Vol 4 Issue 2 October 2016-March 2017

Abstract: Pulmonary alveolar microlithiasis (PAM) is a rare disease that affect bilateral lungs. It characterized by widespread deposition of calcium phosphate within the alveolar airspaces. The etiology of PAM is not well understood, some studies showed a mutation in SLC34A2 gene that encodes a sodioum-phosphate co-transport in the alveolar type 2 cells has, which result in the accumulation of microliths rich in calcioum phosphate are the cause of the disease. Other theories include exudate that forms as a result of an abnormal inflammatory response, resulting in a formation calcification. The clinical manifestation of the disease varies; many patients are asymptomatic and could progress into pulmonary fibrosis and cor pulmonale. The most effective treatment of PAM is lung transplant, medications and artificial respiratory support known to be ineffective. This case reviews the clinical manifestation, the investigations finding and the treatment with goal of contributing to a better understanding of this disease. Keywords: Bilateral Sequential Lung Transplant, Pulmonary Fibrosis and Cor Pulmonale. Title: Bilateral Sequential Lung Transplant for Pulmonary Alveolar Microlithiasis Author: Ibrahim Saud Abdullah Altamimi, Mohammed Ahmed Ali Alsahabi, Feras Khaled Abdulsalam Aledrees, Latifah Abdullah Mohammed Alnahidh, Abduljalil Hussain Mohammed Almarzooq, Badea Abdulraouf Salman Almarzooq, Hassan Ali Hassan Alyousef International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Smokeless tobacco is Smokeless tobacco is a tobacco or a tobacco product that is used by means other than smoking, it is available as loose leaves, plugs (bricks), or twists of rope. A piece of tobacco placed behind the lower lip, sometimes next to cheek at either side of mouth. It is either chewed or held in place. Objectives: To determine the prevalence, perceived factors that may lead and deter secondary school students to use tobacco and knowledge on hazards of tobacco chewing on health among secondary school students in jeddah city (2014). Materials and methods: This was a descriptive cross-sectional study conducted among secondary schools in jeddah city. A sample of 530 students from 10 schools were selected using stratified random sampling procedure. Selected students were requested to fill in an Arabic version of pre-tested questionnaire. Data analysis was done using SPSS version 19 and Chi-square test was used to measure the association between independent and dependent variables. The level of statistical significance was set at p<0.05. Results: The prevalence of tobacco chewing among secondary school students in jeddah city was 28.7%. Majority of students ( 61.7%, 64% ) were respectively highly knowledgeable on relationship between tobacco chewing and occurrence of oral cancer and periodontal diseases. ‘Influence of friends’ was the most common factor that influence students to start chewing tobacco by (66.5%). ‘‘Good guidance from parents and guardians’ 'Knowing detrimental health effects caused by tobacco chewing’ and ‘Religious teachings’ were perceived as factors that may inhibit a person to start chewing tobacco. The tobacco smoking was significantly higher among students who chew tobacco compared with the ones who don’t [ ( 25% & 2.9%, P = 0.00) and (30.3 % & 4.5 %, P = 0.00) respectively]. Conclusions: The prevalence of tobacco chewing among secondary school students in jeddah city appear to be high. Majority of students who participated in this study had good level of knowledge on the detrimental effects of tobacco chewing on health. ‘Influence of friends’ was the most common factor that influence students to start chewing tobacco. Finally, There was a significant association between tobacco chewing and tobacco smoking. Recommendations: There is need for intervention among secondary school students to prevent possible continued trend of tobacco chewing. There should be a call for religious leaders, parents, school teachers to be involved in discouraging chewing of tobacco among secondary school students. Health education should be directed to raise awareness regarding detrimental effects of tobacco chewing among secondary school students. Keywords: Tobacco, Smokeless tobacco, Prevalence, Addiction, Secondary school. Title: Prevalence, Perceived Factors and Knowledge on Hazards of Tobacco Chewing Among Secondary School Students in Jeddah City 2013-2014 Author: Ameen Alhadri, Nahla S. Saati, Yahya M. Aloosh, Amjd A. Slagor, Saleh S. Alqarni, Abdulaziz A. Alshahrani, Hanadi A. Alsadeq, Amwaj Q. Alqhtani, Samih A. Dawas, Mohammed H. Alruwaili, Faisal A. Rafie, Abdullah A. Alamoudi, Mohammed S. Alqahtani, Reem A. Almukhtar, Bashayer M. Almadan International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The aim of this review study was to overview the role of MRI in the diagnosis and severity evaluation of multiple sclerosis (MS). We conducted a narrative search using electronic databases; Medline, PubMed, Embase, and Scopus from their inception dates up to end of 2016. Studies that reporting roles of MRI in detection and evaluation of multiple sclerosis were included in this review. Keywords used for the PubMed search included the medical terms as following: “multiple sclerosis” along with “magnetic resonance imaging”. Restriction to English language and human subjected published articles was applied during our search. In the diagnostic procedure of patients with believed multiple sclerosis, use of post-contrast series provides essential details for differential medical diagnosis. MRI stays a valuable tool for recognition of children and adults with numerous sclerosis, both at the time of an incident attack when applied serially to verify the chronic nature of this disease. Advanced imaging strategies provide info about local CNS participation with greater level of sensitivity than standard MRI and might contribute to diagnostic uniqueness. Whether MRI features constant with multiple sclerosis in the absence of medical involvement can confirm several sclerosis medical diagnosis stays an area of argument that requires further study and deliberation, specifically in view of proof that some such individuals have international and focal loss of tissue stability however are not eligible for multiple-sclerosis-directed therapies at present. Keywords: Multiple Sclerosis (MS), MRI, Medical Involvement. Title: Overview of Roles of MRI in the Diagnosis and Evaluation of Multiple Sclerosis Author: Ibrahim Abdulrhman Hamed Alazwari, Mohammed Hassan Almalki, Waleed Abdullah Alzahrani, Yasser Yahya Alzahrani, Ftayes Saeed Kadasah, Abdulhadi Salem Towairqi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The main goal of this review was to emphasizes the roles of Doppler ultrasound in the diagnosis and evaluation of deep vein thrombosis (DVT), and to discuss the accuracy, advantage and disadvantage in compared with other diagnostic methods. A comprehensive review of the literature for all studies evaluating the roles and accuracy of Doppler ultrasound in diagnosis, was performed using Database searches included: Medline from PubMed, and Embase for those studied published up to January,2017. Following Mesh terms were used in search strategies: “thrombosis, venous thrombosis, thrombophlebitis, venography, ultrasonography, ultrasound, Doppler, and duplex”. Only English-language articles indexed principally in Medline were included, and with human subjects only. Several research studies in literary works vouch for the total precision of Doppler ultrasound in the detection of DVT in the symptomatic patient. The total precision of evaluating ultrasound in the asymptomatic patient is less clear. Lots of reports on using screening ultrasound (Doppler) lack corroboration of precision with comparison venography. There have actually varied results between research studies in the accuracy of colour Doppler or compression sonographic methods in showing calf bone DVT. Much of these research studies have struggled with high prices of practically inadequate examinations. Power Doppler (colour Doppler power) has a higher sensitivity than standard colour Doppler. It needs to consequently enable the detection of sluggish venous circulation in patent vessels, that may not be demonstrated by conventional colour Doppler. Keywords: Deep Vein Thrombosis (DVT), Doppler ultrasonography. Title: Roles of Doppler Ultrasonography in Diagnosis of Deep Vein Thrombosis (DVT) Author: Maha Mohammad Alshahrani, Alaa Mohammed Al_Shahrani, Hawra'a Jawad Al-Qasim, Mohammed Jawad Al-Qassim, Zuhair Alhasan Jabour, Mashael Atiah Alzahrani, Muna Ali Aqeel Alshehri, Muhannad Abdulrahman Alsukhayri, Faisal Abdulghani Althobaiti, Rashad Hussain Alhamyani, Hamdy Muhammad Tashary, Rayan Mohammed Alofi, Rasha Abdulmuti Alsulami International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Wolf-Hirschhorn syndrome (WHS) is a rare chromosomal disorder characterized by dysmorphic features, multiple congenital anomalies, hypotonia, psychomotor retardation and epilepsy. Results: 3 year old Saudi female presented with history of generalized tonic-clonic seizures at the age of 8 months. She had lagoopthalmos and other dysmorhic features. Genetic studies showed terminal deletion in short arm of chromosome 4 consistent with the diagnosis of WHS. Phenobarbital was started initially for the treatment of her seizure. Later, she developed atypical absence seizures and valproic acid was started. Liver enzymes were elevated and the seizures remained uncontrolled. Levetiracetam was started and valproic acid discontinued. She had excellent control on Leviteracetam without clear adverse reaction. Conclusion: Atypical absence seizures are known type of epilepsy occurring in WHS. Valpric acid was reported to the drug of choice. We believe that Leviteracetam is a good alternative especially in cases of valprioc acid intolerance or side effects. Keywords: Wolf-Hirschhorn syndrome; status epilepticus; EEG; levetiracetam. Title: Deletion of Short Arm of Chromosome No. 4 (4p-)-Wolf Hirschorn Syndrome Seizure Disorder, Control on Levetiracetam Author: Zainab H. Al Alawi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The main goal of this review paper was to overview the Multiple myeloma (MM) in many clinical aspects, and mainly discussing the risk factors, and more importantly the treatment approaches toward this type of malignant bone marrow cancer. We conducted a comprehensive review through the literature using electronic databases; Medline, PubMed and Embase. Eligible studies were sought in PubMed with language restriction to English articles and with human subjects only; search was over these studies published up to January, 2017. Several myeloma (MM) is defined by the neoplastic spreading of a solitary clone of plasma cells generating a monoclonal immunoglobulin. The initial step in coming close to a possible brand-new patient with MM is to verify the diagnosis given that the premalignant phases of myeloma, specifically monoclonal gammopathy of undetermined importance (MGUS) as well as smoldering numerous myeloma (SMM), do not require treatment and may be easily misdiagnosed as MM The therapy of myeloma relies on whether the patient has smoldering myeloma or symptomatic myeloma. Patients with smoldering myeloma are generally observed, with treatment initiated after disease progression to energetic MM. There is no evidence that early therapy of asymptomatic myeloma extends total survival. Patients with symptomatic, energetic myeloma require treatment. This treatment is patient-specific and relies on numerous factors including age, comorbidities, and performance condition. Keywords: Multiple myeloma (MM), risk factors, disease progression, therapy, symptomatic, treatment. Title: Overview of Multiple Myeloma, Risk Factors, Treatment Approaches Author: Zuhair Alhasan Jabour, Mohammed Omar Mohammed Alsayed, Hassan Mohammad Homadi, Mohammed Abdullah Eidoh, Mohammad Abdullah Mohammad Alkhallaf, Mariam Mohammed Hassan Ayashi, Sanhan salman Jaber al-malki, Ahmad Saeed Mohammad Alayed, Manar Mohammad Dabi, Waleed Hassan Ahmed Al Abdulhadi, Mohammed Awadh Masoud ALQahtani, Ali Omar Moftah International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The main goal of this study was to discuss the pathogenesis and treatment options of hepatitis B virus infection (HBV). We conducted a comprehensive electronic databases of biological and health sciences including MEDLINE (PubMed), Scopus, EMBASE, Embase, Ovid, Google Scholar, and Scientific Information Database (SID). The main keywords used in search for studies included in this review included: “Hepatitis B”, “HBV”, “Pathogenesis”, “Treatment”. Search was restricted to English language published until January, 2017. The loved one invisibility of HBV to the innate sensing machinery of the cells probably reflects its duplication method with the replicating viral genome being protected within viral capsid particles in the cytoplasm. The monitoring of dually infected patients also differs from that of HBV-mono-infected patients. With regard to the effect of HIV on HBV, essential modifications occurred with the introduction and also extensive use of effective antiretroviral therapy. Keywords: Hepatitis B Virus Infection (HBV), pathogenesis. Title: A Comprehensive Review of Hepatitis B Virus Infection; Pathogenesis, and Management Author: Hisham Hussain H. Alawaji, Saad Khalil Abuhasbu, Fahad Naif Almarwani, Ali Hussain Alfahal, Ahmed Abdulaziz Almuhamdi, Abdulrahman Samir Khateiri, Atheer Ali Maghram Almoria, Sumayyah Rudda Altalhi, Omaima Tawfiq Al-Omani, Hassan Salman Al Khalaf, Banan Matuq Aloufi, Faisal Mohammed Al-Atawi, Ahmed Daif Allah Hamad Alharbi, Omar Mobarak Almotairi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Our main goal of this review study was to evaluate the safety and efficiency, and discuss the surgical techniques of Laparoscopic adjustable gastric banding (LAGB), through reviewing the most recent base evidence trials which were concerned with this type of surgical intervention. We conducted a comprehensive review of literature for relevant studies reporting Laparoscopic adjustable gastric banding (LAGB) surgical procedures and safety and effectiveness of this procedure, this search was performed using several medical and science databases; MEDLINE, AMED, CINAHL and Cochrane Database. Search method was done using MESH terms, focusing on studies published up to December, 2016 with English language and human subject. Laparoscopic gastric banding remains a reliable method for the therapy of dark weight troubles in addition to is an advised in addition to primary alternative for various centres, the information offered in the three HTA documents, it turns up that LAGB was much more secure compared with, or at least as safe as, open RYGB or open VBG in relation to short-term (about five years) death as well as morbidity. Laparoscopic adjustable gastric banding with the Laparoscopic Band system provides a risk-free and effective medical therapy choice for morbid obesity. The development of the surgical method has actually improved results in regards to satisfactory brief- as well as long-lasting outcomes and also lower difficulty rates. Keywords: Surgical Techniques of Laparoscopic Adjustable Gastric Banding (LAGB). Title: Overview of Surgical Method of Laparoscopic Adjustable Gastric Banding (LAGB) Author: Ahmed Mohammed Mashdali, Emad Mohammed Mashdali International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The aim of this review study was to discuss the treatment approaches of Pemphigus vulgaris (PV), and also to review the dermatological lesions which are mostly oral mucosal and face area lesions. We conducted a computerized search through; PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases, for relevant articles reporting data on lesions and treatment of pemphigus vulgaris up to December, 2016. And reference lists were searched for more relevant articles concerned with treatment modality for pemphigus vulgaris. Restriction were applied in the search method to English language and only human subjects. Pemphigus vulgaris is a chronic autoimmune mucocutaneous disease that at first materializes through intraoral lesions, which infected various other mucous membranes and the skin. The etiology of pemphigus vulgaris is still unknown, although the disease has brought in substantial rate of interest. The pemphigus group of disease is characterized by the production of autoantibodies versus intercellular materials and is thus identified as autoimmune diseases. In pemphigus vulgaris, treatment with systemic glucocorticosteroids is lifesaving; it could, nevertheless, create severe side effects, consisting of death. A patient with pemphigus vulgaris as well as myasthenia gravis was treated for roughly 5 years with the cholinomimetic Mestinon (pyridostigmine bromide), Imuran (azathioprine), and a topical corticosteroid gel before they have to present systemic glucocorticosteroids. Keywords: Pemphigus vulgaris (PV), Cochrane Central Register of Controlled Trials. Title: Dermatological Lesions of Pemphigus Vulgaris, And Treatment Approaches Author: Yasser Yahya Ali Al-Habtar Asiri, Abdullah Khallufah Abdullah Asiri, Ibrahim Hassan A. Abu Saq, Naif Dahman Abdullah Alshehri, Salem Mohammed Alqarni, Yasser Dhafer Ali Alshahrani, Abdulwahab Salem Ahmad Alghamdi, Abdullah Ali Abdullah Alqahtani, Hassan Fayez Abdullah Alshehri, Saleh Abdullah M Alqahtani, Yazeed Mohammed Yahya Al Hadi, Fahad Abdulrahman Alazragi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: We aimed by this review paper to focus on discussing different aspects concerning parotidectomy, intended to review evidence about the surgical techniques of this surgical intervention, and then discuss the complications and outcomes following this type of surgery. We searched Medline, PubMed, Cochrane, and CINHAL databases for studies reporting and concerning with parotidectomy that was published in English language and in the period of establishment of these databases up to 2016, December. We used parotidectomy and the following free Mesh terms; “surgical techniques, surgical procedures, indications, outcomes, and complications,”. And we restricted our search to the English-language literature on human subjects. Reference lists were screened manually to find more relevant studies. Surgical methods for salivary gland surgical procedure will continuously develop as new modern technologies develop. A detailed understanding of the disease processes as well as anatomy will certainly remain of extremely important value in the effective medical administration of salivary gland disease. Although a number of records in the literature have actually documented the medical technique, as well as the oncological result attained with parotidectomy, just a few articles have actually explained the problems of parotid gland surgical treatment and also their monitoring. Numerous problems have been reported in parotid surgical treatment. Keywords: Surgical Approaches Of Parotidectomy, Cochrane, and CINHAL databases. Title: Surgical Approaches of Parotidectomy: Overview Author: Dr. Raed Rasheed Z Almutairi, Dr. Rakan Mansour H Aldhahri, Dr. Dheifullah Mastour D ALzaidy, Dr. Ahmad Faisal Albishry, Dr. Ibrahim Saleh Almalki, Dr. Najdi Ibrahem Najdi, Dr. Hassan Ali Alzahrani International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Collecting data about medical errors is important in order to improve patient safety. However, factors affecting medical errors reporting by physicians are poorly understood. Objectives and study design: This study develops a theoretical framework based on the theory of reasoned action (TRA) and social cognitive theory (SCT) to study factors that may influence physicians to report medical errors. These factors include gender, loss of reputation, social image, punishment, relationship with senior, incentives and attitudes towards reporting medical errors. A multi-section questionnaire measuring the factors was distributed to physicians at seven public hospitals in Makkah. Results and Conclusions: An exploratory factor analysis was performed, and found that the measures demonstrated acceptable convergent validity. The results of the correlations analysis showed that the measures are discriminately valid. Then, the research model was tested using path analysis. The analysis of the responses from 301physicians found that physicians with high attitudes towards reporting medical errors had a greater intention to report medical errors. The analysis also found positive links between (a) relationship with senior and attitudes towards reporting medical errors, and (b) the presence of incentives and attitudes towards reporting medical errors. We also found that loss of reputation is related the attitudes of reporting medical errors. Contrary to our prediction, this study did not find support for the posited paths from gender, social image and punishment to the attitudes towards reporting medical errors. An exploratory path analysis showed that social image and relationship with senior is directly related to intentions. Keywords: Theory of Reasoned Action (TRA), Social Cognitive Theory (SCT). Title: Physicians Attitude towards Reporting Medical Errors at Seven Public Hospitals in Makkah Authors: Tariq Hameed Razen Alotaibi, Abdullah Matar S Alotaibi, Saud Owaidh Saeed Algethami, Musab Khalaf H Alhumaidi, Sarah Salih H Altalhi, Hameed Mohammad Razin Alotaibi, Abdullah Mutlaq K Alotaibi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Vision is very important for a child's development during infancy and early childhood and later on for learning and communications. Almost three-fourth of a child's early learning is acquired through vision. In this study were focusing to determine eye diseases in an elementary school in Taif city, western region of Saudi Arabia. We have conducted a cross-sectional short study on Alandalous private elementary school children for screening for eye diseases in general, which is a part of our evaluation in Family Medicine module in college of medicine, Taif university. In November-2015. The study included 118 male students throughout all academic elementary years from 1st to 6th. Their age ranges from 6 to 13 years old. The need for visual screening is important because in this study there was a relatively large percentage of students with decreased visual acuity that they don’t know they have a problem which may lead to problems to their academic level and learning ability and thus an affection them and their family’s emotional well-being that can be prevented only by visual screening and then correction of their vision. Keywords: elementary school children, students, Eye Diseases, Medicine. Title: Prevalence and Pattern of Eye Diseases in ONE Elementary School Children, A Cross Sectional Study Author: Sami Meshal M Althobaiti, Turki Muteb S Alotaibi, Rayan Azeb R Alharthi, Loaiee Faisal I Halawani, Seham Saed S Alrubaie, Huda Daifalkareem M Alsaadi, Saleh Hassan A Almuntashiri, Muhannad AbdulAziz H Jawmin International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Troponin I (Trop-I) is considered the most sensitive cardiac biomarker for diagnosis of acute MI. However, it lacks specificity since it can be elevated with other conditions such as pulmonary embolism and non-coronary cardiac disorders. Our primary objective is to determine the cut-off blood level values of Trop-I that has the best sensitivity and specificity for differentiating MI from PE. Methods: We performed a retrospective chart review of 122 patients admitted to King Abdulaziz Medical City-Western Region with diagnosis of MI or PE between October 2012 and March 2014. We included patients with measured Trop-I blood level and excluded patients with end stage renal disease or chronic elevation of Trop-I. The primary outcome was to estimate the sensitivity and specificity of Trop-I at different level in comparison to the clinical diagnosis. Diagnosis of MI was based on the third universal consensus definition of MI, and the diagnosis of PE was based on CT pulmonary angiogram or ventilation perfusion scan. The secondary objectives were to determine any association between Trop-I elevation with left ventricular (LV) dysfunction among MI patients and with right ventricular (RV) dysfunction among PE patients. Data was analyzed using chi-square, t test, or regression analysis as appropriate. Statistical significance was determined using two-tailed p-value of 0.05. Results: Among 122 patients included, 64 were diagnosed to have MI and 58 were diagnosed to have PE. 58% were males with mean age of 61 years. Figure 1 shows the ROC curve, which describes the diagnostic performance of Trop-I for differentiating MI from PE. At Trop-I blood level of 0.05, the sensitivity is 98.4% (95% CI: 91.6 – 100%) and specificity is 84.5% (95% CI: 72.6 – 92.7%). At the level of 0.1, the sensitivity is reduced to 76.6% (95% CI: 64.3 – 86.2%) but with almost perfect specificity of 98.3% (95% CI: 90.8 – 100%). No association was identified between post-MI Trop-I level and echocardiographic finding of ventricular wall motion abnormality (OR, 1.02; 95% CI: 0.98 – 1.05) or LV dysfunction (OR, 1.02; 95% CI: 0.99 – 1.04). There was a strong association between post-PE elevation of Trop-I and RV dysfunction (p-value = 0.002). Conclusion: The blood level of Trop-I may have clinical implication in differentiating MI from PE at the initial presentation. Trop-I level is not associated with LV dysfunction among MI patients, but has strong association with RV dysfunction among PE patients. Keywords: Troponin I (Trop-I), RV dysfunction, myocardial infarction. Title: Troponin I Blood Level Value and its Utility in Differentiating Myocardial Infarction from Pulmonary Embolism Author: Eman Sami Badawood International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Hepatic encephalopathy (HE) is a disturbance in the central nerve system (CNS) feature because of hepatic deficiency or portal-systemic shunting. HE creates a spectrum of neurologic symptoms that create in association with different liver diseases. The purpose of this paper was to discuss the Hepatic encephalopathy (HE), in different manners, we intended to review the pathogenesis, and the treatment of HE. A search was conducted through electronic databases; Medline/ PubMed, direct science and Embase, literature search was performed to identify relevant series discussing and reporting data on Hepatic encephalopathy (HE). A PubMed search was conducted using MeSH term “Hepatic Encephalopathy, combined with Pathogenesis and treatment approaches.” further search was done on references lists of these selected article to find more relevant articles supporting our review. HE includes a range of neuropsychiatric signs as well as indications amongst patients with liver failing. Serious HE portends poor end result and also is considered a sign for liver transplantation. In patients with cirrhosis as well as portosystemic shunting, HE creates useful impairment and also considerable morbidity. Numerous factors (specifically ammonia) have actually been implicated in its pathogenesis. Treatment is routed at the adjustment of precipitating factors such as blood poisoning, stomach blood loss, medicines, as well as liquid and also electrolyte imbalance. The pillar of pharmacologic administration includes nonabsorbable disaccharides, mainly lactulose, and anti-biotics. Keywords: Hepatic encephalopathy (HE), central nerve system (CNS). Title: Pathogenesis and Management Approaches of Hepatic Encephalopathy (HE) Author: Wesam Nafea S Alsharari, Majed Fahad K Alsharari, Muath Abdullah S Alshayban, Sami Naji G Almutiri, Mohammed Ayadhah F Alanazi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The benefits of exercise have been known a long time ago, physical activity and physical fitness are important factors in reducing the risk of unhealthy weight gain and related illnesses, and moderate to high fitness brings about health benefits, also certain types of foods and eating habits have been linked to weight and BMI. Objectives: To explore the impact of lifestyle factors on adult body mass index in Saudi Arabia. Methods: This study (2017) was carried out among a sample of 750 adults aged between 18 and 45 years old. To assess adults’ demographic and lifestyle factors and their association with body BMI, A pre-tested, pre-designed close ended questionnaire was distributed randomly to consenting adults after collecting their anthropometric measurements and calculating their BMI. The data were verified and analyzed using SPSS version 22. Results: The sample is consisted of 69,2% women and 30,8% men. Among the respondents 28,9% were overweight and 12,8% obese. The proportion of physically inactive persons was elevated (57,3%) compared to active ones 42,7% and we found 70,3% as having acceptable eating habits. The results of the study showed a statistical significant association between exercise, smoking and eating habits since p<0,05 (respectively p=0,03, p=0,014 and p=0,04). Conclusion: Bad lifestyle habits, such as sedentarily, bas eating habits and the consumption of addicts in the Saudi population, are becoming more and more common. Thus it becomes necessary to revise the academic medicine programs and awareness programs that aim the population in order to face these problems, to improve subjects’ lifestyle and to prevent possible complications such as cardiovascular diseases. Keywords: lifestyle, food, exercise, body mass index, health, habits, weight, smoking. Title: The Effectiveness of Lifestyle on BMI in Adult People in Saudi Arabia Author: Mutaz A alghufaili, Lina A Alyousif, Mooj Al ghofaili, Yara Al balawi, Hanan Bin saddeq International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals