL contributing to the maximum (8.5%) followed by total cholesterol (1.5%), HDL (0.5%). Thus from this study it is presumed that premenopausal women are no longer protected by their hormonal status and age factor. Keywords: dyslipideamia, women, lipid profile, premenopausal, prevalence. Title: Prevalence of Dyslipideamia in Premenopausal Women: A Study in Pune, Maharashtra Author: Dr. Surbhi Seth, Dr. Vikas Madaan International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Background: DM is a metabolic disorder that threatens life. It occurs when there is insulin resistance or impaired insulin secretion. Aim: To study the association between DM type 2 and risk factors as obesity, physical activity, family history, diet, job stress smoking and age. Methods: A case control study was conducted in Al Mubarak hospital. 28 cases and 42 controls was interviewed. Data were collected by administering a questionnaire, which was analyzed using SPSS. Results: The results showed that 53.6% of cases were 50 years old or above compared to 83.3% of controls, which was statistically significant. In the gender, 57% of the cases were male while they were 86% of controls. In gender, was statistically significant. More females 86% were affected in comparison to males 57%, sibling was carried 50% of cases and 16.7% of controls there were a significant difference in family history between cases and control. Physical activity was showing a statistical difference between cases and controls were cases are living a sedentary life 78.5%. Conclusion: A considerable of DM type 2 was detected among people in Al Mubarak hospital. Age, gender, family history, and physical activity showed statistically significant difference between diabetes and non-diabetic personnel. Keywords: Diabetes Mellitus. Title: Risk Factors of Diabetes Mellitus Type 2 Author: Mohammad A.B. Al Noor, Youssef F. Horaib, Sultan A. Albreak, Abdulrahman N. Alzaid, Abdulmalik A. Almajed, Mohamed I. Yassin, Abdulrhman F. Almutairy, Abdulmajeed M. Alolayah, Fahad F. Almutairi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertension, also known as high blood pressure is defined as a blood pressure reading of 140/90 or above. WHO estimates the incidence of PIH to be seven times higher in developing countries (2.8% of live births) than in developed countries (0.4%). In Nigeria, prevalence ranges between 2% and 16.7% in different zones. In our study, an assessment of the effect of certain blood rheological variables on the blood pressure of pregnant women was undertaken. One hundred and sixty eight women in advanced stages of pregnancy were assessed, using fifty non-pregnant women as control subjects. The result showed that there is a significant association between Erythrocyte sedimentation rate (ESR) and blood pressure changes in pregnancy. There was also a significant association between ESR and parity. The study suggests that inflammatory processes triggered off during the first pregnancy may become exacerbated in subsequent pregnancies in multiparous pregnant women. The study shows that ESR levels may be used in predicting possible development of pregnancy-induced complications in pregnant women, especially during the early third trimester in low-income countries where access to adequate health facilities may be difficult. Keywords: Hypertension, ESR. Title: Erythrocyte sedimentation rate as a simple test to predict late-stage pregnancy complications of women in low-resource settings Author: Ayodele O. Ilesanmi, Rashidat Abimbola Ibrahim, Bayo Akinosun, Waheed A. Akinleye, Esther Ngozi Adejumo International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Background: By reviewing the data of the registration in emergency department of Abha Maternity Children hospital (AMCH) in one year you will find a total number of emergency visits exceeding 120,000 cases per year, Only 12,000 of them needed admission, that gave the idea that majority of cases treated in emergency departments are of minor non urgent nature which can be treated in primary health care clinic (PHCC) instead of causing the unneeded overcrowding and overutilization of the limited resources in emergency and will lead to delay in picking up and treating the real emergencies , so this study was designed to investigate the reasons lead to this problem and try to prove that improvement of PHCC services and population awareness about it and also that health insurance are key solution of this problem. Methods: Questionnaire based cross-sectional study on group of 300 patients, male & female of different ages & nationalities who visited the emergency department with non-emergency reasons in Aseer region. To identify reasons of overutilization of emergency department by non-emergency cases in Assir Region & why they are not going to primary health care centers (PHCC). Inclusion criteria depends on the Canadian Triage Acuity Scale (CTAS) we included in the study cases presented to emergency department and triaged as level 4 and 5, and excluded levels 1,2 and 3. Questionnaire is composed of twenty eight direct questions investigating all the hypothesized causes and was filled up by 6th year medical students of King-Khalid University (KKU)-Abha and analyzed the date & results by SPSS & R statistic programs and Chi-Square test, under the supervision of the principle investigator the Consultant and Head department of Pediatric Emergency Medicine in AMCH. Keywords: PHCC services, ED, AMCH. Title: Overutilization of Emergency Department by non-emergent cases in Aseer Region in Saudi Arabia Author: Almalki AS, Alsayeri FS, Alsharani AA, Aseri AJ, Alqatani RM, Algarni AM, Alzahrani B International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Stroke is one of the leading causes of death. One-third of cases are deadly, and survivors normally have actually lengthened or irreparable specials need. Color Doppler ultrasound (CDU) of carotid arteries forms a fundamental part of the examination of extracranial deficiency. Precise diagnosis of hemodynamically substantial stenosis is crucial to determine patients who would take advantage of surgical intervention. We conducted a systematic review of the literature to determine the diagnostic accuracy of color dopplor ultrasound, in diagnosing vertebral and carotid arteries stenosis or occlusion in stroke patients. A comprehensive review of the literature combining online and conventional library searches as well as searches to find unpublished studies was performed including different database such PUBMED up to October 2016. Doppler ultrasonography is fairly conscious modifications in the intracranial arterial speeds. A raised intracranial circulation speed is not particular for intracranial arterial dissection, this condition is consisted of in the differential diagnosis, which likewise consists of atherosclerosis and vasospasm. Keywords: Color Doppler ultrasound (CDU), hemodynamically substantial stenosis. Title: Colour Doppler Evaluation of Carotid Arteries & Vertebral Arteries in Patients with Stroke Author: Fahad Jaber salman Alfaifi, Abdullah Ali Mohammed Alfarhan, Jubran Abdullah Ali Shnaimer International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Emergency services need to be restructured due to increase in volume of patients both in emergency department and in terms of admission. We need to find out an alternate care pathway by which we will not only reduce the pressure of the A & E department, but also reduce the admissions and readmissions and thus save beds for the hospital. With this idea the concept of ‘Surgical Hot Clinic’ was established. The study was conducted to show the capabilities of ‘Hot Clinic’ in reducing admissions, readmissions and associated cost. We also conducted patient experience and GP feedback survey. Methodology: A prospective study of all patients attending the hot clinic over a period of 6 weeks (Feb-Apr 2013) was undertaken. Results: There were 346 patient attendances in the hot clinic during the study period. The age range of patients was 16-92 with a mean of 47 years. There were 148 males and 198 females in the study group. 133(38.4%) primary admissions and 36(10.4%) readmissions were avoided through the service of ‘Surgical Hot Clinic’ over the study period of. The cost per day at ‘Barking, Havering and Redbridge Hospital trust’ is £300. This translates to a saving of £39,900 over 6 weeks period of the study even if patients were only admitted for one day and the projected savings £345,800 over a 12-month period. There are other cost savings that are not calculated here. 98.5% of the GPs, who were surveyed, recommended this service to be available in the hospitals. >95% of the patients who attended the clinic during the study period had a very good experience and they recommended their family and friends of this service. Conclusions: ‘Surgical Hot Clinic’ reduces emergency admissions and readmissions and associated cost. Keywords: Hot Clinic, Emergency readmissions, readmission cost, surgical readmission. Title: Surgical Hot Clinic – An Effective Pathway of Reducing Emergency Admissions and the Associated Costs Author: MR. IMTIAZ, A. SREELEKHA, V. SHATKAR International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Polycystic ovary syndrome (PCOS) is a common endocrine condition of ladies, identified by a heterogeneous discussion of hyperandrogenism and ovulatory dysfunction. We aimed to construct a systematic review and of all available studies to document the reported overall prevalence and diagnostic approaches of PCOS according to all diagnostic criteria. An extensive literature search was performed up to October 2016 in PubMed and OvidSP by different blind investigators to generate the review analysis. This review showed that PCOS prevalence under the NIH criteria, in a predominately different communities, is higher than previously believed. The reported frequency of PCO morphology was over 40% in many studies, therefore these findings might guide the local use of different diagnostic criteria and adoption of treatment approaches according to geographical region. Keywords: Hyperandrogenism And Ovulatory Dysfunction, Polycystic ovary syndrome (PCOS). Title: Prevalence and Diagnosis of Polycystic Ovary Syndrome; Systematic Review Author: Fathiah mohammed etaiwi, Ibrahim Khalid Aljahli, Ramzi Mohammed Maashi, Rand Abdulrahman Aljoubi, Eman Ibrahim Aljubayri, Wejdan Abdullah AlGarni International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Graves’ disease (GD) is an autoimmune disorder, which is brought on by unusual hereditary changes, consisting of modifications in the expression levels of specific human cellular genes, and different ecological aspects, such as smoking cigarettes. This systematic review study was aimed to determine the most sensitive biomarkers used to predict and diagnosis of GD through a evidence based studies. We conducted electronic bibliographic research independently according to the validated methods of the Preferred Reporting Items for Systematic Reviews (20¬) using the following databases: Medline, Embase, Web of Science, and The Cochrane Library. The database search (date range, 1970–2016) was performed using the following MeSH search terms: ‘‘Graves’ disease,’’ ‘‘toxic goiter,’’ and ‘‘biomarker.’’ interleukin-2, interleukin-10, genetic polymorphism. Direct proof revealed that OPN may cause distinction of Th17 cells in the peripheral blood and thyroid glands or draw in Th17 migration to thyroid glands of GD patients. The relationships in between OPN and CCL20/CCR6/Th17 axis in GD still have to be examined. Keywords: Graves’ disease (GD), Sensitive Biomarkers. Title: Systematic Review of Sensitive Biomarkers of Graves’ Disease Author: ALANAZI, ABDULLAH MOFAREH M, ALANAZI, MUNEEF SUWAILEM A, ALSHAMMARI, BADER OBAID K, ALMATRAFI, ABDULAZIZ RAMDAN H, ALENEZI, ABDULLAH MUNIF, ALANAZI THAMER THEYAB M., ALANAZI, NASSER SALEM M International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Infertility affects an estimated 15% of couples globally, amounting to 48.5 million couples. Males are found to be solely responsible for 20-30% of infertility cases and contribute to 50% of cases overall. However, this number does not accurately represent all regions of the world. We performed a systematic review in accordance with the PRISMA guidelines. PubMed, Embase, and the Cochrane Library were searched for articles published before August 1, 2016, using the MeSH terms for a variety of epdimeiology, Etiology, causes and Male infertility, to demonstrate the evidence based for an enhanced understanding of male factor infertility prevalence in the world, and to review the different causes of fertility among men. We concluded, as such, data from a significant number of infertile individuals is never included, which may bias the data. Genetic factors that impact male factor infertility will provide valuable insights into the creation of targeted treatments for patients and the determination of the causes of idiopathic infertility. Male subfertility occurs commonly in patients that endocrinologists see in their practice: men with obesity, diabetes mellitus, Klinefelter syndrome and hypogonadotropism due hyperprolactinemia, opiates, or corticosteroids. Keywords: Infertility affects, epdimeiology, Etiology, causes and Male infertility. Title: Systematic Review of Epidemiology and Etiology of Male Infertility Author: Alsharif, Rakan Alhussain A, Alharbi, Khalid Abdullah Z, Abukashba , Abdulrahman Adnan A, Abdulghani, Fahad majdy M, Alharbi, Faisal Meshaal B, Dr.Magdy Hassan Youssef International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: This systematic review aimed to evaluates the use of Calprotectin as marker for inflammatory bowel diseases among children and the challenges facing family physicians using this method to accurate the diagnosis of IBD in children. Literature searches were conducted in Medline (through PubMed), the Cochrane Library, and Scopus. Using both MeSH terms and All Fields, the following search terms (synonyms and combinations) were used: (“Leukocyte L1 Antigen Complex” [Mesh] OR “calprotectin”[tw]) AND (“Inflammatory Bowel Diseases”[Mesh] OR “inflammatory bowel disease”[tw] OR “inflammatory bowel diseases”[tw] OR “IBD”[tw] OR “Crohn”[tw] OR “Colitis”[tw]). We searched publications up to October 2016. Thus faecal calprotectin is an accurate marker of IBD in both children and adult patients. In pediatric patients, the calprotectin assay had better sensitivity and specificity than in adult patients in identifying organic causes of chronic diarrhea. Children with organic diarrhea had significantly higher faecal calprotectin values than those without diarrhea. Keywords: Calprotectin, Inflammatory Bowel Disease, Chronic Diarrhea. Title: Challenges in Diagnostic Accuracy of Fecal Calprotectin in Pediatric Inflammatory Bowel Disease in Family Practice, Systematic Review Author: Amal Saleh Alazmi, Alhanouf Mamluh Alazmi, Noor Naif AlAzmi, Fandiyyah Rajeh alruwaili International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Endometrial polyp in postmenopausal women is a common reason for referral to gynaecologist. This can often be an incidental finding in the asymptomatic patient. Although the risk of malignant transformation is low, endometrial polyps should be removed in symptomatic postmenopausal women as its malignant potential is more likely when symptomatic. Studies have shown that the risk of malignant polyp in asymptomatic postmenopausal women is low at 1.5%. Other known risk factors for endometrial cancer such diabetes, hypertension, obesity, use of Tamoxifen and HRT should be taken into when considering treatment option. Asymptomatic postmenopausal polyps are unlikely to be malignant and observation is an option after discussion with the patient. However, each patient should be assessed on its own merits after careful consideration of other risk factors for endometrial cancer. Keywords: Incidental endometrial polyp, asymptomatic postmenopausal women, malignancy potential of endometrial polyp. Title: Incidental Finding of Endometrial Polyp in Asymptomatic Postmenopausal Women. Should We Remove It? Author: Ying Yiing Lou International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Obesity is abnormal or execs body fat has accumulated to the extent that it may have negative effect on health. Being overweight or obese contributes to numerous health conditions that limit the quality and length of life. Determine the level of overweight and obesity; describe factors related to obesity in student’s behavior and to find out the awareness about obesity. Method: A cross-sectional was conducted on Obesity. A questionnaires was designed to collect data from the sample size was 110 medical students in Al-maarefa college during the period from 20/3/2014 to 24/5/2014. Result: Of the obese students, 35% sleep 7-8 hours. This variation in proportion of students for sleep 7-8 hours over the body weight categories was statistically significant (P= 0.0304). It was found that 76% of the medical students of Al-maarefa College are strongly agreed that eating fruits would make them healthier. Those who strongly agree on these parameters, with significant difference of (P=0, 0252). Among the 110 medical students in Al-mararefa College about 18.18% are over strongly agree that watching television would make them eat more this was statistically significant. Percentage was 31.81% and who were disagree was 68.18%and statistically no significant (p=0.0024). Conclusion: watching television, sleep less and not eating fruit were the major risk factors of obesity. Keywords: Obesity, overweight, BMI, health, obese. Title: Obesity among the Medical Students in Al-Maarefa Colleges in Riyadh-Saudi Arabia Author: Mohammed N. Alothman, Sohail S. Alshahrani, Altaher M. Alfaez, Yazed A. Alkriadees, Khaled A. Alkriadees, Khalid A. Abualela, Mutaz M. Alharbi, Shibl A. Alotaibi, Talal S. Alyahyawi, Faisal H. Alhadeedi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Sickness presenteeism may at best represent a physical presence only but psychological absence in the workplace. The study and research of sickness presenteeism has gained less interest from researchers in comparison to sickness absenteeism. The researchers of the topic seem to have reached a common agreement that employees working in the health care profession or care givers are more vulnerable to sickness presenteeism. Among health care professionals, nurses are highly susceptible to sickness presenteeism adversely affecting delivery of patient care responsibilities. SP in nurses is associated with loss of productivity, an increase in medication errors, patient falls, along with poorer quality of patient care. Various studies conducted over a period of time confirmed that combination of different factors have causative effects on sickness presenteeism namely: organizational policies, job design and culture of presenteeism. This study has taken into account the findings of the researchers that suggest – what, why – of sickness presenteeism, primarily among nurses and recommends enforcement of policies as solutions how sickness presenteeism can be minimized. The policies should include availability of unrestricted paid sick leaves, systematic approach to screen staff before shifts and to provide adequate staffing. During the study, it was felt that there is scope of further research as to how sickness presenteeism can be minimized without affecting loss of the organization Keywords: Sickness presnteeism, nurses, presnteeism, Working through illness. Title: IMPACT OF SICKNESS PRESENTEEISM AMONG NURSES Author: Dr. Anjanjyoti Sarma, Rajita B. Sarma International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Diabetes mellitus is a leading reason for morbidity and death worldwide, with an approximated 346 million grownups being impacted in year 2011. The occurrence is anticipated to double in between years 2005 and 2030. A systematic review of published studies reporting the effects of melatonin on diabetes mellitus was undertaken in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement for systematic reviews of interventional studies. A three staged comprehensive search of the literature was conducted in the following databases; PubMed (U.S. National Library of Medicine, USA), and SciVerse Scopus (Elsevier Properties S.A, USA) for studies published before October 2016. The data discussed in this review shed new light on melatonin as a hormone which acts on diverse physiological processes in mammals and, particularly, on pancreatic islet functions. General agreement exists that the physical effects of melatonin are mediated through the activity of two known membrane receptor isoforms, MT1 and MT2, which belong to the large family of G-protein-coupled receptors. Numerous studies support the notion that activation of either receptor isoform leads to a reduction in second messenger cAMP or, in the case of the MT2, also to cGMP levels, due to a coupling of the receptor with G-proteins which inhibit AC activity. Keywords: Diabetes mellitus, melatonin. Title: Role of melatonin in Diabetes mellitus, Systemic review Author: Khaled S.S Shabrawy, Duaa Jihad Zain Basrawi, Rasha Shaker Alkhunizi, Saleh Abdulaziz Alghamdi, Salman Abdulrahman Alolait International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals