Vol 4 Issue 2 October 2016-March 2017

Abstract: Osteoarthritis (OA) is the most common arthritis, a common cause of disability and frequent cause of consultation with a GP. OA is predominantly managed in primary care, and comprehensive guidance suggests that much can be done to alleviate symptoms from osteoarthritis; combinations of therapeutic options including pharmacological and non-pharmacological treatments are recommended. Our first objective was to overview the attitude of GPs about osteoarthritis and its management in primary general care practice. a systematic review study was performed and relevant publications were searched from three databases (PubMed, EMBASE and the Cochrane Library) without any limitation on time (up to October 2016). We also searched for articles in the references of selected publications and the main congresses of rheumatology for OA (American College of Rheumatology (ACR), European League Against Rheumatism (EULAR) and Osteoarthritis Research Society International (OARSI)) and congresses of endocrinology (Endocrine society's annual meeting, European Congress of Endocrinology, American Diabetes Association and European Association for the Study of Diabetes). This review highlights marked divergence over management, between patient and doctor. Patients may have complex expectations and fears regarding treatment that are inadequately explored in the consultation. While patients seem keen to explore non-pharmacological options, GPs report frustration and lack of knowledge around issues to do with lifestyle change. When asked about challenges to management, GPs tend to report resource issues or time in the consultation, or patient factors, whereas patients report lack of communication. Keywords: Osteoarthritis. Title: Osteoarthritis in general practice, Systematic review Author: Alrashdi, Abdulelah Rashed A., Aljohani, Hassan Hamdan N., Alfuhigi, Khalid Dhaifallah A., Alfuhigi, Abdullah Sami S. International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Laparoscopic surgery has become the “gold standard” for common for typical surgeries such as appendectomies and cholecystectomies. Surgical simulators have an increasing function in the guideline and training in surgical abilities, and simulation-based training with natural experiences has the prospective to make a substantial contribution to advancement of the surgical curriculum. The aim of this systematic review was to determine whether skills acquired through simulation-based training are transferable to the operative setting. Studies were identified by searching MEDLINE, EMBASE, CINAHL, Current Contents, PubMed, and the Cochrane Library, from the inception of the databases to October 2016. The York (UK) Centre for Reviews and Dissemination databases, Clinicaltrials.gov, National Research Register, Meta-Register, and the Australian Clinical Trials Registry were also searched in October 2016. Laparoscopic surgery is particularly well suited to technical skills training as it requires a skill-set based on instrumentation, depth perception, and fine motor control. The aim of this systematic review was to determine whether skills acquired through simulation-based training are transferable to the operative setting. Keywords: Laparoscopic surgery. Title: A Systematic Review of Significant Skills Improvement in Laparoscopic Simulation Training Surgical Techniques in General Surgeries Author: Razan Abdulsamad Abdulsalam, Waad Mohammed Alsofyani, Reem Hamoud Altowairqi, Malak Fahad Almogthali International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Small bowel obstruction (SBO) occurs when the normal flow of intestinal contents is disrupted. The management of bowel obstruction relies on the etiology, intensity, and area of the obstruction. Severe intestinal blockages prevail incidents amongst patients with shared pelvic and stomach malignancies. This systematic review aimed to focus on the surgical management of mechanical small bowel obstruction, and to overview the different surgical procedures for SBO and evaluate their benefits through choosing evidence based studies. A computerized search of the National Library of Medicine MEDLINE database was undertaken using the PubMed Enters interface. English language citations during the period of 1980 through October 2016 using the primary search strategy, we then searched other two bibliographic databases. Further searching was from references from three standard textbooks and citation tracking of all relevant reports found using the Science Citation Index. The references of all relevant reports and review articles were searched for additional trials. Evaluation and management of SBO continue to evolve with advances in medical technology and techniques. Since the publication of the EAST practice management guideline on SBO in 2008, there has been increased support for the use of CT scans to confirm the diagnosis of SBO and assist in determining the initial clinical management. Minimally invasive surgery is being used with increasing frequency and in more complex cases. Keywords: surgical management, Small bowel obstruction. Title: Systematic review of surgical managment of Acute Mechanical Small Bowel Obstruction Author: Ahmed Reyad Elrify, Hussam salem aljehani, Abdullah saeed banaeem, Faisal Jameel Filfilan, Mohammad Mufleh Al-harthi, Ahmed saeed banheem International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Type 2 diabetes mellitus is a major public health issue worldwide. Nearly 10 % of the world's population is anticipated to have diabetes by 2030. The aim of this systematic review was to assess and evaluate the attitude of the family physicians (FPs) toward diabetic patients and their different approaches in management of diabetes, and finally possible interventions to improve the diagnosis and management of Diabetes in family practice. We conducted a systemic review study that performed through Comprehensive literature search was performed in MEDLINE/PubMed and Cochrane Central Register of Controlled Trials according to the validated methods of the Preferred Reporting Items for Systematic Reviews (RRISR). Family physicians keen to implement lifestyle interventions for Diabetes mellitus are hampered by barriers and use of ineffective strategies. Keywords: Diabetes Mellitus, Optimal Treatment. Title: Diabetes Mellitus in Family Practice, Optimal Treatment of Diabetes Mellitus; Systematic Review Author: Alhumaid, Tariq Majed A, Almutairi, Fahad Mohammed O, Alanazi, Muneef Suwailem A, Alshammari, Khalid Mohammed D International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Telemedicine is a good educational medium that paves the way for continuing education or medical training for health care providers in isolated rural areas, who may not have the opportunity or time to travel to a big city and participate in professional training programs and workshops. The main objective of the study was to assess the knowledgebase and perception of Telemedicine among health professionals. This study was a non-experimental, descriptive study which employed a simple random sampling technique in selecting 100 health professionals at the Koforidua Regional Hospital in the Eastern region of Ghana. The study concluded that respondents are willing to work with telemedicine should it be introduced and will prefer in-service training as a way of learning new methods. Participants generally had a fair idea of telemedicine. Although, some of health professionals think ICT does not hinder healthcare delivery, the rampant power cut rather slows down the process. Keywords: Telemedicine, Knowledge, Perception, Information, Healthcare, Communication. Title: KNOWLEDGE AND PERCEPTION OF TELEMEDICINE AMONG HEALTH PROFESSIONALS AT THE KOFORIDUA REGIONAL HOSPITAL, GHANA Author: Kojo Osei Frimpong, Samuel Asare, Daniel Kwakye Nomah, Dorothy Oforiwah Antwi-Asante International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: There are no enough studies that focus on the relationship between the modifiable risk factors and their effectiveness among cardiovascular diseases patients. Objective: To determine the relationship and the main modifiable risk factors among cardiovascular patients in our community. Design: A Cross – Sectional Descriptive Study. Setting: Ibn – Sina Teaching hospital, Hadhramout Province, Yemen. Method: This study was conducted from 1st January 2014 to the end of December 2014. Two hundred and thirty seven admitted patients with cardiovascular diseases were included in our study. Data was entered and analyzed by Statistical Package for Social Software Program (SPSS) version 14. Result: Among Two hundred and thirty seven (237) patients, Male was the predominant gender (60.75%) in our study. Most patients were in the age group of ≥70 years at the time of admission (46.83%). Diabetes Mellitus, Hypertension, Obesity, Physical Inactivity, Smoking and incompliance to treatment were the powerful risk factors among our studied patients with Significant Statistical relationship ( P=0.000). Conclusion: we have tremendously defected approaches among preventive measure perspective and health education to aware the public community about the dangerous of those factors and strong impact on their health. Keywords: Modifiable Risk Factors, Cardiovascular Diseases. Title: Effects of Modifiable Risk Factors among Admitted Patients with Cardiovascular Diseases Author: Mohammed Ahmed Khamis Omar International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Cell signaling pathways play significant role in cell fate in naive stem cells and mature cells. They maintain homeostasis by signaling for cell multiplication leading to genesis of new cells either from existing cells or from stem cells. The constant pool of functional cell type of particular tissue/organ is maintained at all the times. Constituents of cell signaling are extra-cellular cell surface markers and intra-cellular proteins. Signaling pathways are critical in stem cells to maintain ‘stemness’ leading to hallmark properties like self-renewal and plasticity. Abnormal signaling proteins may lead to loss of routine function of the pathway which may subsequently results into disastrous consequences ranging from different disorders to forming malignant neoplasm. The reasons for abnormal protein could be mutation in the gene which codes it or heredity. Stem cells and cancer cells share many properties like self-renewal & high level of acclimatization into the microenvironment they are in. Only difference being stem cells are highly regulated while cancer cells are not in terms of control over cell multiplication. Literature reveals involvement of abnormal signalling proteins in transformed cells. It is imperative to study different pathways in cancer cells to device possible therapeutic strategy to reverse abnormal signaling protein or pathway with the help of normal stem cell pathway. The underlying mechanism behind this approach is cell to cell contact leading to possible repair of malignant cell type. The present review article deals with seven key cell signaling pathways possibly involved in transforming cells into malignant cell type. The article compares normal pathway with aberrant pathway in cancer cells. This concise approach is helpful in identifying the potential pathway signaling protein to be targeted for therapeutic application. Keywords: Stem Cells, Wnt Signaling Pathway, Neoplasm, MAP Kinase Signaling Pathways, Cancer. Title: Normal Cell Signaling Pathways Maintains ‘Stemness’ in Stem Cells But Aberrant Pathways Causes Cells to Transform Into Cancer Cells – A Review Author: Sushilkumar Ramdasi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: To study age-wise development and gender differences of static postural control in Indian children between 3-15 years using mCTSIB Methodology: 260 children, between ages of 3-15 years, were divided age wise into 13 groups, each group having 10 boys and 10 girls. They underwent analysis of postural sway velocity under 4 different conditions using the mCTSIB test on Neurocom Balance Master. Mean sway velocity of each group was compared to adult values and between genders for age-wise and gender-wise differences. Results: Unpaired t-test showed no statistically significant difference (p>0.05) between sway velocity in children and adults at following ages. Eyes open on force plate-13 years and beyond; Eyes closed on force plate- 10 years & beyond; Eyes open on foam-15 years & beyond; Eyes closed on foam-8 years & beyond There was statistically significant difference (p<0.05) with girls being better than boys at ages 5 and 9 in condition 3 and 4 of mCTSIB Conclusion: Adult levels of postural sway are reached at age 13 years when all 3 sensory systems i.e. visual, vestibular, somatosensory act. Adult levels reached at 10 years when Vestibular and somatosensory system act, 15 years when visual and vestibular systems provide more information, 8 years when only vestibular system acts At ages 5 and 9, girls are significantly better than boys under challenging sensory conditions Clinical Significance: Basis for age-appropriate balance testing and exercise. Keywords: Postural Control, mCTSIB, sway velocity. Title: Development and Gender Differences of Static Postural Control in Indian Children between 3 to 15 Years using the mCTSIB Author: Dr. Priya Chitre, Dr. Hutoxi Writer International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Aim: To report findings from analysis of the concept of health literacy (HL) in an effort to clarify its meaning, decrease ambiguities associated with the use of this concept and promote the consistency in using this concept in Nurse practitioners (NP) primary care clinics and research. Background: The concept of HL is relatively new and was identified a decade ago. HL was defined as individuals/patient’s ability to understand health information and self-management care as they relate to individual health outcomes. It is imperative for Nurse Practitioners to gain a clear understanding of this concept. Clear understanding of this concept will help NPs to develop awareness of this concept and the role it plays in client health outcomes. Clarification of this concept is important, as it will aid the NP to assess all aspects of the defining attributes of the concept. Method: The eight steps of the Walker and Avant (2005) method were used for the analysis of the aforementioned concept. The eight steps of Walker and Avant include the following: identification of the concept, conduct a literature review from a broad range of disciplines, identify the key characteristics or attributes of the concept, identification of the antecedents of the concept, identify the consequences, construct model case, construct contrary case, construct borderline case , and empirical will be applied. Literature from various disciplines was conducted utilizing Psych Info, CINAHL, OVID, Eric, Health Science ProQuest, Medical, Health Science and Nursing, Social Science literature databases, and government websites. Articles from 1974 to present were reviewed. Literature review searched was done by using the following keywords: health, health literacy, chronic disease, diabetes, humanities, psychology, concept analysis, and concept. The numbers of articles retrieved from the aforementioned databases were one thousand and Articles not including the attribute, antecedent, and consequences were included in the analysis. Findings: Analysis of this concept showed, patients with adequate health-literacy skills are capable of making sound decisions regarding their health diagnosis and treatment regimen, and are able to navigate the complex health care system. Having adequate health-literacy on readings, numeracy, and comprehension skills also help patients to read and comprehend health information on chronic diseases that require self-management such as diabetes, asthma and hypertension. The antecedents of Health Literacy are literacy and other experiences that relate to health. Positive consequences of Health Literacy consist of improved quality of life, decrease frequency of hospital admissions, and improved interpretation of test results and improvement of health knowledge. Reading and numeracy skills, comprehension, the ability to use health-related information in an effort to make successful health-related decisions, such as understanding informed consent, taking medication as prescribed, reading and comprehending the food label, diet and calories management are the defining attributes of health literacy. Reduction in emergency room visits, reduction in complications from chronic disease, improved lab results and self-reported been confidence in disease managements, and reduced health care cost are the consequences of health literacy. Most the literature reviewed followed either the World Health Organization, AMA, and Healthy people 2020, definitions of health-literacy. Empirical referents: The Test of Functional Health Literacy in Adults (TOFHLA), The Newest vital signs, and REALM, will be used to measure the proposed concept. Results: The defining attributes are reading and numeracy skills, comprehension, the ability to make a health care related decision, and function adequately as a health care consumer. Consequences of HL consist of self-reported improvement in quality of life, lower health-related cost, improved health knowledge, decrease use of emergency rooms and hospitalizations. Conclusion: Health literacy analysis promotes improved HCP assessment skills. NPs need to assess patients HL levels in order to provide appropriate interventions to the patients. Proper identification of patients with low literacy or poor literacy and shame associated with low literacy will help NPs to use an appropriate method to deliver health messages to clients with low HL and there by improve clients’ health outcomes as well as, reduce cost associated with low HL. Keywords: health, health literacy, chronic disease, diabetes, humanities, psychology, health informatics, and concept analysis. Title: HEALTH LITERACY: CONCEPT ANALYSIS Author: Ihuoma Ezebuihe, Carmen Sigley International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Epilepsy a disease that can affect any age, gender or race in the world. At least 50 million people in the world have epilepsy with prevalence rate of 6.5 per 1000 in Saudi Arabia. Objective: This study was aimed to evaluate and investigate the knowledge, awareness and attitude of epilepsy among the population of Buraydah, Saudi Arabia. Methodology: The study was cross-sectional based and consisted of a survey using a questionnaire of 11 questions. A questionnaire about knowledge, awareness and attitudes toward epileptics was applied after it has been translated into Arabic language. Results: Of the 797participants who completed the questionnaire, around (684) 85.9% of the study population have read or heard of epilepsy. About (396) 49.7% knew of at least one person with epilepsy. On witnessing a person with seizure, about 59.7% of participants have seen patients while seizure attacks. However, six hundred and sixty-five participants (83.5%) correctly thought that epilepsy is not a contagious disease, while 15.6% stated that they don’t know whether it’s contagious disease or not. About 40% believed epilepsy to be a psychiatric disorder as it would be type of insanity or madness, while 31% of them stated they have no knowledge if it was psychiatric disorder. majority of the population (40.15%) thought that epilepsy is a Brain disease. while only (17%) believed that epilepsy is inherited disorder, while the second majority (21.25%) believed that epilepsy is due to Mental or emotional disorders. A higher proportion of respondents (46.49%) thought that epilepsy attacks Convulsions manifested, and about 27% think that Foaming from the mouth is epilepsy manifestation. Conclusion: Absence of awareness and knowledge may cause lack of confidences to epilepsy and might be an aspect discussing preconception. This research study was an essential tool to get precise details of the public awareness and knowledge about epilepsy, which has actually typically been subjected to misunderstanding, stigmatization and social misconception, eventually impacting the overall of the patients with epilepsy more than the epilepsy as disorder itself. Keywords: Public Awareness, stigmatization and social misconception. Title: Public Awareness towards Epilepsy in Buraydah Population Author: Ali Othman Aldubakhi, Abdullah Suleman Almazied, Abdulrahman Mohammad Alrshody, Meshal Mohammad Alrumayh International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: In diabetics with low bone mass, histomorphometry research studies recommended that osteopenia was because of reduced bone development rate . Hyperglycemia has actually been linked in the pathogenesis of diabetic bone illness and, reduced activity of osteoblasts under diabetic conditions has actually been reported in both animal designs and humans. The aim of this systematic review study was to examine Biochemical bone turnover markers between patients with T1D and T2D and evaluate the effect of glucose on bone turnover, and to evaluate the evidence based which involved the discussion of BTMs in diabetes mellitus. A systematic literature search was conducted in September 2016. The databases searched were Medline at Pubmed and Embase. Medline at Pubmed was searched by using the key words “Diabetes Mellitus” (MESH) and “bone turnover markers” leading to more than 250 potential studies limited to human studies. Biochemical markers of bone resorption and bone formation were lower in patients with type 2 diabetes compared to patients with type 1 diabetes. Bone turnover markers were negatively associated with p-glucose. In conclusion, some BTMs may yield the potential to predict fractures in diabetes patients. Keywords: bone turnover, diabetes mellitus. Title: Systematic review of bone turnover Biochemical markers in diabetes mellitus (DM) Author: Saeed Aqeel Alzubaidi, Asim Ibrahim Bin Salman, Aabed Abdullah Alguraigari, Abdulaziz mohammed bamberook, Fahad Sultan Al-Rajhi, Hamzah yahya khogah International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Gout is a disease of urate metabolism where an excess of serum uric acid leads to the formation of monosodium urate crystals in various tissues of the body and presents with chronic inflammatory joint condition, urate nephropathy, and/or tophi deposits. this study was aimed to investigate and evaluate the validity of diagnosis of Gout by family physicians, through a review of evidence based that discussed many different approaches such synovia fluid analysis, MSU crystals as the reference test or by the signs and symptoms of patients. We conducted a systematic search of different database, PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) from the 1970s to the 2016 to find articles on gout diagnosis and management in family practice. We used a search strategy based on the Cochrane Highly Sensitive Search Strategy for identifying all kind of studies including randomized trials, systematic reviews, Cohort, and case reportsAcute gout manifests as severe joint pain, of rapid onset, reaching maximal intensity within a few hours. Gout has a predilection for lower extremity joints. The joint affected is usually hot, red, swollen and very painful. This is often associated with skin erythema. Identification of MSU crystals in the synovial fluid of an inflamed joint or from tophi allows a definite diagnosis of gout to be made. Keywords: MSU crystals, PubMed and Cochrane, Central Register of Controlled Trials (CENTRAL). Title: Systematic Review of Recognition Possibilities and Management of Gout in Primary Care Author: Abeer Ahmed Sharahili, Yusra Saad Alruwaili, Maryam Mohammed ALkhaldi, Waad Hamoud Alenazi, Iman Nazal Alanazi, Ohoud Salman Alenazi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The occurrence of VTE is generally triggered by a confluence of environmental and constitutional risk factors. Environmental risk factors for thrombosis include trauma, surgery, or immobility. Therefore the early diagnosis of this condition is very important in primary care. Objective: to assess the possibility of the diagnostic tests used for suspected pulmonary embolism, DVT in Primary care. Method: We searched literature-indexing systems to identify the articles relevant to our review, including MEDLINE, EMBASE, the Cochrane Controlled Trials Register, and the Cochrane Database of Systematic Reviews through the period of July 2016. Conclusion: The accuracy of tests for suspected deep venous thrombosis and pulmonary embolism varies greatly, but it is possible to estimate the range of pretest probabilities over which each test or strategy can confirm or rule out pulmonary embolism. Keywords: VTE, MEDLINE, EMBASE, Environmental risk factors. Title: Systematic Review of Screening Prediction Diagnostic Models of Deep Venous Thrombosis and Pulmonary Embolism in Family Practice Author: Amal Saleh Q. Alluhaibi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Cerebral aneurysms are common among the general population, occurring in 2%–3%, but there are several factors that may increase one's risk. Cerebral aneurysms are seen more commonly in woman than men, particularly in those over 50 years of age, a group in which women are twice as likely to have cerebral aneurysms. This study was aimed to use systematic review to evaluate and demonstrate the different surgical approaches in management of cerebral aneurysms based on evidence studies that compared the clinical outcomes in patients with different surgical procedures and outcome treatment. We searched the published literature using Medline (Pubmed) and CENTRAL databases with following keywords combinations: cerebral aneurysm, endovascular coiling or microsurgical clipping, stent-assisted coiling, balloon-assisted coiling, aneurysm; coiling, aneurysm, stent and balloon. Additionally, we hand-searched references in relevant primary publications to identify other eligible trials and studies. The described searches included original literature published up to August 2016. We concluded that both techniques were associated with similar and low complication rates. It was previously reported that the rates of complications with both surgical clipping and. Endovascular coiling is higher in ruptured aneurysms versus unruptured aneurysms. In cases of ruptured aneurysms, preference is often given to Endovascular coiling procedure to avoid potential complications caused by antiplatelet regiment accompanying surgical clipping. Keywords: Cerebral aneurysms, surgical approaches. Title: Surgical Approaches to Manage Cerebral Aneurysms, Systematic Review Author: Abdulrazaq Hudhayri A. Alhazeemi, Fahad Khalid F. Alshubaily, Abdulaziz Hamdan A. Alazmi, Abdullah Suleman S. Almazied, Sultana Ali S. Alshammari, Amirah Ali S. Alshammari, Dalia Abdullah M. Aljohani International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The spondyloarthropathies (SpA) are a rheumatologic group of inflammatory diseases that include ankylosing spondylitis (AS), reactive arthritis (ReA), enteropathic spondylitis, or arthritis associated with inflammatory bowel disease (IBD), psoriatic arthritis (PsA), and undifferentiated spondyloarthropathy (uSpA). The aim of this systematic review was this to demonstrate and highlight the updates on the diagnosis and managment of spondyloarthritis throught evdiance based studies. Studies were retrieved by searching six electronic databases (MEDLINE/PubMed, EMBASE, PEDro, AMED, CINAHL, and The Cochrane Central Register of Controlled Trials) from their inception to October, 2016. Search terms were adapted for use with each database. Common keywords and medical subject headings were related to components: "spondyloarthritis," "ankylosing spondylitis," "sacroiliitis," "psoriasis arthritis," "reactive arthritis," "arthritis and inflammatory bowel disease," "inflammatory back pain, diagnosis and management." Based on several studies which were identified, NSAIDs are especially effective in patients with axial involvement, reducing pain and stiffness substantially in a majority of patients, as shown in a number of clinical trials with nonselective cyclooxygenase (COX) inhibitors as well as with selective COX-2 antagonists. Keywords: spondyloarthropathies (SpA), ankylosing spondylitis (AS), reactive arthritis (ReA). Title: Roles of Diagnosis and Management of Spondyloarthritis, Systematic Review Author: Fatimah Nasr AlShaikhAhmed, Fatimah Rada Alsammak, Sharifah Radhi AlSammak, Fatimah Nasser Al-Rebh, Sakinah Ahmed Aljishi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals