Index Medicus for the WHO Eastern Mediterranean Region: with abstract: IMEMR current content

ISSN: 2071-2510 IMEMR Current Contents September 2012 Vol. 11 No.2 Providing Access to Health Knowledge to Build a Healthy Future For further information contact: World Health Organization Regional Office for the Eastern Mediterranean Health Publications, Production & Dissemination (HPD) Library & Health Literature Services (LHL) Abdul Razzak Al-Sanhouri Street, P.O. Box 7608, Nasr City, Cairo 11371, Egypt http://www.emro.who.int/lin e-mail: hpd@emro.who.int Tel: +20 2 22765047 Fax: +20 2 22765424 http://www.emro.who.int/information-resources/imemr/imemr.html Vol. 11 No. 3 Index Medicus for the WHO Eastern Mediterranean Region with Abstracts IMEMR Current Contents September 2012 Vol. 11 No. 3 © World Health Organization 2012 All rights reserved. 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Requests for permission to reproduce, in part or in whole, or to translate publications of WHO Regional Office for the Eastern Mediterranean – whether for sale or for noncommercial distribution – should be addressed to Regional Adviser, Global Arabic Programme, WHO Regional Office for the Eastern Mediterranean, at the following address: email: WAP@emro.who.int Design, layout and printing by WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt ISSN: 2071-2510 i Table of Contents IMEMR Current Contents ................................................................................................... vii Subject Index ....................................................................................................................... ix ABO Blood-Group System .............................................................................................................. 1 Abortion, Habitual ........................................................................................................................... 1 Accreditation ................................................................................................................................... 1 Acinetobacter Infections ................................................................................................................. 2 Adenocarcinoma, Mucinous ........................................................................................................... 2 Adrenal Cortex Neoplasms ............................................................................................................. 3 Aflatoxia M1 .................................................................................................................................... 3 AIDS Serodiagnosis ....................................................................................................................... 3 Aluminum Compounds ................................................................................................................... 4 Amantadine .................................................................................................................................... 4 Amyotrophic Lateral Sclerosis ........................................................................................................ 5 Anesthesia, Spinal .......................................................................................................................... 5 Angina Pectoris .............................................................................................................................. 6 Anopheles ....................................................................................................................................... 6 Anti-Inflammatory Agents, Non-Steroidal ....................................................................................... 6 Antibiotic Prophylaxis ..................................................................................................................... 7 Anxiety ............................................................................................................................................ 7 Argasidae ....................................................................................................................................... 8 Arteriovenous Malformations .......................................................................................................... 8 Arthrodermataceae ......................................................................................................................... 8 Arthroplasty, Replacement, Hip ...................................................................................................... 9 Asparaginase .................................................................................................................................. 9 Asthma ......................................................................................................................................... 10 Attention Deficit Disorder with Hyperactivity ................................................................................. 10 Attitude of Health Personnel ......................................................................................................... 11 Azathioprine .................................................................................................................................. 11 Bacillus thuringiensis .................................................................................................................... 12 Behcet Syndrome ......................................................................................................................... 12 beta-Lactamases .......................................................................................................................... 12 beta-Thalassemia ......................................................................................................................... 13 Biodegradation, Environmental .................................................................................................... 13 Biomedical Research .................................................................................................................... 14 Blepharoptosis .............................................................................................................................. 14 Blood Coagulation Disorders ........................................................................................................ 14 Blood Coagulation Tests .............................................................................................................. 15 Blood Platelets .............................................................................................................................. 15 Bone Density ................................................................................................................................ 15 Botulism ........................................................................................................................................ 16 Brain Diseases ............................................................................................................................. 16 Breast Neoplasms ........................................................................................................................ 17 Bulinus .......................................................................................................................................... 17 CA-125 Antigen ............................................................................................................................ 18 Cancer Vaccines .......................................................................................................................... 18 Carbon Tetrachloride .................................................................................................................... 19 Carboxylesterase .......................................................................................................................... 19 Carcinoma, Basal Cell .................................................................................................................. 20 Carcinoma, Hepatocellular ........................................................................................................... 20 Cardiovascular Diseases .............................................................................................................. 21 Caseins ......................................................................................................................................... 21 Catheter-Ralated Infections .......................................................................................................... 21 Catheterization, Central Venous ................................................................................................... 22 Catheterization, Peripheral ........................................................................................................... 22 ii Cell Differentiation ........................................................................................................................ 23 Chewing Gum ............................................................................................................................... 23 Chickens ....................................................................................................................................... 24 Child Abuse, Sexual ..................................................................................................................... 25 Child Mortality ............................................................................................................................... 25 Cholecystectomy, Laparoscopic ................................................................................................... 25 Chronic Disease ........................................................................................................................... 26 Cichlids ......................................................................................................................................... 26 Cleft Palate ................................................................................................................................... 26 Cobra Cardiotoxin Proteins .......................................................................................................... 27 Collagen Diseases ........................................................................................................................ 27 Colorectal Neoplasms .................................................................................................................. 27 Common Bile Duct Neoplasms ..................................................................................................... 28 Competency-Based Education ..................................................................................................... 28 Constipation .................................................................................................................................. 29 Coronary Angiography .................................................................................................................. 29 Coronary Artery Bypass ............................................................................................................... 29 Coronary Artery Disease .............................................................................................................. 30 Craniocerebral Trauma ................................................................................................................. 31 Craniofacial Abnormalities ............................................................................................................ 32 Culture Media ............................................................................................................................... 32 Cyclophosphamide ....................................................................................................................... 32 Cystadenoma, Mucinous .............................................................................................................. 33 Dalbergia ...................................................................................................................................... 33 Delivery of Health Care ................................................................................................................ 34 Dengue ......................................................................................................................................... 34 Densovirinae ................................................................................................................................. 34 Dental Caries ................................................................................................................................ 34 Dental Casting Technique ............................................................................................................ 35 Dental Implant-Abutment Design .................................................................................................. 35 Dental Pins ................................................................................................................................... 36 Dexamethasone ........................................................................................................................... 36 Diabetes Mellitus, Experimental ................................................................................................... 37 Diabetes Mellitus, Type 1 ............................................................................................................. 37 Diabetes Mellitus, Type 2 ............................................................................................................. 38 Diabetic Foot ................................................................................................................................ 39 Diabetic Retinopathy .................................................................................................................... 40 Disability Evaluation ..................................................................................................................... 40 Drug Resistance ........................................................................................................................... 41 Dyslipidemias ............................................................................................................................... 41 Echinococcosis ............................................................................................................................. 42 Education, Medical ....................................................................................................................... 42 Education, Medical, Graduate ...................................................................................................... 42 Education, Medical, Undergraduate ............................................................................................. 43 Enamel Microabrasion .................................................................................................................. 43 Endometriosis ............................................................................................................................... 43 Enterocolitis, Pseudomembranous ............................................................................................... 44 Epstein-Barr Virus Infections ........................................................................................................ 44 Escherichia coli Infections ............................................................................................................ 44 Exercise ........................................................................................................................................ 45 Factor XIIIa ................................................................................................................................... 45 Familial Mediterranean Fever ....................................................................................................... 46 Fetal Membranes, Premature Rupture ......................................................................................... 46 Fetomaternal Transfusion ............................................................................................................. 46 Fluid Therapy ................................................................................................................................ 47 Foreign Bodies ............................................................................................................................. 47 Fractures, Ununited ...................................................................................................................... 47 Fresh Water .................................................................................................................................. 48 Ganglioneuroma ........................................................................................................................... 48 Gastric Bypass ............................................................................................................................. 49 Gastrostomy ................................................................................................................................. 49 iii Geologic Sediments ..................................................................................................................... 50 Granulocyte Colony-Stimulating Factor ........................................................................................ 50 Guillain-Barre Syndrome .............................................................................................................. 50 Head and Neck Neoplasms .......................................................................................................... 51 Health Behavior ............................................................................................................................ 51 Health Expenditures ..................................................................................................................... 52 Health Promotion .......................................................................................................................... 52 Heart Rate, Fetal .......................................................................................................................... 52 Hemangioma ................................................................................................................................ 53 Hemianopsia ................................................................................................................................. 53 Hepatitis B .................................................................................................................................... 53 Hepatitis B Surface Antigens ........................................................................................................ 54 Hepatitis B Vaccines ..................................................................................................................... 54 Hepatitis C .................................................................................................................................... 55 Hepatitis C, Chronic ...................................................................................................................... 55 Herbal Medicine ............................................................................................................................ 56 HIV Infections ............................................................................................................................... 56 Homeless Youth ........................................................................................................................... 57 Hypothyroidism ............................................................................................................................. 57 Immunoglobulins, Intravenous ...................................................................................................... 58 Infant, Newborn ............................................................................................................................ 58 Influenza, Human ......................................................................................................................... 59 Insulin Resistance ........................................................................................................................ 59 Interleukin-4 .................................................................................................................................. 60 Intestinal Obstruction .................................................................................................................... 60 Iodine ............................................................................................................................................ 61 Jaw Neoplasms ............................................................................................................................ 61 Jejunal Diseases .......................................................................................................................... 61 Juvenile Hormones ....................................................................................................................... 62 Kidney Failure, Chronic ................................................................................................................ 62 Lepidium sativum .......................................................................................................................... 63 Leprosy ......................................................................................................................................... 63 Leptin ............................................................................................................................................ 64 Lettuce .......................................................................................................................................... 64 Leukemia, Myelogenous, Chronic, BCR-ABL Positive ................................................................. 65 Leukemia, Promyelocytic, Acute .................................................................................................. 65 Levonorgestrel .............................................................................................................................. 66 Liver Neoplasms ........................................................................................................................... 66 Lymphoma .................................................................................................................................... 67 Magnesium Sulfate ....................................................................................................................... 67 Malaria .......................................................................................................................................... 68 Malnutrition ................................................................................................................................... 69 Malocclusion, Angle Class III ........................................................................................................ 69 Maxillary Neoplasms .................................................................................................................... 69 Mediastinal Emphysema .............................................................................................................. 70 Mesenchymal Stem Cells ............................................................................................................. 70 Mitosporic Fungi ........................................................................................................................... 71 Mitral Valve Prolapse .................................................................................................................... 71 Morbidity ....................................................................................................................................... 72 Motor Activity ................................................................................................................................ 72 Mullerian Ducts ............................................................................................................................. 72 Myocardial Reperfusion Injury ...................................................................................................... 73 Myoepithelioma ............................................................................................................................ 73 Nasal Obstruction ......................................................................................................................... 74 Neuroblastoma ............................................................................................................................. 74 Noise, Transportation ................................................................................................................... 75 Obesity ......................................................................................................................................... 75 Octreotide ..................................................................................................................................... 76 Operating Rooms ......................................................................................................................... 76 Orthodontic Wires ......................................................................................................................... 77 Osteoarthritis ................................................................................................................................ 77 iv Osteoarthritis, Knee ...................................................................................................................... 78 Osteoporosis ................................................................................................................................ 78 Ovarian Neoplasms ...................................................................................................................... 78 Overweight ................................................................................................................................... 79 Pancreatic Neoplasms .................................................................................................................. 79 Panniculitis ................................................................................................................................... 80 Panniculitis, Peritoneal ................................................................................................................. 81 Paranasal Sinus Diseases ............................................................................................................ 81 Patient Rights ............................................................................................................................... 81 Pelvis ............................................................................................................................................ 82 Perinatal Care ............................................................................................................................... 82 Personal Satisfaction .................................................................................................................... 83 Pesticide Residues ....................................................................................................................... 83 Phenylenediamines ...................................................................................................................... 84 Phlebetomus ................................................................................................................................. 84 Plants, Medicinal .......................................................................................................................... 85 Poliomyelitis .................................................................................................................................. 85 Polyhydramnios ............................................................................................................................ 86 Postpartum Hemorrhage .............................................................................................................. 86 Prenatal Diagnosis ....................................................................................................................... 86 Presbycusis .................................................................................................................................. 87 Pressure Ulcer .............................................................................................................................. 87 Pterygium ..................................................................................................................................... 88 Pulmonary Atelactasis .................................................................................................................. 88 Pulmonary Embolism .................................................................................................................... 89 Pyrazoles ...................................................................................................................................... 89 Rage ............................................................................................................................................. 90 Renewable Energy ....................................................................................................................... 90 Respiratory Tract Infections .......................................................................................................... 90 Resuscitation ................................................................................................................................ 91 Rh-Hr Blood-Group System .......................................................................................................... 91 Rhabdomyosarcoma .................................................................................................................... 92 Rhinitis, Vasomotor ...................................................................................................................... 92 Rhizopus ....................................................................................................................................... 93 Sandhoff Disease ......................................................................................................................... 93 Scenedesmus ............................................................................................................................... 93 Scrub Typhus ............................................................................................................................... 94 Scurvy ........................................................................................................................................... 94 Selenium ....................................................................................................................................... 95 Setaria Nematode ......................................................................................................................... 95 Silicon Dioxide .............................................................................................................................. 96 Silver Compounds ........................................................................................................................ 96 Sinus Thrombosis, Intracranial ..................................................................................................... 96 Skin Diseases ............................................................................................................................... 97 Snails ............................................................................................................................................ 97 Soil ................................................................................................................................................ 98 Somatosensory Disorders ............................................................................................................ 98 Spermatogenesis .......................................................................................................................... 99 Spinal Cord Injuries ...................................................................................................................... 99 Splenectomy ............................................................................................................................... 100 Staphylococcus aureus .............................................................................................................. 100 Stomach Ulcer ............................................................................................................................ 101 Streptococcus agalactiae ........................................................................................................... 101 Streptokinase .............................................................................................................................. 102 Stress Disorders, Post-Traumatic ............................................................................................... 102 Stroke ......................................................................................................................................... 103 Struma Ovarii .............................................................................................................................. 103 Surgical Procedures, Elective ..................................................................................................... 103 Surgical Sponges ....................................................................................................................... 104 Tachycardia, Reciprocating ........................................................................................................ 104 Temporomandibular Joint Disorders .......................................................................................... 104 v Thrombolytic Therapy ................................................................................................................. 104 Thyroid Neoplasms ..................................................................................................................... 105 Tobacco Use Cessation ............................................................................................................. 105 Tooth Injuries .............................................................................................................................. 106 Torque teno virus ........................................................................................................................ 106 Toxocariasis ............................................................................................................................... 107 Toxoplasmosis ............................................................................................................................ 107 Tracheal Stenosis ....................................................................................................................... 107 Tracheoesophageal Fistula ........................................................................................................ 108 Travel Medicine .......................................................................................................................... 108 Tuberculosis ............................................................................................................................... 108 Tuberculosis, Multidrug-Resistant .............................................................................................. 109 Turbinates ................................................................................................................................... 110 Ureter .......................................................................................................................................... 110 Urinary Bladder Neoplasms ........................................................................................................ 111 Uterine Hemorrhage ................................................................................................................... 111 Vaginal Birth after Cesarean ...................................................................................................... 112 Vaginal Discharge ...................................................................................................................... 112 Vibrio cholerae ............................................................................................................................ 112 Waste Management ................................................................................................................... 113 Wegener Granulomatosis ........................................................................................................... 113 Wind ........................................................................................................................................... 113 Wounds and Injuries ................................................................................................................... 114 Zoonosis ..................................................................................................................................... 114 Appendix I: Author Index ................................................................................................. 115 Appendix II: List of EMR Journals Indexed in IMEMR (by country) ............................. 131 Appendix III: List of EMR Journals Indexed in IMEMR (by title) ................................... 151

vii IMEMR Current Contents Rationale The Index Medicus for the WHO Eastern Mediterranean Region (IMEMR) has sustained its indexing policy, which has made it a vital current awareness information tool, for technical staff of the Regional Office, health care staff, and medical professionals who are able now to access heath literature published in the Region as soon as it is published. A document delivery service to support the Index has also been activated which will enable any user to acquire a copy of any article listed in the Index. The cumulative version of the Index Medicus is available now on the Internet as part of EMRO web site. A CD-ROM version of the same is also being provided upon request. Scope and Coverage The IMEMR Current Contents is issued on a quarterly basis including the most recent articles added to Index Medicus for the Eastern Mediterranean Region (IMEMR) Database1. Indexing Level Each article has been indexed and assigned to a “Main Heading”, plus added headings according to the Medical Subject Headings (MeSH) list of the National Library of Medicine (NLM). Up to five added headings (including the respective country) have been allowed. Subheadings (or qualifiers) are used in indexing to qualify MeSH headings by pinpointing some specific aspects of the concept represented by the heading, e.g. “LIVER-Drug Effects” indicates that the article is not about the liver in general, but about the effect of drugs on the liver. Organization of the IMEMR Subject Index The Index is organized in alphabetical order, according to the Main Subject Headings (MeSH). In most cases one main subject is assigned to each article. Under the main subject, entries are sorted by Subheading in alphabetical order also. Each entry includes the bibliographic information of the article e.g. title of the article, author(s), first author’s affiliation, journal title, year (date of publication), volume number, issue number, page numbers, number of references, subject descriptors and geographic descriptors. Abstracts have been added and are searchable on the database on the Internet. (as shown in Figure 1) Author Index The IMEMR includes the author’s index, which also indicates the subjects covered by each author. (Appendix I) List of EMR Journals by Country The IMEMR includes an updated list of EMR Journals, which are indexed in the index. The list is sorted in alphabetical order by the country of publication, which also indicates the number of journals in each country. (Appendix II) List of EMR Journals by Title The IMEMR includes an updated list of EMR Journals, which are indexed in the index. The list is sorted in alphabetical order by journal’s title, which also indicates the status of indexing for each journal. (Appendix III) Computer facilities The Current Contents has been produced using the UNESCO WINISIS package. Countries or journals publishers interested in a subset of the database may be provided with data sets in WINISIS format upon request. 1 Including the countries of Afghanistan, Bahrain, Djibouti, Egypt, Islamic Republic of Iran, Iraq, Jordan, Kuwait, Lebanon, Libyan Arab Jamahiriya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syrian Arab Republic, Tunisia, United Arab Emirates, Yemen viii Availability of photocopies Photocopies of articles cited in IMEMR may be obtained from EMRO Library free of charge upon request. Availability on the Internet This issue, as well as all forthcoming issues, will appear in WHO/EMRO web site on the Internet, as part of the complete edition of the Index. Internet address is http://www.emro.who.int/information-resources/imemr/imemr.html Figure (1): Sample of IMEMR citation Antibodies, Antinuclear Main Subject Heading Keywords: Arthritis, Rheumatoid-diagnosis; Lupus Erythematosus, Systemic-diagnosis; Enzyme-Linked Immunosorbent Assay; Crithidia; Fluorescent Antibody Technique Descriptors Abstract: To study the correlation between enzyme linked Immunosorbent assay [ELISA] and immunofluoresencent [IF] anti-dsDNA antibody measurement in different diseases. One hundred and forty sera from patients with systemic lupus erythematosus [SLE, n=40], rheumatoid arthritis [RA, n=30], disease control [n=40] and from healthy control subjects [n=30] were included. Using the ELISA, serum anti-dsDNA was detected in 24/40 [60%] SLE, 5/30 [16.6%] RA, 9/40 [22.5%] disease controls and 1/30 [3.3%] of normal healthy controls. When IF assay was employed, anti-ds DNA antibodies were detected in 16/40 [40%] SLE, 3/30 [10%] RA, 5/40 [12.5%] disease controls but none in the normal subjects. These results suggest that both ELISA and IF techniques can be used for the measurement of anti- ds DNA antibodies in clinical laboratories and, these antibodies are not unique to SLE. Abstract immunology Subheading Title Evaluation of anti-DS DNA antibodies in anti-nuclear antibody positive Omani patients. Journal Title Year Issue Pages No. of References Volume Pakistan Journal of Medical Sciences 2007; 23 (2): 211-215 (22 ref.) Author(s) Alnaqdy, Adel; Al Busaidy, Juma; Hassan, Batool First author's e-mail address E-mail:aalwan@squ.edu.om First author's affiliation Sultan Qaboos University - College of Medicine and Health Sciences - Department of Microbiology and Immunology Subject Index

IMEMR Current Contents Subject Index 1 ABO Blood-Group System Association between ABO blood groups and cardiovascular risk factors in general population of Golestan province, Iran. Abdollahi, A.A.; Qorbani, M.; Asayesh, H.; Nouroozi, M.; Mansourian, M. Golestan University of Medical Sciences Scientific Journal of Iranian Blood Transfusion Organization Research Center [The] 2012; 8 (4): 293-297 (13 ref.) Keywords: Cardiovascular Diseases-etiology; Risk Factors; Cross-Sectional Studies; Questionnaires Abstract: Cardiovascular disease [CVD] is a common cause of morbidity and mortality. The relationship between ABO blood groups and main risk factors of CVD is unknown. So this study was designed to investigate whether there is an association between ABO blood groups and cardiovascular risk factors in healthy population. In this cross- sectional study, risk factors screening for CVD on 2920 healthy individuals of Golestan province in 2005 were estimated by a questionnaire that aimed to extract information about age, sex, physical activity, smoking, blood group type, weight, height, blood pressure and family history of CVD. Data were analyzed with SPSS 13 and by using Chi Square and ANOVA tests. Out of the total number of 2920, 57.4% were male, 70% inactive, 14% smoker, 25% hypertensive, 23% obese, and 21% had family history of CVD with the mean age of 41.52 +/- 12.317. Blood groups O [32.9%], A [30.1%], B [23.3%] and AB [13.7%] were the most frequent ones, respectively. Amongst cardiac risk factors, it was only the frequency of family history of CVD that varies across different blood groups, and individuals with A blood group reported to have a more frequent family history of CVD as compared with other blood groups. These findings illustrate amongst cardiovascular risk factors only family history of CVD as having a significant correlation with ABO. Abortion, Habitual A rare case of pericentric inversion, inv [21] [p12;q22] in repeated pregnancy loss: a case report. Tayebi, Naeimeh; Khodaei, Hossain E-mail:ntayebi@yahoo.com Welfare Organization - Genetic Research center Oman Medical Journal 2011; 26 (6): 441-443 (19 ref.) Keywords: Chromosome Aberrations; Chromosomes, Human, Pair 21; Amniocentesis; Chromosome Inversion Abstract: Pericentric inversions are among the most frequent chromosomal rearrangements with a frequency of 1- 2%. There is no phenotypic effect in the majority of pericentric inversion heterozygote carriers, when it is a balanced rearrangement. However, miscarriages, infertility and/or chromosomally unbalanced offspring can be observed in carriers of a pericentric inversion. This is a case of pericentric inversion of one chromosome 21: inv [21] [p12; q22] in repeated pregnancy loss. A couple was referred for cytogenetic examination due to idiopathic miscarriages. The proband proved to be a carrier of chromosomal inversion and her partner's karyotype was found to be normal. The karyotype of the proband is 46, xx, inv [21] [p12; q22]. This abnormal karyotype is reported as a probable reason of miscarriage in the investigated couple. The risk of further miscarriages and the risk of a progeny with abnormal karyotype are rather high. Therefore, amniocenthesis for finding the chromosomal abnormality as a prenatal diagnosis are proposed for the patient if future pregnancy does not lead to miscarriage. Accreditation Benchmarking the post-accreditation patient safety culture at King Abdulaziz University Hospital. Al Awa, Bahjat; Al Mazrooa, Adnan; Rayes, Osama; El Hati, Taghreed; Devreux, Isabelle; Al Noury, Khaled; Habib, hamed; El Deek, Basem Salama E-mail:balawa@kau.edu.sa King Abdulaziz University Hospital - Planning and Development Department Annals of Saudi Medicine 2012; 32 (2): 143-150 (8 ref.) Keywords: Patient Safety; Hospitals, University-standards; Culture; Nurses; Questionnaires; Prospective Studies; Retrospective Studies; Cross-Sectional Studies Abstract: Accreditation is an internationally recognized evaluation process used to assess, promote, and guarantee efficient and effective patient care and safety. Saudi Arabia is one of the first countries in the eastern Mediterranean region to implement health care accreditation standards. This study provides valuable information pertaining to the impact of accreditation in the unique multicultural, multilingual competitive environment at King Abdulaziz University IMEMR Current Contents Subject Index 2 Hospital in Saudi Arabia. The objective of this study was to perform an unbiased assessment of the impact of accreditation on patient safety culture. Cross-sectional retrospective and prospective study post-accreditation at King Abdulaziz University Hospital in Jeddah, Saudi Arabia from January 1, 2006 to December 31, 2009. A total of 870 registered nurses from eight different cultural backgrounds working at 22 hospital units were given electronic access to the survey. A 5-point Likert scale was used, ranging from 1 for [Strongly disagree] to 5 for [Strongly agree]. The survey results were matched with the international benchmarks from the hospital survey on patient safety culture, 2005. A total of 605 nurses answered the survey questionnaire. The comparison between the percentages of nurses at King Abdulaziz University Hospital [KAUH] and those at international hospitals who answered [Agree] and [Strongly agree] showed a post-accreditation improved perception of the culture of patient safety. Accreditation has an overall statistically significant improvement in the perception of the culture of patient safety. Acinetobacter Infections drug therapy Three distinct clones of carbapenem-resistant Acinetobacter baumannii with high diversity of carbapenemases isolated from patients in two hospitals in Kuwait. Al Sweih, N.A.; Al Hubail, M.; Rotimi, V.O. E-mail:nalsweih@hsc.edu.kw Kuwait University - Faculty of Medicine - Department of Microbiology Journal of Infection and Public Health 2012; 5 (1): 102-108 (30 ref.) Keywords: Acinetobacter Infections-genetics; Acinetobacter Infections-enzymology; Carbapenems-pharmacology; Drug Resistance, Multiple, Bacterial-genetics; beta-Lactamases-genetics; Microbial Sensitivity Tests; Bacterial Proteins-genetics; Hospitals, Teaching Abstract: This study was undertaken to investigate the clonal relatedness of multidrug-resistant [MDR] Acinetobacter baumannii isolates collected from patients in two teaching hospitals in Kuwait. Clinically significant consecutive isolates of A. baumannii obtained from patients in the Mubarak [36] and Adan [58] hospitals over a period of 6 months were studied. These isolates were identified using molecular methods, and their antimicrobial susceptibility was determined by the Etest method. The mechanism of resistance to carbapenem was investigated by PCR, and pulsed-field gel electrophoresis [PFGE] was used to determine the clonal relatedness of MDR isolates. Of the 94 isolates investigated, 80 [85.1%] were multidrug resistant [MDR]. The A. baumannii PFGE clone A and subclone A1 were the most prevalent in patients infected with MDR isolates. Fifty-five [94.8%] and 15 [41.7%] of the MDR isolates from the Adan and Mubarak hospitals, respectively, belonged to PFGE clone A; isolates in this group showed higher resistance rates to antibiotics than isolates form other groups. Of the 94 isolates, 40 [42.6%] were resistant to either imipenem or meropenem or to both [CRAB]. Most CRAB isolates [29/40 or 72.5%] carried bla genes, which code for MBL [VIM-2 and IMP-1] enzymes. Two isolates harbored bla[OXA]23- Three distinct clones of CRAB were isolated, providing evidence of a high diversity of carbapenemases among our geographically related isolates. 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved. Adenocarcinoma, Mucinous complications Bilateral diffuse mucinous cystic adenocarcinoma of the lungs complicated by recurrent pneumothorax in a pregnant woman. Al Rashidi, Fahed M.; Mothafar, Fatmah J.; Muqim, Abdulaziz T. E-mail:drfahedq8@yahoo.ca Mubarak Al Kabeer Hospital - Pulmonary Division - Department of Internal Medicine KMJ - Kuwait Medical Journal 2012; 44 (1): 56-59 (8 ref.) Keywords: Adenocarcinoma, Mucinous-pathology; Lung Neoplasms-pathology; Lung Neoplasms-complications; Pneumothorax-etiology Abstract: The incidence of lung cancer continues to rise among young females. The pulmonary mucinous cystic tumor is very rare with few reported cases and it is an uncommon histological type of primary lung adenocarcinoma. The cystic nature of this type of carcinoma makes it unique radiologically. We report a very rare case of bilateral diffuse mucinous cystic adenocarcinoma of the lungs in a young pregnant woman. IMEMR Current Contents Subject Index 3 Adrenal Cortex Neoplasms pathology Hepatic metastasis from adrenocortical carcinoma fifteen years after primary resection. Mawardi, Mohammed; Al Judaibi, Bandar; Marotta, Paul The University of Western Ontario - Division of Gastroenterology Saudi Journal of Gastroenterology [The] 2012; 18 (2): 140-142 (18 ref.) Keywords: Adrenal Cortex Neoplasms-complications; Liver Neoplasms-secondary; Adrenalectomy; Liver Neoplasms-pathology; Neoplasm Metastasis Abstract: We report the case of a 73-year-old man who presented with an asymptomatic hepatic mass during investigation of mild chronic obstructive pulmonary disease by a plain chest radiograph, followed by ultrasonography, which revealed a solitary hepatic lesion measuring 7.1 cm x 6.5 cm x 5.8 cm in dimension. Fine- needle aspiration of the mass revealed malignant cells compatible with hepatocellular carcinoma. Interestingly, the patient had a left adrenalectomy and complete left nephrectomy in 1987, for a non-functioning left adrenocortical carcinoma [ACC]. The ACC was diagnosed as stage two, with no evidence of local invasion or distant metastases. No adjuvant therapy was recommended postoperatively. After a five-year follow-up, there was no evidence of ACC recurrence and the patient was declared cured from his ACC. The patient underwent a complete segmental resection of the right lobe of the liver successfully. The final diagnosis of the mass was a well-differentiated metastatic adrenocortical carcinoma. Aflatoxia M1 Infants' exposure to aflatoxin M1 from mother's breast milk in Iran. Ghiasain, S.A.; Maghsood, A.H. E-mail:s.a.ghiasian@umsha.ac.ir Hamadan University of Medical Sciences - School of Medicine - Department of Medical Parasitology and Mycology Iranian Journal of Public Health 2012; 41 (3): 119-126 (35 ref.) Keywords: Milk, Human; Mycotoxins; Mothers; Breast Feeding; Enzyme-Linked Immunosorbent Assay; Cross- Sectional Studies; Questionnaires Abstract: The occurrence of aflatoxin Ml [AFM1] in milk, especially breast milk, is a valuable biomarker for exposure determination to aflatoxin B[1] [AFB[1]]. In the present study, the risk of exposure to AFM[1] in infants fed breast milk was investigated. An enzyme-linked immunosorbent assay [ELISA] was used for the analysis of AFM[1] in breast milk samples from 132 lactating mothers referred to four urban Mothers and Babies Care Unit of Hamadan, western Iran. AFM[1] was detected in eight samples [6.06%] at mean concentration of 9.45 ng/L. The minimum and maximum of concentration was 7.1 to 10.8 ng/L, respectively. Although the concentration of AFM[1] in none of the samples was higher than the maximum tolerance limit accepted by USA and European Union [25 ng/kg] however, 25% had a level of AFM[1] above the allowable level of Australia and Switzerland legal limit [10 ng/L]. Lactating mothers and infants in western parts of Iran could be at risk for AFB[1] and AFM[1] exposure, respectively. Considering all this information, the investigation of AFM[1] in lactating mothers as a biomarker for postnatal exposure of infants to this carcinogen deserves further studies in various seasons and different parts of Iran. AIDS Serodiagnosis statistics and numerical data Provider-initiated HIV testing and counseling among tuberculosis patients in Kassala, Eastern Sudan. Abdallah, Tajeldin M.; Ali, Abdel Aziem A.; Adam, Ishag E-mail:tajeldinmm@yahoo.com Kassala University - Faculty of Medicine Journal of Infection and Public Health 2012; 5 (1): 63-66 (10 ref.) Keywords: AIDS-Related Opportunistic Infections; Tuberculosis-complications; Counseling; HIV Infections- diagnosis; Cross-Sectional Studies; HIV Seropositivity-diagnosis; Mass Screening Abstract: Because of the overlapping global incidence of tuberculosis [TB] and human immunodeficiency virus [HIV] infections, collaborative efforts are required for successful TB and HIV control programs. The current study was IMEMR Current Contents Subject Index 4 conducted at Kassala Hospital in Eastern Sudan and investigated the implementation of provider-initiated HIV testing and counseling [PITC] for patients infected with TB. Using a cross-sectional study design, patients who had been recently diagnosed with TB between January and December 2010 were consecutively enrolled. A total of 858 newly infected TB patients were enrolled in the study. Of these patients, 152 patients [17.7%] were given counseling, and 109 patients [12.7%] underwent HIV testing. The overall HIV infection rate among those tested was 18.3%. From a multivariate analysis, female sex [OR =17.0, 95% Cl = 8.7-33.1; P< 0.001], education level below secondary education [OR = 2.6, 95% Cl = 1.6-4.1; P< 0.001], rural residency [OR = 1.7, 95% Cl = 1.3-2.9; P = 0.001], and non-governmental employee status [OR=10.4, 95% Cl = 6.7-16.3; P<0.001] were each associated with lower rates of PITC. Thus, in this setting, the frequency of PITC is low among TB-infected patients and is especially low for females, those of low educational status, and non-governmental employees. 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved. Aluminum Compounds poisoning Wheat pill: clinical characterisitcs and outcome. Iftikhar, Raheel; Tariq, Khalid Mehmood; Saeed, Farrukh; Khan, Muhammad Babar; Babar, Nabeela Fazal Combined Military Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 350-353 (19 ref.) Keywords: Triticum; Retrospective Studies; Phosphines-poisoning; Mortality; Suicide; Preservatives, Pharmaceutical-adverse effects; Preservatives, Pharmaceutical-poisoning; Hypotension; Acidosis; Vomiting Abstract: To determine the clinical characteristics and outcome in patients presenting with wheat pill poisoning. Retrospective study. Department of medicine, Combined Military Hospital, Kharian from 1st July 2009 to 30 December 2010. Fifty two patients with wheat pill ingestion were included in the study. All patients' history, symptoms, signs and management data was collected on a pre-designed data collection form. Mean age was 25.10 +/- 5.35 years with 51.9% females. Time interval between ingestion of pills and presentation to hospital was 2.5 +/- 1.27 hours. Numbers of pills consumed were 2.73 +/- 20. Most common symptom seen in patients was vomiting seen in 88.5% of the patients. Other common symptoms were irritability in 63.5% and confusion in 55.8% patients. Most common clinical sign hypoxia in 75% patients. Overall mortality was 86.5 percent. Wheat pills are highly toxic with rapid and high mortality rate. These patients develop refractory hypotension and metabolic acidosis which progresses to death. More research is required to develop antidote and to minimize toxicity. Strict legislations are required to control sale of aluminium phosphide over the counter. Amantadine therapeutic use The effect of amantadine on clomipramine induced sexual dysfunction in male rats. Devaangam, Sheshadri Shekar; Satyanarayana, S.; Kumar, K.Eswar; Vivek, B.; Velmurugan, C.; Kumar, Ashok E-mail:sheshadrishekar@gmail.com Sri K.V College of Pharmacy - Department of Pharmacology Oman Medical Journal 2011; 26 (6): 404-409 (48 ref.) Keywords: Sexual Dysfunction, Physiological-drug therapy; Clomipramine-adverse effects; Random Allocation; Rats, Sprague-Dawley; Sexual Behavior, Animal-drug effects; Testosterone; Testis-drug effects Abstract: Several studies have reported that Clomipramine has the ability to suppress male rat sexual behavior. Literature indicates that the activation of brain D2 receptors causes facilitation of penile erection, and a number of reports have indicated dopamine's involvement in sexual function. Hence this study was undertaken to investigate the effect of Amantadine, a dopamine agonists on the Clomipramine induced sexual dysfunction. The study subjects involved a total of 48 males and 48 females, 4 months old Sprague-Dawley albino rats, all housed in a group of six males and females separately in plexi glass cages in an acclimatized colony room [25 +/- 0.5[degree sign]C] maintained on a 12/12 hr light/dark cycle. The male rats were randomly divided into four groups of 12 male rats each. Group I served as controls. Group II, III, and IV were treated with Amantadine [9 mg/kg body weight, p.o] 30 min, prior to the treatment with 13.5 mg/kg, 27 mg/Kg and 54 mg/Kg bodyweight p.o of Clomipramine respectively for 60 days. The control group received vehicle 1 ml / kg p.o. The sexual behavior of the male rats was observed to determine the following parameters: mount latency, intromission latency, ejaculation latency, post ejaculatory pause, and intromission frequency. As well as the sexual behavior; serum testosterone and histopathology of the testes were also investigated IMEMR Current Contents Subject Index 5 in this study. The results indicate that Amantadine in all aspects failed to antagonize Clomipramine induced sexual dysfunction in male rats. Even the sexual competence of male rats treated with 1/2 therapeutic dose [TD] of Clomipramine failed to regain their sexual competence in the presence of Amantadine. Testicular damage and decline in testosterone levels continued in the presence of Amantadine. Overall, the results suggest that Amantadine could not be a safe antidote to antagonize Clomipramine induced sexual dysfunction. Amyotrophic Lateral Sclerosis Cortical excitability in amyotrophic; lateral sclerosis. Khedr, Eman M.; Ahmed, Mohamed A.; Hamdy, Ahmed; Shawky, Ola A. Assiut University Hospital - Department of Neurology Assiut Medical Journal 2011; 35 (1): 35-42 (20 ref.) Keywords: Evoked Potentials, Motor-physiology; Transcranial Magnetic Stimulation-utilization; Electrophysiology Abstract: The primary purpose of this study was to provide insight into the central changes that occur in amyotrophic lateral sclerosis with a view to pointing out that these could contribute to symptoms, Seventeen patients with definite ALS and 17 control healthy volunteers were included in the study. Clinical examination, amyotrophic lateral sclerosis severity score [ALSSS] and transonic magnetic stimuli investigations including measurement of resting and active motor threshold [RMT, and AMT], motor evoked potential [MEP], input-output curve, contralateral silent period and transcallosal inhibition [CSP and TI] were measured for each participant. There were no significant differences in RMT or AMT in either hemisphere between patients and the control group. Despite this there was a significant negative correlation between ALSSS and RMT, and AMT meaning that increased seventy was associated with higher thresholds. MEPs were significantly smaller in ALS patients in comparison to the control group [P=0.03]. There was a significant decrease in the slope of the I/O relationship of MEP amplitude to TMS intensity in patients group in comparison to controls. ALS patients had a significant prolongation of CSP and TI for both hemispheres. There was a tendency for there to be a significant negative correlation between left TI and ALSSS [P= 0.051]. Measurements of cortical motor excitatory and inhibitory changes in ALS confirm the presence of hypoexcitability and GABAb dysfunction, that was correlated with the severity of ALS. Anesthesia, Spinal methods A randomized trial of epidural volume extension by sequential combined spinal epidural anesthesia using three different techniques. Bhandari, Shyam; Haleem, Shahla; Hbib, S. Kamran; Sharma, Dheeraj; Varshney, Rohit; Ali, Qazi Ehsan J N Medical College - Department of Anesthesia KMJ - Kuwait Medical Journal 2012; 44 (1): 30-34 (20 ref.) Keywords: Analgesia, Epidural-methods; Prospective Studies; Double-Blind Method; Bupivacaine-therapeutic use; Fentanyl-therapeutic use Abstract: Sequential combined spinal epidural anesthesia [SCSEA] is gaining popularity in ASA grade III / IV, elderly, low cardiac output state and high risk patients. In view of contradicting results related to sensorimotor characteristics, we undertook this study with the null hypothesis that epidural volume extension [EVE] with local anesthetic or normal saline results in augmentation of initial intrathecal block. Prospective, randomized, double blind study. J N Medical College, Aligarh Muslim University, Aligarh, India. Seventy-five ASA I/II patients divided into three groups and operated upon from September 2007 to January 2009. Group I received 1.5 ml bupivacaine [0.5%] + 25 microg fentanyl in subarachnoid space and epidural catheter was inserted without any top ups. In group II and III with the same technique top ups were given after 10 minutes of the intrathecal block in the form of either 10 ml NS or 10 ml of 0.125% bupivacaine. Augmentation of initial intrathecal block. Significant increase in height of block was seen after EVE by different techniques of epidural top up [T4.64 +/- 0.86 and T3.92 +/- 0.99 in group II and III respectively, p- value < 0.05] as compared to group I [T7.12 +/- 0.83]. The average increase was 3.12 +/- 0.97 and 3.48 +/- 1.35 segments in group II and III respectively as compared to 0.48 +/- 0.51 segments in group I.. Height of low-dose intrathecal block can be enhanced by SCSE using EVE effect even with normal saline. IMEMR Current Contents Subject Index 6 Angina Pectoris therapy Assessing the efficacy of danshenform compound in patients with stable angina pectoris. ul Hassan, Mahmood; Qureshi, Saqib; Hussain, Chiragh; Gul, Adnan Mahmood; Hafizullah, Mohammad E-mail:mahmoodlrh@yahoo.com Lady Reading Hospital - Department of Cardiology JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 17-21 (28 ref.) Keywords: Exercise Test; Exercise; Heart Diseases Abstract: To assess the efficacy of danshenform compound in patient with angina pectoris already on optimal dose of anti anginal therapy assessed by exercise tolerance test. Thirty eight patients with stable angina were included in the study. Patients were exercised on treadmill according to Bruce protocol at baseline and one week later. At second week, Danshenform compound 500 mg was prescribed bid for four weeks. At the end of 4 weeks, exercise tolerance test was performed. Duration and number of anginal episodes before and at the end of 4[th] week recorded. Total exercise time, onset of chest pain during exercise, onset of ST segments depression before and after treatment with Danshenform compound was recorded. The number of anginal episodes after 4 weeks treatment with danshenform was reduced significantly from 4.2 +/- 2.4 to 1.4 +/- 1.6/ week [p=0.001]. Time of onset of chest pain improved from 4.63 +/- 2.4 to 5.4 +/- 3.7 minutes [p=0.35] on exercise tolerance test. Duration of exercise increased from 6.52 +/- 1.9 minutes to 8.32 +/- 2.3 [p=0.001]. Time of onset of ST depression increased from 5.8 +/- 1.7 to 7.7 +/- 1.6 minutes [p=0.001] on stress test. Anginal class improved significantly after 4 weeks of treatment with danshenform compound [p=0.001] with no significant effect on resting heart rate [p=0.58] and systolic blood pressure [p=0.07] respectively. Danshenform compound is useful in reducing anginal episodes, increasing exercise duration, improving functional anginal class, delaying the onset of ST depression on exercise tolerance test in patient with ischemic heart disease. Anopheles parasitology The impact of three anopheline mosquito species in Toshka, on the introduction of chloroquine / resistant P. Falciparum to Egypt. El Bahnasawy, Mamdouh M.; Saleh, Nagla Mostafa K.; Khalil, Mona F.; Morsy,Tosson A. Military Medical Academy - Department of Tropical Medicine Journal of the Egyptian Society of Parasitology 2011; 41 (3): 573-592 (101 ref.) Keywords: Malaria-transmission; Plasmodium falciparum; Malaria, Falciparum-therapy; Chloroquine-therapeutic use; Drug Resistance Abstract: Malaria still tops the prevalent human arthropod-borne diseases. In Egypt, sporadic cases of human malaria were reported with a focus in Al-Fayoum. Besides, many Egyptian Anopheles species were reported allover which are either malaria vectors or incriminated ones. This study recorded An. multicolor, An. sergentii, and An. algeriensis in Toshka. Many authors reported that A. sergentii is a malaria-vector and A. multicolor is a suspected vector. Consquently, the endemicity of Chloroquine resistant Plasmodium falciparum on the Egyptian-Sudanese border pave the way for malignant malaria transmission particularly among travelers returning back from Sudan. Anti-Inflammatory Agents, Non-Steroidal adverse effects Gastrointestinal and cardiovascular risk of nonsteroidal anti-inflammatory drugs. Al Saeed, Abdulwahed E-mail:wasaeed2004@yahoo.com Dammam Medical Complex Hospital - Department of Medicine Oman Medical Journal 2011; 26 (6): 385-391 (112 ref.) Keywords: Gastrointestinal Tract-drug effects; Cardiovascular System-drug effects; Cyclooxygenase 2; Cyclooxygenase 1; Digestive System-drug effects; Analgesics-adverse effects; Anti-Inflammatory Agents-adverse effects IMEMR Current Contents Subject Index 7 Abstract: Nonsteroidal anti-inflammatory drugs [NSAIDs] confer a gastrointestinal [GI] side effect profile and concerns regarding adverse cardiovascular effects have emerged associated with considerable morbidity and mortality. NSAIDs are highly effective in treating pain and inflammation, but it is well recognized that these agents are associated with substantial gastrointestinal toxicity. Cyclo-oxygenase-2 inhibitors may also reduce the risk for gastrointestinal events, although they may increase cardiovascular adverse events. The selection of an appropriate analgesic or antiinflammatory agent with or without gastroprotective therapy should be individualized. Antibiotic Prophylaxis Antibiotic prophylaxis- is it necessary in clean general surgery? Anjum, Raheel; Parvez, Muhammad E-mail:raheelanjum@yahoo.co.uk Combined Military Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 364-366 (24 ref.) Keywords: General Surgery; Surgical Wound Infection; Wound Infection; Postoperative Complications; Preoperative Care Abstract: The aim of this study was to compare the use of prophylactic antibiotics in reducing wound infection in clean elective general surgical operations with no use of prophylactic antibiotics in these operations. Randomized Controlled Trial [RCT]. Six months study from January 2007 to June 2007 conducted at surgical department of Combined Military Hospital Peshawar. One hundred and twenty patients were included in the study and divided into two groups A and B. Group A received prophylactic antibiotics and Group B did not, both groups were compared for post operative wound infection. In Group A, one patient [1.6%] developed infection and in Group B, four patients [6.6%] developed infections. The results were not statistically significant by Chi-Square test [P> 0.5]. preoperative antibiotic prophylaxis is not recommended routinely in clean general surgical operations. Evaluation of prophylactic antibiotic administration at the surgical ward of a major referral hospital, Islamic Republic of Iran. Vessal, G.; Namazi, S.; Davarpanah, M.A.; Foroughinia, F. E-mail:gvessal@yahoo.com Shiraz University of Medical Sciences - Faculty of Pharmacy - Department of Clinical Pharmacy EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 663-668 (31 ref.) Keywords: Evaluation Studies as Topic; Surgery Department, Hospital; Guideline Adherence; Cefazolin-therapeutic use Abstract: We evaluated the appropriateness of antibiotic prophylaxis administered before surgery at a major referral hospital in Shiraz, against the American Society of Hospital Pharmacists [ASHP] guidelines. Data on surgical procedure, choice of antibiotic and administration were gathered for all surgeries performed on hospitalized patients during 15 days in March 2010, Of 155 patients included in the analysis, 98% received prophylactic antibiotic before surgery; according to ASHP guidelines, prophylaxis was needed in only 106 [68.4%]. Of these 106, only 8 patients received the correct antibiotic regimen. The commonest regimens administered were cefazolin + gentamicin [47.6%], cefazolin [20.5%] and cefuroxime [8.5%]. Antibiotic prophylaxis was continued in 83% of cases, while this was necessary in only 37%. In only 1 surgical procedure were all evaluated parameters correct. Anxiety epidemiology Anxiety and depression in nurses working in government tertiary care teaching hospitals of Peshawar khyber pakhtunkhwa and their relationship with job stress. Khan, Shajaat Ali; Farooq, Saeed; Bano, Akhther E-mail:bannuchipsych@yahoo.com Department of Psychiatry JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 34-38 (22 ref.) Keywords: Depression-epidemiology; Nurses-psychology; Cross-Sectional Studies; Stress, Psychological; Severity of Illness Index; Questionnaires Abstract: To estimate the prevalence and intensity of anxiety and depression and its relationship with job stress among the nursing staff. This cross sectional analytical descriptive study was conducted in three teaching hospitals of Peshawar from 1[st] August 206 to 30[th] November 2006. Convenient sampling was used. The samples consisted of IMEMR Current Contents Subject Index 8 700 nurses. Sociodemorgraphic details were collected through a proforma. Self rating translated Job Stress Questionnaire was administered followed by self rating Urdu version of AKUAD scale for estimation of job stress and intensity of anxiety and depression. SPSS version 16 was used for statistics. The prevalence of anxiety and depression was 100% with mean score of 41 +/- 10.70 and job stress 38.96 +/- 18.76. The prevalence of mild, moderate, severe and very severe degrees of anxiety and depression was 55.6%, 39.3%, 4.6% and 0.6% respectively. There was no significant correlation between total scores on [AKAUDS] and job stress on JSQ [0.836 P>/= 0.5]. Five items of job stress: Inability to satisfy patients [0.022, P </= 0.5], health hazards [0.003, P</= 0.5], dealing violent patients [0.001, P</= 0.5], dealing abusive patients [0.043 </= 0.5] and shift work [0.027, P</= 0.05] showed statistically negative correlation with severity of anxiety and depression. All nurses in our study had anxiety and depression, majority were in mild to moderate intensity range. Although no significant relationship was observed between anxiety and depression and job stress as a whole, yet significant negative relationship with some aspects of job stress was found. The findings reflected a public health issue. Argasidae classification Study the protein content differences between common argasid species found in Egypt. Gabr, Hanan Sobhy Mohamed E-mail:nanagabr@yahoo.com Cairo University - Faculty of Agriculture - Department of Zoology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 635-639 (17 ref.) Keywords: Ticks; Proteins-analysis Abstract: This work showed protein analysis differentiates between the argasid tick species. Protein band numbers found in the different ticks were 15, 12, 8 and 14 bands of Argas persicus, A. hermanni, A. arborius, and the Ornithodorus savignyi respectively. The proteins with molecular weights 410 and 17 kD were found only in A. persicus. One protein with M.W 126 kD was found in O. savignyi. The absence of the protein with MW 88 kDa is only shown in A. hermanni. A. arborius, only eight protein bands are shown and the nonexistence proteins Mw were [181, 77, 21, 15.6 and 8.66 kDa] which are found in the other tick samples. Arteriovenous Malformations An unusual cause of hemoptysis in a young female. Gupta, Pankaj; Sharma, Raju; Sharma, Surendra K. All India Institute of Medical Sciences Oman Medical Journal 2011; 26 (6): 457-458 (10 ref.) Keywords: Hemoptysis; Epistaxis; Pulmonary Artery-abnormalities; Telangiectasia, Hereditary Hemorrhagic; Lung Diseases-congenital Arthrodermataceae isolation and purification Use of single-enzyme PCR-restriction digestion barcode targeting the internal transcribed spacers [ITs rDNA] to identify dermatophyte species. Matehkolaei, A. Rezaei; Makimura, K.; Shidfar, M.R.; Zaini, F.; Eshraghian, M.R.; Jalalizand, N.; Sisakht, S. Nouripour; Hosseinpour, L.; Mirhendi, H. Tehran University of Medical Sciences - School of Public Health, National Institute of Health Research - Department of Medical Parasitology and Mycology Iranian Journal of Public Health 2012; 41 (3): 82-94 (25 ref.) Keywords: Arthrodermataceae-genetics; Polymerase Chain Reaction-methods; Dermatomycoses-diagnosis; Dermatomycoses-epidemiology Abstract: Dermatophytes are the most common causative agents of superficial mycoses. Species identification of these fungi is important from therapeutic and epidemiological point of wive. Traditional approaches for identification of dermatophytes at the species level, relying on macroscopic and microscopic features of the colonies, usually are time- consuming and unreliable in many circumstances. Recently a broad varieties of rapid and accurate DNA-based IMEMR Current Contents Subject Index 9 techniques were successfuly utilized for species delineation of dermatophytes. The ITS1-5.8S-ITS2 region of rDNA from various reference strains of dermatophyte species were amplified using the universal fungal primers ITS1 and ITS4.The PCR products were digested by a single restriction enzyme, MvaI. The enzyme was evaluated in both in silico and practical PCR-RFLP assay to find the exact differentiating restriction profiles for each species. To validate the standardized PCR-RFLP system, all tested strains were subjected to sequencing and sequence analysis. The obtained RFLP patterns were specific for many species including T. interdigitale, T. rubrum, T. violaceum, M. persicolor, M. audouinii, M. nanum [A. obtusum] and E. floccosum but were similar for some closely related species such as M. canis / M. ferrugineum. Sequencing of the ITS1-5.8S-ITS2 fragment from all type strains affirmed the RFLP findings. It was practically revealed that the ITS-PCR followed by MvaI-RFLP is a useful and reliable schema for identification and differentiation of several pathogenic species and can be used for rapid screening of even closely related species of dermatophytes in clinical and epidemiological settings. Arthroplasty, Replacement, Hip Total hip replacement after hip fracture: primary or secondary surgery? a comparison of clinical and radiological results. Pospula, Wieslaw; Bonajmah, Abdullah A.; Abu Noor, Tarek; Prakash, Chetan E-mail:pospula.wieslaw@gmail.com Farwaniya Hospital - Department of Orthopedic Surgery KMJ - Kuwait Medical Journal 2012; 44 (1): 35-39 (23 ref.) Keywords: Hip Fractures-surgery; Hip Fractures-radiography; Treatment Outcome; Retrospective Studies Abstract: To compare clinical and radiological results of primary and secondary total hip replacement [THR] after displaced fracture of the femoral neck. Retrospective review of a cohort of 47 patients. All surgeries were performed by the senior author in Al Razi Hospital, Kuwait between 2002 and 2007. Follow- up assessment was done in Al Razi and in Farwaniya Hospital, Kuwait by all authors. Twenty-nine cases of primary THR compared with 18 cases of secondary THR. Cementless, cemented and hybrid implants were used for total hip replacements. Clinical assessment was done using Merle D' Aubigne hip score and radiological assessment was done using standard criteria of geometry of the implant and its stability. Clinical results were better in the primary THR group but radiological results were equivocal. There was tendency to position the cup horizontally in the secondary surgery group. Cementless, cemented and hybrid implants did equally well in our cohort. Primary THR seems to be a better option in displaced fracture of the femoral neck. Cemented cementless and hybrid hip can be used in these cases. Asparaginase isolation and purification Expression of recombinant escherichia coli L-asparaginase II, purification and characterization. Maharem, Tahany M.; Sabry, Gilane M.; Mohamed, Mohamed R.; Emam, Manal A. Ain Shams University - Faculty of Science - Department of Biochemistry EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 237-256 (32 ref.) Keywords: Antineoplastic Agents; Asparaginase-genetics; Escherichia coli; Asparaginase-chemistry; Cloning, Organism; Precursor Cell Lymphocytic Leukemia-Lymphoma Abstract: L-Asparaginase [ASNase] is an anti-cancer [[antineoplastic] or [cytotoxic] ] chemotherapy drug that is used for the treatment of acute lymphoblastic leukemia [ALL]. An efficient and economical scheme was developed for over expression and rapid purification of the Escherichia coli enzyme. The gene encoding for the Escherichia coli L- asparaginase was PCR-amplified and cloned in pGEX-4Tl expression vector. The recombinant L-asparaginase was purified to homogeneity by affinity chromatography on glutathione Sepharose column. The recombinant enzyme had an apparent MW of 152 kDa and a K[m] value of 12.5 microM for the main physiological substrate L-asparagine. The pI value was 5.6 while the turnover number [catalytic constant] was 1 x 10[2] s[-1] and the K[cat]/K[m] value [specificity constant] was 0.8 x 10[7] M[-1]s[-1]. Purification and characterization of camel liver L-asparaginase. Maharem, Tahany M.; Sabry, Gilane M.; Mohamed, Mohamed R.; Emam, Manal A. Ain Shams University - Faculty of Science - Department of Biochemistry EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 217-236 (42 ref.) Keywords: Liver; Camels; Asparaginase-chemistry IMEMR Current Contents Subject Index 10 Abstract: L-asparaginase from camel liver was isolated and purified by heat denaturation followed by QAE- Sephadex A-50 column chromatography and SP-Sepharose column chromatography. The purified camel liver L- asparaginase had a molecular weight of 180 kDa [consistent with a homotetramer] and a pI value of 8.6. The enzyme was thermostable with relative structure rigidity and an optimum temperature at 65°C . It had a pH optimum at 9.6 and was stable for storage at 4°C in the refrigerator for 7 days. Asthma Risk factors associated with childhood asthma among children aged 1-12 years in Rawalpindi. Afzal, Muhammad; Qureshi, Shaukat Mahmood; Hussain, Shabbir; Tariq, Naseer Alam; Khan, Muhammad Babar; Ahmed, Sagheer; Jillani, Lutfullah E-mail:afzalchpak@yahoo.com Combined Military Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 372-376 (31 ref.) Keywords: Risk Factors; Child; Questionnaires; Case-Control Studies Abstract: To explore various risk factors associated with childhood asthma in Rawalpindi garrison and city among children 1-12 years old. Case Control study. Pediatric departments of Military Hospital [MH] and Combined Military Hospital [CMH] Rawalpindi from 1st Aug to 30th Nov 2009. A total of 128 children with diagnosis of asthma presenting in outpatient and indoor pediatric departments of MH and CMH Rawalpindi between ages of 1-12 years were included. Age, gender and socioeconomically matched 112 children without diagnosis of asthma were included as controls. A predesigned questionnaire containing various factors associated with childhood asthma was filled by the researcher by detailed interview with either of parents. Data was analyzed by SPSS version 15 and chi-square test was applied to determine significance. p value <0.005 was considered significant. Out of 15 risk factors studied 8 were found significantly associated with childhood asthma. Significant factors were education of any of the parents more than matric, history of fever at least three times in last year, use of antibiotics, history of hay fever, raised IgE levels, exposure to passive smoking, living in urban areas and family history of asthma [p value<0.005]. Non significant factors were mode of delivery, exclusive breast feeding for more than 3 months, partial breastfeeding for more than 6 months, history of eczema, atopy, history of viral respiratory infections in infancy and less than three number of rooms at home. Male preponderance was noted amongst cases. Education of parents, fever, antibiotics, hay fever, raised IgE levels, exposure to passive smoking, living in urban areas and family history of asthma proved to be significant factors which are similar to those reported in other studies. However, difference was found in other factors. Recognition of these factors can help to optimize management of asthma in children in this area. therapy Self management education in asthma and COPD: what does it involve and does it work? Partridge, Martyn R. E-mail:m.partridge@imperial.ac.uk Imperial College JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 7-12 (16 ref.) Keywords: Patient Education as Topic-methods; Pulmonary Disease, Chronic Obstructive-therapy; Treatment Outcome; Guidelines as Topic; Self Care-methods Abstract: Major advances have been made in the delivery of care and outcomes for those with asthma and COPD over the last few decades. However, much of that progress represents of the pharmaceutical industry in producing and promoting efficacious medications. Further improvements in outcomes for those with common lung diseases is only likely to occur if doctors embrace the wider non-prescription elements of care with such elements including everything from enhanced communication, shared decision making, self-management support, pulmonary rehabilitation and easier and more convenient follow up. This review concerns one vital element of that wider package of care, namely self-management support. Attention Deficit Disorder with Hyperactivity therapy The impact of multimodal psychosocial intervention among children with attention deficit hyperactivity disorder. Al Ansari, Ahmed; Asiri, Mohammed Medawi IMEMR Current Contents Subject Index 11 College of Medicine - Department of Psychiatry Bahrain Medical Bulletin 2012; 34 (1): 30-32 (14 ref.) Keywords: Attention Deficit Disorder with Hyperactivity-psychology; Treatment Outcome; Retrospective Studies; Cross-Sectional Studies; Diagnostic and Statistical Manual of Mental Disorders Abstract: Evaluation of the effectiveness of psychosocial intervention in comparison to outpatient management. Child and Adolescent Psychiatric Unit, Psychiatric Hospital, Ministry of Health, Bahrain. Retrospective/cross sectional study. Group 1 [ROM] consist of twenty children from outpatient and group 2 [MPI] consist of 15 children from day- care, aged 4-16 years, diagnosed with DSM IV ADHD were recruited for the study after four weeks of treatment from 2006-2009. Twelve [80%] children from daycare group were from non-intact family [P>.036]. Fourteen mothers [70%] from ROM and 9 mothers [60%] from MPI reported marked improvement in both groups. Blind investigator and therapist/nurse found more improvement among those received more intense psychosocial intervention, group 2 [MPI] [P> .018]. group 2 [MPI] had more psychopathology compared to group 1 [ROM]. The staff and blind investigator reported better improvement among children in Group 2 [MPI]. Difficult ADHD cases benefit more from intense psychosocial intervention in group 2 [MPI]. Attitude of Health Personnel Design and validation of a questionnaire to measure the attitudes of hospital staff concerning pandemic influenza. Naghavi, Seyed Hamid Reza; Shabestari, Omid; Roudsari, Abdul V.; Harrison, John E-mail:hamidreza-naghavi@yahoo.com Havering and Redbridge University Hospitals NHS Trust - Department of Occupational Health - Barking Journal of Infection and Public Health 2012; 5 (1): 89-101 (9 ref.) Keywords: Influenza, Human-epidemiology; Questionnaires-standards; Personnel, Hospital-psychology; Personnel, Hospital-statistics and numerical data; Pandemics; Absenteeism; Pilot Projects Abstract: When pandemics lead to a higher workload in the heathcare sector, the attitude of healthcare staff and, more importantly, the ability to predict the rate of absence due to sickness are crucial factors in emergency preparedness and resource allocation. The aim of this study was to design and validate a questionnaire to measure the attitude of hospital staff toward work attendance during an influenza pandemic. An online questionnaire was designed and electronically distributed to the staff of a teaching medical institution in the United Kingdom. The questionnaire was designed de novo following discussions with colleagues at Imperial College and with reference to the literature on the severe acute respiratory syndrome [SARS] epidemic. The questionnaire included 15 independent fact variables and 33 dependent measure variables. A total of 367 responses were received in this survey. The data from the measurement variables were not normally distributed. Three different methods [standardized residuals, Mahalanobis distance and Cook's distance] were used to identify the outliers. In all, 19 respondents [5.17%] were identified as outliers and were excluded. Azathioprine toxicity Effects of green tea on azathioprine - induced liver injury in adult male albino rats: light and electron microscopic study. Kamal, Ibrahim; Rateb, Amal Al Azhar University - Faculty of Medicine - Department of Histology Assiut Medical Journal 2011; 35 (1): 77-102 (34 ref.) Keywords: Liver-ultrastructure; Microscopy, Electron; Protective Agents; Camellia sinensis-utilization; Plant Extracts- therapeutic use; Treatment Outcome; Rats; Male Abstract: Azathioprine is an immunosuppressive drug that is used inhuman medicine and veterinary medicine to treat different diseases like inflammatory bowel diseases, acute lymphoblastic leukemia, rheumatoid arthritis and ulcerative colitis. There is evidence that it causes hepatotoxicity. These days, applying antioxidants in order to prevent diseases can play a protecting role in liver tissue. So, the present work aimed at a morphological and morphometric evaluation of the role of green tea to protect against azathioprine-induced liver injury in rats. 30 adult male albino rats were divided into 3 groups; each group consisted of 10 rats. Control group, treated group given azathioprine in a dose of 25mg/Kg body weight dissolved in 0.9% NaCl orally via intragastric route 6 days a week for 8 weeks. Protected group given green tea extract in a dose of 175mg/Kg body weight dissolved in water orally simultaneously with azathioprine in the same previous dose, 6 days a week for 8 weeks. The liver specimens were processed for both light IMEMR Current Contents Subject Index 12 and electron microscopic examinations. Morphometric analysis were also carried out. Aza induced degenerative changes manifested at LM; hislological changes in structure of the liver. At EM; manifestations of oxidative damage of hepatocytes. At morphometry; significant changes as regards size of hepatocytes and glycogen content. The protected group showed at LM; improvement of structure of liver. At EM; improved histological changes of hepatocytes. At morphometry; significant improvement of size and glycogen content of hepatocytes. The negative effects of azathioprine could be ameliorated by addition of green tea to the therapeutic regime of patients who may suffer liver injury due to azathioprine treatment. Bacillus thuringiensis isolation and purification Active enhancement of bacillus thuringiensis subspisraelensis toxins and protein-purification. Al Zahrani, Hind A.A. E-mail:h_alzahrani@windowslive.com King Abdulaziz University - Faculty of Science for Girls - Department of Biology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 665-674 (40 ref.) Keywords: Endotoxins-secretion; Mosquito Control; Biological Assay Abstract: Bacillus thuringiensissub sp. ilsraelensis de Barjac, that produce insecticidal protein endotoxins are used for mosquito control. The bacterium produces several cry and cytoxins that individually show activity against mosquitoes. A CryllA protein IA848, which corresponds to the first 848 amino acids from N-terminal of CryllA-gene was purified from E.coli by Ni-NTA affinity isolation, Q-Sepharose Fast-Flow chromatography and Super-200 size exclusion chromatography. It was determined using laboratory bioassays that the purified-IA848 protein has good insecticidal competitive binding bioassays show that IA848 does not compete with CryIAb for binding to the brush border membrane vesicles [BBM] of the Aedesaegyptiborer and does not compete with CryIAb at concentrations below 400- fold excess of un-labeled CrylAb for binding to the peritrophic matrix [PM] of the insect. This IA848 proved good competitive in control strategies. CryllA protein purification demonstrate molecular mechanism by which CytIA synergizes or suppresses resistance to toxins by providing a binding site for CryIIAa that resulted in an efficient formation of CryIIAa pre-pore that inserts into membranes and forms'fonic pores. Behcet Syndrome diagnosis A young male with Behcet's disease and right ventricular thrombi. Al Merri, Khaled; Aleinati, Tareq; Al Mutairi, Mohammad E-mail:Khaleeji@hotmail.com Chest Disease Hospital - Division of Cardiology KMJ - Kuwait Medical Journal 2012; 44 (1): 66-68 (10 ref.) Keywords: Behcet Syndrome-drug therapy; Thrombosis-diagnosis; Heart Ventricles-pathology; Aneurysm, False; Pulmonary Artery-pathology; Prognosis Abstract: Behcet's disease is a multisystem inflammatory disease that can rarely affect the cardiovascular system leading to bad prognosis. We report the case of a 23-year-old male who presented with hemoptysis and recurrent oral and genital ulcers. He was found to have multiple right ventricular thrombi and left lower lobe pulmonary artery pseudoaneurysm and was diagnosed as Behcet's disease. He was successfully treated with warfarin, cyclophosphamide, and corticosteroids in addition to left lower lobe posterior segmentectomy and resection of the pulmonary artery pseudoaneurysm. beta-Lactamases isolation and purification Detection of extended spectrum beta-lactamases in urinary isolates of klebsiella pneumoniae in relation to bla[SHV] bla[TEM] and Bla[CTX-M] gene carriage. Eftekhar, F.; Rastegar, M.; Golalipoor, M.; Samaei, N. Mansour IMEMR Current Contents Subject Index 13 Shahid Beheshti University G.C. - Faculty of Biological Sciences - Department of Microbiology Iranian Journal of Public Health 2012; 41 (3): 127-132 (27 ref.) Keywords: Klebsiella pneumoniae-genetics; beta-Lactamases-genetics; Urinary Tract Infections-microbiology; Drug Resistance, Bacterial-genetics; Microbial Sensitivity Tests Abstract: Resistance to contemporary broad-spectrum beta-lactam antibiotics mediated by extended-spectrum beta- lactamases [ESBLs] is increasing worldwide. Klebsiella pneumoniae, an important cause of nosocomial and community acquired urinary tract infections has rapidly become the most common ESBL producing organism. We examined ESBL production in urinary isolates of K. pneumoniae in relation to the presence of bla[SHV], bla[TEM] and bla[CTX-M] genes Antibiotic resistance of 51 clinical isolates of K. pneumoniae was determined to amoxicillin, amikacin, ceftazidime, cefotaxime, cefteriaxon, ceftizoxime, gentamicin, ciprofloxacin and nitrofurantoin by disc diffusion. Minimum inhibitory concentrations were also measured for ceftazidime, cefotaxime, cefteriaxon, ceftizoxime and ciprofloxacin. ESBL production was detected by the double disc synergy test and finally, presence of the bla[SHV], bla[TEM] and bla[CTX-M] genes were shown using specific primers and PCR. Disc diffusion results showed that 96.08% of the isolates were resistant to amoxicillin followed by 78.43% resistance to nitrofurantoin, 49.02% to amikacin and ceftazidime, 41.17% to ceftriaxone, 37.25% resistance to cefotaxime and ceftizoxime, and 29.42% to gentamicin and ciprofloxacin. Both resistant and intermediately resistant organisms were resistant in MIC determinations. Twenty two isolates [43.14%] carried bla[SHV], 18 [35.29%] had bla[TEM] and 16 [31.37%] harbored bla[CTX-M] genes. ESBL production was present in 14 isolates [27.45%] of which, 3 did not harbor any of the 3 genes. Among the non- ESBL producers, 9 lacked all 3 genes and 2 carried them all. No relation was found between gene presence and ESBL expression. beta-Thalassemia Public awareness of beta thalassemia in Bahrain. Al Hajeri, Amani; Al Arrayed, Shaikha E-mail:alhajeriamani@gmail.com Salmaniya Medical Complex Bahrain Medical Bulletin 2012; 34 (1): 26-29 (10 ref.) Keywords: Awareness; Cross-Sectional Studies; Questionnaires; Health Education; Mass Screening Abstract: Genetic diseases, especially hereditary blood disorders such as thalassemia syndromes impose a significant burden on many countries. Many educational programs have been implemented in Bahrain to increase public awareness of beta thalassemia and other hereditary blood disorders. The aim of the study is to evaluate public awareness level about beta thalassemia. Cross sectional survey. Public in Bahrain. Questionnaires were distributed to 2000 individuals from December 2006 to February 2007. The participants were interviewed by either a health professional or a trained interviewer. Two thousand questionnaires were received; nevertheless, not all of them did answer all the questions. One thousand two hundred ninety-seven [65.1%] heard of beta thalassemia and 809 [40.5%] knew that both parents have to be carriers to have an affected child. One thousand five hundred forty-seven [77.8%] strongly agreed that premarital checking could prevent beta thalassemia. Females showed better knowledge than males and married individuals seem to know more about beta thalassemia than unmarried. The study sample seems to have poor knowledge of beta thalassemia indicating the need for improving their basic knowledge of the disease. Further stress on the importance of continuing the screening campaigns specially the student screening program, premarital counseling and newborn screening service is advised. Biodegradation, Environmental Bioremediation of heavy metal toxicity from factory effluents by transconjugants bacteria. El Zahrani, Hind A.; El Saied, A.I. King Abdul Aziz University - Faculty of Science for Girls - Department of Biology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 641-650 (27 ref.) Keywords: Metals, Heavy-toxicity; Waste Management-methods; Bacteria-genetics Abstract: The presence of heavy metals in aquatic environments is known to cause severe damage to aquatic life, beside the fact that these metals kill microorganisms during biological treatment of waste, water with a consequent delay of the process of water purification. Most of the heavy metal salts are soluble in water and form aqueous solutions and consequently cannot be separated by ordinary physical means of separation. Five bacterial strains were used in this study. Bacterial strains were marking using 10 antibiotics and 7 heavy metals to be use as a selectable markes in conjugation process. Mating were performed using five bacterial strains. These strains were genetically marking in relation to their tolerance to the different antibiotics and heavy metals. All matings between bacterial strains were successes. The bio-sorption capacities for all heavy metals determined were higher for some metals than others. IMEMR Current Contents Subject Index 14 The transconjugants strain Tr[5] resulted from mating between the parental bacterial strains [B-6bs X B-21] was more efficient in molybdenum uptake than all bacterial strains when supplemented nutrient media with wastewater. Bacterial strains [B-21] appeared a good uptake of heavy metal ions [copper, cadmium, iron, cadmium and Lead] than other bacterial strains. This work highlights the potential of bacterial strains B-21 in uptake of heavy metals. The transconjugant strain Tr[3] resulted from mating between parental bacterial strains [B-1584 X B-287] was more efficient in chromium uptake than all bacterial strains. Biomedical Research Muslims and the medical research: past, present, future. Malik, Tayyaba Gul E-mail:tayyabam@yahoo.com Lahore Medical and Dental College Oman Medical Journal 2011; 26 (6): 383-384 (4 ref.) Keywords: Islam Blepharoptosis Ptosis - types and operations for correction. Shoaib, Khawaja Khalid Combined Military Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 382-386 (35 ref.) Keywords: Treatment Outcome; Postoperative Complications; Horner Syndrome Abstract: To analyze the management of different types of ptosis of upper eyelid. Descriptive Study. Eye department CMH Kharian, from January 2006 to December 2007. Thirty six patients having ptosis of upper eyelid, managed in eye department, were analyzed to find out frequency of different types of ptosis. Fifteen patients [27 eyes] were managed surgically and the rest were managed medically. Results and complications of different procedures required for the surgical correction were also analyzed. Twenty [55.6%] cases were congenital and 16 [44.4%] were acquired. Eight [22.2%] patients had neurogenic ptosis, 5[13.9%] had mechanical ptosis, 17 [47.2%] cases had myogenic, 6 [16.7%] had aponeurotic ptosis. Twenty seven eye of fifteen patients were managed surgically. The procedures performed, included levator resection, which was done in 18 [66.7%] eyes, frontalis suspension done in 8 [29.6%] eyes, conjunctivomuller resection in one [3.7%] eye which had unilateral Horner's syndrome. Post operative complications occurred in 4 [14.8%] eyes requiring reoperation. These included development of exposure keratopathy due to dryness of eyes in both eyes of one patient, overcorrection in one eye of a patient and undercorrection with hypotropia in one eye of another patient. All achieved good results. Different types of ptosis should be identified. Levator resection and frontails suspension can effectively correct the ptosis in most of the cases. Complications of the surgery are infrequent. Blood Coagulation Disorders epidemiology Frequency of bleeding disorders diagnosed at armed forces institute of pathology Rawalpindi. Nazir, Kamran; Ahmed, Suhaib; Kamran, Shawana; Anwar, Jaleel E-mail:saadzaid1@hotmail.com Combined Military Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 387-390 (16 ref.) Keywords: Capillary Fragility; Bleeding Time; Clot Retraction; Factor V Deficiency; Factor VII Deficiency; Factor X Deficiency; Factor XI Deficiency; Factor XII Deficiency; Factor XIII Deficiency; von Willebrand Diseases Abstract: To determine the frequency of bleeding disorders diagnosed at Armed Forces Institute of Pathology, Rawalpindi [AFIP Rwp]. Descriptive study. Department of Hematology, AFIP Rwp from January 2006 to June 2009. A total of 1836 patients of bleeding diathesis were included in the study. Hess test was done to investigate the vascular defects. Bleeding Time [BT] was done to screen platelet function defects. The 'clotting screen' and mixing studies were done to detect coagulation protein defects. Clot solubility test was performed to screen factor XIII deficiency. Out of 1836 patietns of bleeding diathesis 435 [23.7%] were diagnosed as having haemostatic defects. Out of these 435 patients 273 [62.8%] had coagulation factor deficiency, 81 [18.6%] had platelet function defects and 81 [18.6%] had vWF deficiency. Among the 273 coagulation factor deficiency patients, factor VIII deficiency was in 121 [44.3%], factor IX deficiency in 32 [11.7%], factor V deficiency in 18 [6.6%], factor XIII deficiency in 15 [5.5%], factor VII deficiency in IMEMR Current Contents Subject Index 15 12 [4.4%], factor X deficiency in 9 [3.3%], factor I deficiency in 8 [2.9%] and factor II deficiency was in 3 [1.1%]. Multiple factor deficiency was 55 [20.1%]. No defects of vasculature were identified. Coagulation factor deficiencies, with factor VII deficiency being the commonest are the most frequent bleeding disorders. Platelet function defects and vWF deficiency also comprise significant proportion of the bleeding disorders. Blood Coagulation Tests Knowledge and performance among dentists regarding coagulation tests in patients with hereditary bleeding disorders and patients on anticoagulant therapy. Shabestari, S. Basir; Bakhshi, M.; Shirinbak, I.; Mahmoud, K.H. E-mail:samira_bsh@yahoo.com Zanjan University of Medical Sciences - Faculty of Dentistry Scientific Journal of Iranian Blood Transfusion Organization Research Center [The] 2012; 8 (4): 286-292 (13 ref.) Keywords: Blood Coagulation Disorders, Inherited-diagnosis; Dentists; Knowledge; Anticoagulants; Questionnaires Abstract: Some of the dental procedures can cause bleeding. Bleeding control can be affected in some patients due to systemic disease or chronic anticoagulant therapy, so they may be at increased risk for bleeding events or even death following invasive dental procedures. This study was designed to evaluate the knowledge of general dentists in Qazvin city regarding coagulation tests performed in bleeding disorders during 2010-2011. A questionnaire [including 23 questions] was designed with the aid of specialists in the field of oral medicine and hematology. This questionnaire was distributed among 124 general practitioners. Data were analyzed with SPSS version 15 and T-test, one-way ANOVA and Tukey. The mean score for dentists knowledge was 8.64 +/- 1.20. There was no significant difference in the mean knowledge scores among male and female dentists. Tukey test showed a significant difference in the mean knowledge level among 31 -40 year old and over forty year old dentists [p<0.04]. This study showed that knowledge of the dentists regarding bleeding disorders is not at desirable level which requires planning for continuing education courses. Blood Platelets Generation of platelet-derived microparticles during storage in two different storage media. Azadpour, S.H.; Yari, F.; Vaeli, S.H. High Institute for Research and Education in Transfusion Medicine - Blood Transfusion Research Center Scientific Journal of Iranian Blood Transfusion Organization Research Center [The] 2012; 8 (4): 234-241 (20 ref.) Keywords: Cell-Derived Microparticles; Plasma Abstract: Activated platelets release microparticles [MPs] in vivo or in the platelet concentrate [PC] product in response to some stimulators. This study compared the two different storage media of plasma and composol for PC regarding the extent of MPs formation as a new index for comparing platelet stability. In this experimental study, 30 PC units were prepared. The platelets were divided into two equal portions. Plasma was replaced with the additive solution of composol in one of the portions. Sampling was carried out at the days 2, 4 and 7 after storage. Afterwards, the MPs were separated and their concentrations were collected using Bradford method. T-tests was used to compare the results of this experiment. The results showed that the amounts of MPs increased during the storage. In each media of plasma or composol, the concentration of MPs showed a significant difference between the days 4 and 7 of the storage. Besides, the final concentration of MPs did not show a significant difference between the two media at the day 4 of the storage whereas this difference was significant at the day 7 of storage [p<0.05]. There were no significant differences in the quantity of MPs in PCs stored in plasma or composol up to the day 4 of the storage. This difference became significant after 7 days of the storage, in which the generation of MPs showed significant increase in plasma than composol. These observations revealed an advantage for composol as a PC storage medium. Bone Density Bone mineral density in Egyptian adolescents and adults with short stature: results of a national survey. Ibrahim, S.A.; Samy, M.A.; Matter, M.K.; Saleh, A.O.L. E-mail:saharhammouda@yahoo.com NationalNutrition Institute EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 687-693 (19 ref.) Keywords: Body Height; Anthropometry; Body Mass Index; Menarche; Osteoporosis-epidemiology; Absorptiometry, Photon; Health Surveys; Family IMEMR Current Contents Subject Index 16 Abstract: Little is known about bone mass acquisition among stunted adolescents who did not achieve their growth in height. A national survey was made of bone mineral density among stunted adolescents and adults. A multistage stratified random sample of 2500 families [8476 adolescents and their parents] was selected from 6 governorates in different geographical areas of Egypt. Clinical history, anthropometry and measurement of bone mineral density using dual energy X-ray absorptiometry was done. Mean T-scores were significantly lower among both adults and adolescents with short stature compared with those of normal height. The predictors of bone status among adolescent boys were age, body mass index [BMI], height attained [z-score] and maternal T-score and for girls were BMI, age at menarche, paternal T-score and z-score. Stunted adolescents suffered from low bone mass density and low stature adults suffered a high prevalence of osteoporosis. Botulism A case of adult botulism following ingestion of contaminated Egyptian salted fish [[Faseikh]]. Al Nassar, Muath; Mokhtar, Medhat; Rotimi, Vincent O. E-mail:muathalnassar@gmail.com Mubarak Al Kabir Hospital - Department of Medicine KMJ - Kuwait Medical Journal 2012; 44 (1): 63-65 (11 ref.) Keywords: Clostridium botulinum; Paralysis-diagnosis; Foodborne Diseases; Fishes-microbiology Abstract: Food-borne botulism is a rare and serious disease caused by potent neurotoxin of the Clostridium botulinum which is a Gram-positive strictly anerobic organism. It manifests clinically as descending paralysis characterized by prominent oculo-bulbar palsies and symptoms and autonomic signs in an afebrile patient with normal sensorium. If not promptly and aggressively treated it may lead to fatality. In this communication, we report a case of food poisoning resulting in adult botulism that responded to early and effective treatment with specific antitoxin and supportive therapy. The patient made a remarkable recovery and was discharged home three weeks after admission. This case is the first to be reported for adult variant botulism in Arabian Gulf States. Brain Diseases diagnosis Age related white matter lesions on magnetic resonance imaging. Ullah, Hidayat; Ashfaq, Shazia E-mail:hidayat781@gmail.com Combined Miliatary Hospital JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 61-66 (14 ref.) Keywords: Aging-pathology; Magnetic Resonance Imaging; Alzheimer Disease-pathology; Brain-pathology Abstract: To find out the frequency of cerebral white matter lesions [WML] in elderly individuals with no neurological symptoms. This descriptive study was carried out at Radiology Department, Military Hospital, Rawalpindi; January to December 2003. One hundred asymptomatic patients of either gender, aged 50 years and more without a known systemic disease were selected and divided into two groups of age 50-65 years and more than 65 years and MRI brain was performed. WML when found were classified as subcortical and periventricular hyperintensities and rated for both hemispheres simultaneously along with regional distribution of the WML. Frequency of each type of WML was assessed in the sample Relationship with age and gender of patients was also sought. Subcortical WML were present in 54% [n=54] of subjects. Periventricular WML were found in 19% [n=19] of study population. Both subcortical and periventricular WML were more frequently observed in more than 65 years age group. However findings were not statistically significant [-values = 0.8333 and 0.3646 respectively]. Periventricular white matter lesions were observed more commonly in males with statistically significant distribution [p-value = 0.0018]. Subcortical WML were also more frequently observed in males. However the distribution was statistically insignificant [p-value = 0.1566]. Distribution of subcortical WML was most frequent in frontal lobes [62.9%] followed by parieto-occipital regions [33.3%]. WML are a frequent finding on MRI brain of asymptomatic elderly individuals of either gender with periventricular WML having a statistically significant preponderance in males. IMEMR Current Contents Subject Index 17 Breast Neoplasms immunology The prognostic value of autotaxin activity and gene expression, matrix metalloproteinase-9 and p 53 antibodies in breast cancer patients. El Batch, Manal; Said, Soha; Farouk, Gihan; Abdel Hafez, Tamer E-mail:Manal El Batch@yahoo.com Tanta University - Medical biochemistry Department EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 257-272 (40 ref.) Keywords: Matrix Metalloproteinase 9-blood; Tumor Suppressor Protein p53-blood; Neoplasm Metastasis; Antibodies; Gene Expression Abstract: The aim of this study was to analyze changes in autotoxin [ATX] [both enzyme activity and gene expression], metalloproteinase-9 [MMP-9] and p53 antibodies [Abs] serum levels in breast cancer patients and to correlate their results with various clinical, pathological features of breast cancer. Sixty female breast cancer patients [ 42 with lymph node [LN] metastasis and 18 without LN metastasis] were included in this study and subjected to determination of ATX [both activity by colorimetric method and gene expression by RT-PCR] and both p53 Abs and MMP-9 by ELISA technique. Our results showed that there were statistically significant differences between breast cancer patients with and without LN metastasis in all the studied parameters except for p53 Abs. ATX [both activity and gene expression] and the serum levels of both MMP-9 and p53 Abs, were significantly different between different stages and grades of breast cancer patients with increasing activity and levels from stage I to IV and from grade I to III. Only ATX [both activity and expression] was significantly different between patients with tumor size less than or more than 5. There was a highly significant correlation between ATX activity and gene expression. The present study suggested that ATX activity, MMP-9 and p53Abs could serve as useful and convenient prognostic and detection markers of metastasizing breast cancer. Also, ATX activity may be used as an index for increased ATX gene expression. Bulinus parasitology The ecological differences between bulinus beccari, the intermediate host of schistsoma haematobium and biomphalaria pfeifferi the intermediate host of S. mansoni in Jazan Region, Saudi Arabia. Al Sheikh, Adel H.; Dagal, M.A. E-mail:adelalsheikh@gmail.com Ministry of Health - The National Centre for Training and Research [Tropical Diseases] - The General Directorate of Health Affairs Journal of the Egyptian Society of Parasitology 2011; 41 (3): 543-551 (26 ref.) Keywords: Schistosoma haematobium; Biomphalaria-parasitology; Schistosoma mansoni; Ecological and Environmental Phenomena Abstract: Bulinus beccari, intermediate host of Schistsoma haematobium, and Biotm-phalaria pfeifferi, intermediate host of S. mansoni have different geographical distribution in Jazan Region. The role of rain fall, ionic composition of water, water temperature and pH Grades were studied. Fluctuation of snail population densities were accompanied with corresponding fluctuation rates of rainfall. B. pfeifferi showed a wider and heavier shell than B. beccari, which might enable it to resist the effects of flash floods. B. beccari showed a higher tolerance of total dissolved solids and calcium carbonate than B. pfeifferi. Average maximum tolerated concentration of dissolved solids and calcium carbonate for B. beccari was 1254ppm and 813ppm, while that of B. pfeifferi was 455ppm and 603ppm. Average water temperature of B. beccari habitats was 25-36.3°C while that of B. pfeifferi was 25-28°C. No significant statistical difference in different pH grades was observed. IMEMR Current Contents Subject Index 18 CA-125 Antigen blood The diagnostic validity of pre-operative serum CA125 level in women with ovarian masses. Farnaz; Wahab, Samdana; Hassan, Lubna E-mail:farnaz_1410@hotmail.com Hayatabad Medical Complex - Department of Gynecology and Obstetrics Unit JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 73-78 (28 ref.) Keywords: Ovarian Neoplasms-diagnosis; Diagnosis, Differential; Predictive Value of Tests; Sensitivity and Specificity; Preoperative Care; Cross-Sectional Studies Abstract: To determine the validity of serum CA125 levels in differentiating benign and ovarian cancer in patients with ovarian masses, using histopathology as a gold standard. In this cross sectional study, blood samples were obtained from 85 women with ovarian masses who fulfilled the inclusion criteria and sent for the assay of serum CA125 levels. They were scheduled for elective surgery at Hayatabad Medical Complex Hospital between 1[st] April, 2009 and 31[st] March 2010. Of the 85 women enrolled, ovarian cancer was found in 27 cases [31.8%] and benign ovarian mass in 58 cases [68.2%]. The sensitivity, specificity, and accuracy of serum CA125 at the cutoff level of 35 U/mL for prediction of ovarian cancer were 74.14%, 92.5%, 80% respectively; with 95.56% positive predictive value and 62.5% negative predictive value. As stand-alone modality, serum CA125 of more than 35 U/mL in predicting ovarian cancer revealed modest diagnostic accuracy. Cancer Vaccines immunology In vitro-activated tumor-bearing host T cells and the effectiveness of tumor vaccine immunotherapy. Li, Qi ling; Gao, Shang feng; Wang, Yun ping; Ma, Jun; Feng, Cai xia; Wang, Ying; Wang, Yue ling E-mail:liqilinglady@163.com Xi'an Jiaotong University - The First Affiliated Hospital - Department of Gynecology and Obstetrics Annals of Saudi Medicine 2012; 32 (2): 162-168 (24 ref.) Keywords: Lymphopenia-chemically induced; CD4-Positive T-Lymphocytes-immunology; CD8-Positive T- Lymphocytes-immunology; Cyclophosphamide; Rats; Granulocyte Macrophage Colony-Stimulating Factors Abstract: Vaccination during periods of lymphopenia may facilitate immune responses to weak self-antigens and enhance antitumor immunity. The objective of this study was to determine the effectiveness of tumor vaccine immunotherapy combined with immune reconstruction using tumor-bearing host immune cells in lymphopenia, and to investigate the role of tumor-bearing host T cells activated in vitro during immunotherapy. Animal study conducted in the First Affiliated Hospital of Xi'an Jiaotong University from January 2009 to January 2010. Lymphopenia was induced by cyclophosphamide. A reconstituted immune system with different syngeneic lymphocytes was employed, including lymphocytes from naive rats [unsensitized group], tumor-bearing rats [tumor-bearing group], and tumor-bearing rats activated in vitro [activated group] . All rats were immunized with granulocyte-macrophage colony-stimulating factor [GM-CSF] -modified NuTu-19 ovarian cancer [GM-CSF/NuTu-19] cells. Tumor vaccine-draining lymph nodes [TVDLNs] were harvested, and then stimulated to induce effector T cells [T[E]]. T[E] were then adoptively transferred to rats bearing a 3-day pre-established abdominal tumor [NuTu-19], and the survival rate was calculated. Compared with the unsensitized group, the levels of interleukin-2 [IL-2] were significantly lower in the tumor-bearing group, whereas that of IL-4 were significantly higher [P<.05]. The number of CD4+T cells secreting interferon-gamma and the specific cytotoxicity of CD8+ cytotoxic T lymphocytes were significantly lower [P<.05]. The survival was significantly higher in the activated group compared with the other groups. Lymphocytes from tumor-bearing rats activated in vitro can effectively reverse the immunosuppressive effects of tumor-bearing hosts. IMEMR Current Contents Subject Index 19 Carbon Tetrachloride toxicity Effects of honey on carbon tetrachloride - induced kidney injury in adult male albino mice: light and electron microscopic study. Kamal, Ibrahim; Mohammed, Kawther; Kamal, Heba Al Azhar University - Faculty of Medicine - Department of Histology Assiut Medical Journal 2011; 35 (1): 103-128 (47 ref.) Keywords: Kidney-ultrastructure; Microscopy, Electron; Honey-utilization; Protective Agents; Treatment Outcome; Mice; Male Abstract: In the recent years, extensive research work has been focused on the use of natural antioxidants against the toxic oxidative materials to ameliorate their toxic and cell damaging effects. In people who had died after exposure to CC14, kidney failure was frequently reported as the main cause of death. Honey is one of the natural antioxidants. So, the present work aimed at the morphological and morphometric evaluation of the efficacy of honey on the carbon tetrachloride-induced kidney injury.Thirty adult male albino Sprague-Dawley mice were divided into three groups, each group consisted of 10 mice. Control group [group I] received olive oil subcutaneously [S.C.]; CCL4 group [group II] were injected S.C. with 0.3 % CCL4 dissolved in olive oil in a daily dose of 5ml/kg B. W. for 4 weeks. CCL4 + Honey group [group III] recieved both CCL4 and honey simultaneously daily for 4 weeks. The honey mixed with water and was given orally by gastric tube. The kidney specimens were processed for both light and electron microscopic examinations. Morphometric studies were also carried out. At L.M. level; carbon tetrachloride - induced degenerative changes in kidney cortex involved both corpuscles and tubules as well as inflammatory mononuclear cellular infiltration. By E.M.; thick interrupted glomerular basement membrane Morphometry showed significant changes of glomerulus, corpuscles and tubules. Honey effects were at L.M.; improvement of degenerative changes and inflammatory infiltration. At E.M; improvement of corpuscular and tubular changes. Morphometry showed better significant changes of glomerulus, corpuscles and tubules. Processed honey significantly reduced degenerative changes induced by CCL4 in the renal cortex on simultaneous administration. Carboxylesterase isolation and purification Purification and biochemical properties of carboxylesterase from fasciola gigantica. Hamdy, Soha M. Fayoum University - Faculty of Science - Biochemistry Division, Chemistry Department EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 427-444 (47 ref.) Keywords: Fasciola; Carboxylesterase-chemistry; Carboxylesterase-classification Abstract: Carboxylesterase was purified from Fasciola gigantica through ammonium sulfate precipitation, chromatography on DEAE-Sepharose and gel filtration on a sephacryl S300. Three enzymes [El, EII and EIII] were separated. EII and EIII were purified to homogeneity. The molecular weight of EII and EIII enzyme were 66 and 50 KDa, respectively as detected by gel filtration and SDS-polyacrylamide gel electrophoresis. EII and EIII had Km 1.3 and 1.7 mM of p-nitrophenyl acetate. Affinity of esterase EII and EIII decreased as increasing carbon atom number of the substrates. Esterase EII and EIII had optimum temperature at 40 °C. Esterase EII and EIII had pH optima at pH 7.5 in phosphate buffer and pH 8.0 in Tris-HCl buffer, respectively. Studying effect of metal ions on esterase EII and EIII indicated that Li[+], Mn[++], Ba[++] and Mg[++] had activation effect on each isoenzyme. An activation effects could be detected with Nethylmalimaide on EII and EIII]. The order of inhibition on EII was beta- mercaptoethanol > PMSF > DTNB > PCMB > iodoacetate. While the order of inhibition on EIII was beta-mercaptoethanol > iodoacetate > DTNB> PCM > PMSF. IMEMR Current Contents Subject Index 20 Carcinoma, Basal Cell diagnosis Sensitivity and specificity of BerEP4 immunostaining in basal cell carcinoma cases in Asian skin. Mashhood, Asher Ahmed; Sarfraz, Tariq; Atique, Mohammad; Asif, Mohammad E-mail:asher.mashhood@yahoo.com Military Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 423-426 (20 ref.) Keywords: Tumor Markers, Biological; Sensitivity and Specificity; Immunohistochemistry; Skin Neoplasms- diagnosis; Carcinoma, Squamous Cell-diagnosis; Biological Markers Abstract: To evaluate the BerEP4 stain positive cases of basal cell carcinoma in our population [BCC]. A non- interventional descriptive study. Military Hospital and Armed Forces Institute of Pathology [AFIP] Rawalpindi from 1[st] January 2009 to 31[st] August 2009. Patients who reported to the skin department of Military Hospital Rawalpindi with clinical impression of BCC were biopsied. Only those cases which were easily diagnosed on Haematoxylin and Eosin [HandE] were included. All such sections were then subjected to BerEP4 immune marker and the intensity of staining was noted. In addition, 11 cases of straight forward squamous cell carcinoma [SCC] were also stained with BerEP4, which served as controls. The study group [BCC cases] included 17 males [59%] and 12 females [41%], who were histologically diagnosed as BCC. All such cases were subjected to BerEP4 immune staining. All the tumors showed positive staining, the intensity/staining pattern was however variable. Twenty-two out of twenty-nine cases showed diffuse [75.9%], while 7 out of 29 cases showed partial [24.2%] staining; irrespective of the histological subtype and site of tumor. All the SCCs were negative for BerEP4 staining. BerEP4 was positive in 100% of the cases. Its intensity was however variable. Nevertheless, it must be used with confidence in all difficult to diagnose cases of BCC, especially when it is difficult to differentiate from SCC. Carcinoma, Hepatocellular diagnosis Saudi gelines for the diagnosis and management of hepatocellular carcinoma: technical review and practice guidelines created and endorsed by the saudi association for the study of liver diseases and transplantation and the Saudi oncology society. Abdo, Ayman A.; Hassanain, Mazen; ALJumah, AbdulRahman; Al Olayan, Ashwaq; Sanai, Faisal M.; Al Alsuhaibani, Hamad; Abdul Kareem, Huda; Abdallah, Khalid; Al Muaikeel, Mohammad; Al Saghier, Mohammad; Babatin, Mohammad; Kabbani, Monther; Bazarbashi, Shouki; Metrakos, Peter; Bruix, Jordi E-mail:aabdo@ksu.edu.sa King Saud University Liver Disease Research Center King Saud University - College of Medicine - Gastroenterology Unit, Department of Medicine Annals of Saudi Medicine 2012; 32 (2): 174-199 (215 ref.) Keywords: Carcinoma, Hepatocellular-pathology; Carcinoma, Hepatocellular-therapy; Practice Guidelines as Topic; Neoplasm Staging; Consensus; Risk Factors; Liver Transplantation; Ablation Techniques; Population Surveillance Abstract: Recognizing the significant prevalence of hepatocellular carcinoma [HCC] in Saudi Arabia, and the difficulties often faced in early and accurate diagnoses, evidence-based management, and the need for appropriate referral of HCC patients, the Saudi Association for the study of liver diseases and transplantation [SASLT] formed a multi-disciplinary task force to evaluate and update the previously published guidelines by the Saudi Gastroenterology Association. These guidelines were later reviewed, adopted and endorsed by the Saudi Oncology Society [SOS] as its official HCC guidelines as well. The committee assigned to revise the Saudi HCC guidelines was composed of hepatologists, oncologists, liver surgeons, transplant surgeons, and interventional radiologists. Two members of the task force served as guidelines editors. A wide based search on all published reports on all aspects of the epidemiology, natural history, risk factors, diagnosis, and management of HCC was performed. All available literature was critically examined and available evidence was then classified according to its strength. The whole document and the recommendations were then discussed in details by members and consensus was obtained. All recommendations in these guidelines were based on the best available evidence, but were tailored to the patients treated in Saudi Arabia. We hope that these guidelines will improve HCC patient care and enhance the multidisciplinary care needed for these patients. IMEMR Current Contents Subject Index 21 Cardiovascular Diseases economics An overview of the burden of non- communicable diseases in India. Upadhyay, R. Prakash E-mail:ravi.p.upadhyay@gmail.com All India Institute of Medical Sciences - Center for Community Medicine Iranian Journal of Public Health 2012; 41 (3): 1-8 (40 ref.) Keywords: Cardiovascular Diseases-epidemiology; Stroke-economics; Stroke-epidemiology; Diabetes Mellitus- economics; Pulmonary Disease, Chronic Obstructive-epidemiology; Cost of Illness; Prevalence; Risk Factors Abstract: Non-communicable disease continues to be an important public health problem in India, being responsible for a major proportion of mortality and morbidity. Demographic changes, changes in the lifestyle along with increased rates of urbanization are the major reasons responsible for the tilt towards the non-communicable diseases. In India, there is no regular system for collecting data on non-communicable diseases [NCDs] which can be said to be of adequate coverage or quality. Lack of trained health care workers, primary care providers armed with inadequate knowledge and skills along with ill-defined roles of various health sectors i.e. public, private, and voluntary sectors in providing care have played key hurdles in combating the growing burden of non-communicable diseases. Empowerment of the community through effective health education, use of trained public health personnel along with provision of free health care and social insurance would prove beneficial in effectively controlling the growing prevalence of NCDs. Caseins The effect of CPP-ACP paste on shear bond strength of glass ionomer to dentine. Moezzyzadeh, M.; Motamedi, S.H. Shahid Beheshti University of Medical Sciences - Dental School - Departemnt of Operative Dentistry Journal of Dental School - Shahid Beheshti University of Medical Sciences 2012; 29 (4): 260-267 (33 ref.) Keywords: Shear Strength; Dental Bonding; Acrylic Resins; Silicon Dioxide; Dentin; Molar, Third Abstract: CPP-ACP is one of the numerous materials which is used in dental hypersensitivity and works through changing Cagradient in tooth surface, besides glass ionomer is a selective material in restoring non -carious cervical lesions because of chemical bonding. In this study we evaluate the effect of CPP-ACO on shear bond strength of glass ionomer to dentine. In this experimental study, 40 third molar teeth were sectioned to obtain dentine with tubule orientation perpendicular to the surface. The specimens were divided into 4 groups [A to D].Groups A and B were treated with CPP-ACP paste for 60 min x 5 days. Groups A and C were treated with polyacrylic acid 10% for 20 min before glass ionomer adhesion. All specimens were bonded with glass ionomer. After 24 +/- 1 hours water storage, the bonded specimens were sectioned with universal testing machine. There was no significant effect in shear bond strength to dentine in groups except groups B.There was no significant effect in failaure pattern. Most of the failure patterns were adhesive mode. CPP-ACP application in dentine surface reduces the shear bond strength of glass ionomer except the preconditioning of dentine with polyacrylic acid 10%. Preconditioning in dentine surface nontreated with CPP-ACP paste, does not affect the shear bond strength of glass ionomer. Catheter-Ralated Infections prevention and control Alcoholic povidone-iodine or chlorhexidine-based antiseptic for the prevention of central venous catheter-related infections: In-use comparison. Girard, Raphaele; Comby, Christine; Jacques, Didier E-mail:raphaele.girard@chu-lyon.fr Hygiene and Epidemology Unite Journal of Infection and Public Health 2012; 5 (1): 35-42 (17 ref.) Keywords: Anti-Infective Agents, Local-therapeutic use; Chlorhexidine-therapeutic use; Povidone-Iodine-therapeutic use; Cross Infection-prevention and control; Catheterization, Central Venous-adverse effects; Anti-Infective Agents, Local-economics; Prospective Studies IMEMR Current Contents Subject Index 22 Abstract: To make a field comparison of the effectiveness, ease of use, and cost of a chlorhexidine antiseptic solution [CBA] and an alcohol-based povidone-iodine solution [PVP-IA] for the prevention of central venous catheter [CVC]-related infections in an intensive care unit, with the aim of identifying the superior antisepsis agent. We measured the CVC colonization and infection incidence for PVP-IA [Betadine alcoolique] and for CBA [Biseptine] during two successive 1-year periods of routine surveillance [REA RAISIN network]. A questionnaire on the ease of CBA use was administered. Consumption data were obtained from the hospital pharmacy. The study included 806 CVC [CBA period: 371]. Upon switching from PVP-IA to CBA, we recorded a significant reduction in colonization incidence/100 catheter days [1.12 vs. 1.55, p = 0.041], nonsignificant differences concerning CVC-related infection incidence/100 catheter days [0.28 vs. 0.26, p = 0.426], and a nonsignificant reduction in CVC-related bacteremia/100 catheter days [0.14 vs. 0.30, p = 0.052]. PVP-IA users were at significantly higher risk of CVC colonization or infection based on a multivariate Cox model analysis [relative risk [95% Cl]: 1.48 [1.01-2.15], p = 0.043]. The main drawbacks of CBA use were its low cleansing activity and its colorless solution. No cost advantage was found. Our field study revealed no major clinical advantage of CBA use in CVC infection and no cost advantage in addition to limited ease of use. 2011 Published by Elsevier Limited on behalf of King Saud Bin Abdulaziz University for Health Sciences. All rights reserved. Catheterization, Central Venous adverse effects Complications of PORT-A-CATH in patients with sickle cell disease. Alkindi, Salam; Matwani, Samaa; Al Maawali, Alghalia; Al Maskari, Buthaina; Pathare, Anil E-mail:sskindi@yahoo.com Sultan Qaboos University - College of Medicine and Health Sciences - Department of Hematology Journal of Infection and Public Health 2012; 5 (1): 57-62 (19 ref.) Keywords: Catheter-Related Infections-etiology; Cross Infection-etiology; Anemia, Sickle Cell-complications; Exchange Transfusion, Whole Blood-instrumentation; Sepsis-etiology; Thrombosis-etiology; Retrospective Studies Abstract: Red cell exchange/transfusion is frequently used in the management of patients with medical complications related to acute severe sickle cell disease [SCD]. However, peripheral venous access is often difficult without central venous catheters [CVCs] in adult patients with moderate or severe SCD. To review our experience with the use of the PORT-A-CATH device in sixteen patients with SCD undergoing exchange or simple transfusions. Among a cohort of 550 patients who frequently visited the inpatient service, sixteen SCD patients required the insertion of a PORT-A-CATH device. These patients included 3 males and 13 females, aged 25-44years [31.1 +/- 2.3; mean +/- [SD]. A total of 24 PORT-A-CATH devices were implanted in these 16 patients during the study period. Eleven patients had 1 device implanted, three patients had 2 devices, one patient had 3 devices, and one patient had 4 devices implanted. Out of the 24 devices implanted, 17 required removal, due to either infection associated with sepsis and/or thrombosis. The organisms involved were Candida spp. [3], C. Parapsilosis [2], C. albicans [1], C. famata [1], C. lusitanice [1], Staphylococcus spp. [6], and S. aureus [3], as well as the coagulase-negative Staphylococcus [2], alpha hemolytic Streptococcus [1], Diphtheroidbacilli [2], Pseudomonas aeruginosa [2], Ps. Spp. [3], Escherichia coli [3], Klebsiella oxytoca [1], Klebsiella pneumoniae [1], Klebsiella spp. [1], Serratia liquefaciens [1], Serra-tia fanticola [1], Achromobacter spp. [2] Chromobacterium violaceum [1], Delftia acidovirans [1], Stenotrophomonas maltophile [1], Alcaligenes faecalis [1], and Enterobacter cloacae [1]. Two episodes of documented thrombosis were observed. Catheterization, Peripheral adverse effects Peripherally inserted central catheter bloodstream infection surveillance rates in an acute care setting in Saudi Arabia. Al Tawfiq, Jaffar A.; Abed, Mahmoud S.; Memish, Ziad A. E-mail:jaffar.tawfiq@aramco.com Internal Medicine Unit Annals of Saudi Medicine 2012; 32 (2): 169-173 (26 ref.) Keywords: Cross Infection-epidemiology; Cross Infection-etiology; Sepsis-epidemiology; Sepsis-etiology; Sepsis- microbiology; Prospective Studies IMEMR Current Contents Subject Index 23 Abstract: Peripherally inserted central venous catheters [PICCs] are alternatives to short-term central venous catheters and provide intravenous access in the acute hospital setting. In this study, we describe the rate of PICC- associated bloodstream infections [BSI]. Prospective cohort study using data on PICC lines reviewed from January to December 2009. The infection control team was responsible for prospective BSI case findings. The infection rate was calculated per 1000 device-days. During the study period, 92 PICC lines were inserted with a total of 3336 device-days of prospective surveillance. The most frequent reasons for the insertion of the PICC lines were chemotherapy [n=19, 20.7%], intravenous antimicrobial therapy [n=34, 37%], and for patients in the medical intensive care unit [ICU] [n=16, 17.4%]. The overall BSI rate was 4.5/1000 PICC days. The PICC line-associated BSI rates for a specific indication were as follows: chemotherapy 6.6/1000 device-days, intravenous antimicrobial therapy 1.2/1000 device-days, medical ICU 7.3/1000 device-days, surgical ICU 4.6/1000 device-days, and total parental nutrition patients 2.4/1000 device- days [P<.001]. The rates were not adjusted for patient severity of illness. Our data suggest that underlying conditions and indications for the PICC line use may play an important role in the development of BSI. Cell Differentiation genetics Osteogenic gene expression in osteoblastic differentiation of human mesenchymal stem cells. Ashki, M.; Amirizadeh, N.; Jalili, M.A.; Roudbari, N. Hayati; Mohammadi, M.H.; Amani, M. Islamic Azad Univetrsity - Science and Research Branch Scientific Journal of Iranian Blood Transfusion Organization Research Center [The] 2012; 8 (4): 251-264 (62 ref.) Keywords: Osteoblasts; Mesenchymal Stem Cells; Gene Expression; Osteopontin-genetics; Osteocalcin-genetics Abstract: During differentiation of mesenchymal stem cells [MSCs] into various cells, the expression of a variety of genes undergoes some changes; in this study we decided to investigate the expression rate of some genes like osteopontin [OPN] and osteocalcin [OCN] during this process in order to find a better and faster way for these cells to be differentiated into osteoblasts. In this experimental study, the mononuclear cells of bone marrow were separated and then cultured in DMEM-LG culture media with 10% FBS. During some definite days, the RNA of differentiating cells was extracted. Then, the effective genes in osteogenesis like OPN and OCN were amplified by speciefic primers. The mesenchymal cells were cultured on 3D calcium phosphate scaffolds, and finally the activity rate of the alkaline phosphatase was examined. This research has demonstrated that in the process of differentiation, the expression of the two genes of OPN and OCN changed orderly with the maximum expression of OPN in the 6th day and the maximum expression of OCN in the 7th and 8th days of differentiation. The osteogenic differentiation of MSCs was not confirmed by the coloration of mineral sediments. The activity rate of alkaline phosphatase revealed the preference of 3D calcium phosphate scaffold to 2D environment in this differentiation. The calcium phosphate scaffold positively affects the differentiation process. The expression of OPN and OCN genes changes during differentiation and can be used as away to a better and faster differentiation of these cells into osteoblast. Chewing Gum Role of gum chewing on the duration of postoperative ileus following lleostomy closure done for typhoid ileal perforation: a prospective randomized trial. Marwah, Sanjay; Singla, Sham; Tinna, Pradeep E-mail:drsanjay.marwah@gmail.com Postgraduate Institute of Medical Sciences - Department of Surgery Saudi Journal of Gastroenterology [The] 2012; 18 (2): 111-117 (30 ref.) Keywords: Ileus-therapy; Postoperative Complications; Ileostomy-adverse effects; Typhoid Fever-complications; Typhoid Fever-surgery; Treatment Outcome Abstract: There is ample evidence in the recent literature that gum chewing after elective colonic anastomosis decreases postoperative ileus [POI]. But there are very few studies on small bowel anastomosis done in relaparotomy cases. This study aimed to evaluate the effect of gum chewing on the duration of POI following small bowel anastomosis performed for the closure of intestinal stoma, made as temporary diversion in the selected cases of typhoid perforation peritonitis. Hundred patients undergoing elective small bowel anastomosis for the closure of stoma were randomly assigned to the study group [n=50] and the control group [n=50]. The study group patients chewed gum thrice a day for 1 h each time starting 6 h after the surgery until the passage of first flatus. The control group patients had standard postoperative treatment. Study and control group patients were comparable at inclusion. The mean time for the appearance of bowel sounds as well as the passage of first flatus was significantly shorter in the study group [P=0.040, P=0.006] . The feeling of hunger was also experienced earlier in study group cases [P=0.004]. The postoperative hospital stay was shorter in the study group, but the difference was not significant [P=0.059]. The cases IMEMR Current Contents Subject Index 24 of relaparotomy requiring additional adhesiolysis and small bowel anastomosis for stoma closure are benefited by postoperative gum chewing. Chickens Effect of the colour of feeders and drinkers on development of some maintenance behaviors in newly hatched chicken. Mahmoud, Motamed Elsayed; Dosoky, Reem Mahmoud; Ahmed, Moustafa Mohamed Assiut University - Faculty of Veterinary Medicine - Department of Animal Hygiene Assiut University Bulletin for Environmental Researches 2011; 14 (2): 1-11 (31 ref.) Keywords: Animal Feed; Color; Behavior, Animal Abstract: Colors of long wave lengths and color contrast can increase the responsiveness of chicken to stimuli. This study was designated to assess the effect of feeders and drinkers colors and their contrast on ingestion rate and development of some maintenance behaviors. This study includes z Experiment I: effect of different colors of feeders and drinkers on rates feeding rates and water intake during 6 weeks rearing period was examined in Ross broiler chicken. Experiment II: assessment of the effect of color contrast of feeders and drinkers with the floor on development of maintenance behaviors in newly hatched chicken. The results indicated that red colored feeders and drinkers increased the feed and water intake rates during the first week post hatching [P < 0.05]. But no such effect was observed in older ages. In addition, the presence of color contrast feeders and drinkers with the floor enhanced the appearance of certain behaviors necessary for survival in newly hatched chicks. Red colored feeders and drinkers attracted chicks, increased ingestion rate and color contrast accelerated the development of some maintenance behaviors and decreased distress calls. Thus using red colors and presence of contrast environment could enhance the development of maintenance behaviors in newly hatched chicken. Estimation of sensible heat loss in capsaicin- desensitized chicken after exposure to disruption of thermal homeostasis. Mahmoud, Motamed Elsayed; Dosoky, Reem Mahmoud; Ahmed, Moustafa Mohammed; Takewaki, Tadashi Gifu University - The United Graduate School of Vet.Sciences - Department of Basic Vet.Science, Laboratory of Physiology Assiut University Bulletin for Environmental Researches 2011; 14 (2): 57-68 (24 ref.) Keywords: Capsaicin; Homeostasis; Body Temperature Regulation Abstract: Thermal conditioning in newly hatched chicken is of great importance. Induction of thermotolerance to cold, heat and disrupted thermal balance is one of the most important managemental tools used to improve survival in chicken. It is well known that chicken is in sensitive to capsaicin [main ingredient of hot chilli peppers] due to insensitivity of transient membrane potential of vanilloid subtype-1 [TRPV1] receptors to capsaicin. These receptors are responsible for perception of pain burning sensation and thermoregulation in mammals. Owing to the capsaicin's availability as an rodent repellent function in poultry ration and its preference by many birds, we investigated the mechanism of thermoregulation of capsaicin in chicken. To interpret the phenomenon of thermotolerance in capsaicin [CAP] desensitized chicken and to study its effect on sensible heat loss mechanisms in newly hatched chicks. In this study, chicken were treated intravenously [IV] in wing vein once with CAP [10 mg/kg, body weight] at 1[st], 2[nd] and 3[rd] days of age. Then after one week from CAP- pretreated chicken were exposed to cold [8°C], heat [38°C] or injected with lipopolysacharide [LPS; outer memebrane of Gram negative bacteria]. LPS at a low dose [1 mg/kg, body weight, IV] induce fever or at a high dose [10 mg/kg, IV] to induce hypothermia. Surface [skin of back] and colonic temperatures were measured to calculate heat loss index [HLI] as an indicator to the sensible heat loss. The HLI was 0.95 in control non-treated chicken at ambient temperature [Ta 25°C]. In CAP-desensitized chicken HLI was increased to a maximum of 0.97 at Ta 38°C and up to 0.99 at climax of fever induced by LPS. The controversial finding was observed in chicken exposed to cold; HLI in CAP-desensitized chicken was not increased but reduced to 0.94, however no such effect of capsaicin at nadir of hypothermia induced by high dose of LPS. CAP-sensitive receptor [Transient membrane potential of vanilloid subtype-l;TRPVl]-independent pathway may exert a thermoregulatory role during heat and cold exposure, and in LPS-induced fever in part through affecting sensible heat loss in chicken. IMEMR Current Contents Subject Index 25 Child Abuse, Sexual statistics and numerical data RE: Reported child sexual abuse in Bahrain: 2000-2009. Al Mendalawi, Mahmood D. E-mail:mdalmendalawi@yahoo.com Baghdad University - Al Kindy College of Medicine - Department of Pediatrics and Child Health Annals of Saudi Medicine 2012; 32 (2): 213 (4 ref.) Keywords: Incidence; Awareness; Child Abuse, Sexual-prevention and control Child Mortality Child mortality rate in ethiopia. Susuman, A. Sathiya E-mail:sappunni@uwc.ac.za University of the Western Cape - Department of Statistics Iranian Journal of Public Health 2012; 41 (3): 9-19 (27 ref.) Keywords: Infant Mortality; Breast Feeding; Health Surveys; Demography; Mothers; Ethiopia; Vital Statistics Abstract: Ethiopia's childhood mortality has continued to decline although at a swift pace. The drop in urban childhood mortality decline, duration of breastfeeding is the principle reason for the overall decline in mortality trends in Ethiopia. Data from the Ethiopian Demographic and Health Surveys 2000 and 2005 were used. Indirect estimation of Brass and Trussell's methods were adopted. Selected demographic and socio-economic variables were included in the analysis with statistically significant effects. Findings clearly show neonatal and post neonatal mortality decline gradually. Even though, Ethiopia's childhood mortality rates are still high. The result shows less than 2 years birth interval have higher infant mortality rates than higher birth interval [113 deaths per 1000]. The proper spacing of births allows more time for childcare to make more maternal resources available for the care of the child and mother. Therefore, further research is urgent for regional level and national level investigation. Cholecystectomy, Laparoscopic Single incision tans-umbilical laparoscopic cholecystectomy using conventional laparoscopic instruments: initial experience of single institute. Hassan, Ahmed Mohamed Abdel Aziz; Hedaya, Mohamed Saied; Nasr, Magid Mahmoud; Nafeh, Ayman Ihab; Elsebae, Magdey Mohamed E-mail:ahmedelmaghney@yahoo.com Theodor Bilharz Research Institute - Department of General Surgery Journal of the Egyptian Society of Parasitology 2011; 41 (3): 675-684 (27 ref.) Keywords: Postoperative Complications; Length of Stay; Esthetics Abstract: Laparoscopic cholecystectomy [LC] had been considered the gold standard treatment for symptomatic gall bladder [GB] stones. Single incision laparoscopic cholecystectomy [SILC] was emerged as a less invasive alternative with better cosmesis and less post operative pain. This study evaluated the feasibility, safety, advantages and complications of SILC using the conventional laparoscopic instruments. A total of 52 patients [47 females and 5 males] with symptomatic GB stones underwent elective SILC using the conventional laparoscopic instruments. The mean operative time was 61.75 min and the mean estimated blood loss was 17.21 ml. Gall bladder perforation occurred in 5 cases [9.6%] in which 3 cases calculi spillage occurred. Troublesome cystic artery bleeding occurred in 2 cases [3.8%] while gall bladder bed bleeding happened in 1 case [1.9%]. An intraoperaive cholangiogram was performed in 3 cases and a drain was inserted in one case. No conversions of the technique occurred. 49 patients discharged in the first post operative day and 3 patients [5.8 %] in the 2nd day. Three month post-operative wound length was an average of 1.58 cm while patient satisfaction of the surgery was an average of 9.32. IMEMR Current Contents Subject Index 26 Chronic Disease epidemiology Five-year evaluation of chronic diseases in Hamadan, Iran: 2005-2009. Poorolajal, J.; Zamani, R.; Moeini, R.S. Mir; Amiri, B.; Majzoobi, M.M.; Erfani, H.; Bathaei, S.J. E-mail:poorolajal@umsha.ac.ir Hamadan University of Medical Sciences - School of Public Health - Research Center for Health Sciences and Department of Epidemiology and Biostatistics Iranian Journal of Public Health 2012; 41 (3): 71-81 (13 ref.) Keywords: Risk Factors; Prevalence; Cross-Sectional Studies; Smoking-adverse effects; Body Mass Index; Lipids- blood Abstract: Now the increasing growth of chronic diseases is the major health challenge worldwide. This survey was conducted to assess noncommunicable diseases related risk factors. A population-based cross sectional study was conducted in 2005 and repeated annually by 2009 in Hamadan province, the west of Iran using two-stage cluster sampling method. A total sample of 6500 subjects 15 to 64 years old were enrolled. The total prevalence of cigarette smoking was 18% [95% CI 17% to 19%], 35.1% in men versus 1.1% in women. The smokers consumed on average 15 cigarettes per day. Almost 26.3% [95% CI 24.8% to 27.7%] of the target population eat five or more servings of fruits and vegetables per day; 52.8% [95% CI 51.2% to 54.3%] had work related physical activity; 28.1% [95% CI 26.7% to 29.4%] had physical activity during leisure time; 80.3% [95% CI 79.0% to 81.5%] had transportation related physical activity; 47.2% [95% CI 46.0% to 48.4%] were either overweight or obese; 8.1% [95% CI 7.1% to 9.2%] had impaired fasting blood sugar or were confirmed diabetes; 33.7% [95% CI 31.9% to 35.5%] had hypercholesterolemia; and 15.6% [95% CI 13.0% to 18.3%] had hypertriglyceridemia. There was a statistically significant association of age and gender with body mass index, systolic and diastolic hypertension, hyperglycemia, hypercholesterolemia and hypertriglyceridemia. The evidences of the present survey promise a silent progressive epidemic of chronic diseases among Iranian citizens that may lead to an increasing growth of noncommunicable diseases in the next decade. Cichlids parasitology Parasite community of wild and cultured oreochromis niloticus from lake Manzalah, Egypt. Ibrahim, Mohamed M.; Soliman, Maha F.M. E-mail:mmossa77@yahoo.com Suez Canal University - Faculty of Science - Department of Zoology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 685-697 (40 ref.) Keywords: Fishes; Protozoan Infections; Prevalence; Body Size Abstract: A total of 323 O. niloticus [168 wild fishes and 155 cultured fishes] were collected from Lake Manzala, Egypt from July to September 2010. The fish samples were examined for both ectoparasites and endoparasites. The parasite community of wild and cultured, O. niloticus consisted of ten parasitic species, one protozoon [Trichodina spp.], six monogenea [Cichlidogyrus sclerosus, C. thurstonae, C. hallitypicus, C. tilapiae, C. ergensi, C. tiberianus], one acanthocephalan [Acanthogyrus [Acanthosentis] tilapiae] and two crustacean species [Lernaea cyprinacea and Ergasilus sp.]. Mean parasite species richness significantly differed between wild [4.9 +/- 0.3] and cultured [6.6 +/- 0.8]. The overall prevalence of infection in cultured O. niloticus [54.84%] was significantly higher as compared to that in wild fish [39.9%]. The most prevalent parasite was C. thurstonae [37.46%] and C. sclerosus [35.91%] while the less prevalent one was Ergasilus sp. [14.55%]. Host sex and host body size significantly affect parasitism in most parasite species. Cleft Palate Frequency of fistula formation after two stage repair of cleft palate. Shah, Syed Asif; Khan, Firdous; Bilal, Mohammad Khyber Teaching Hospital JKCD - Journal of Khyber College of Dentistry 2011; 2 (1): 27-31 (25 ref.) Keywords: Cleft Lip; Oral Fistula; Fistula; Postoperative Complications; Treatment Outcome IMEMR Current Contents Subject Index 27 Abstract: To estimate the frequency of fistula formation after two stage repair of cleft palate. A total of 50 patients having completed cleft palate repair with or without lip repair were recruited from December 2007 to February 2009. Patients were diagnosed on history and oral examination. Informed consent was taken from parents. Width of the cleft measured preoperatively. Two stage repairs were done by a single surgeon with a time lapse of six months. Five patients developed clinically significant oronasal fistula. All these fistulas occurred at the junction of hard palate and soft palate within 3 weeks time. The overall rate of true fistula development was 12% over a mean follow up period of 6 months. The incidence of true fistulas that were symptomatic and subsequently required surgical repair was 10%. Fistula rates were higher for more wide clefts but were not affected by gender or age. Cobra Cardiotoxin Proteins isolation and purification Isolation of a cytolytic component from Naja nigricollis nigricollis [spitting cobra] venom. Gaber, Dalia; Basheer, Ayman; Zaki, Kamelia; El Asmer, M. Farid E-mail:dr_do99@yahoo.com Misr University for Science andTechnology - Faculty of Medicine - Biochemistry Department EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 407-426 (33 ref.) Keywords: Hemolytic Agents; Cytotoxins-therapeutic use; Antineoplastic Agents Abstract: A cytolytic compound [Vlb] was isolated by fractionation of crude venom from Egyptian Cobra Snake, Naja nigricollis nigricollis using Sephadex G-75, followed by CM- Sephadex. The isolated protein has a cytolytic effect on red cells, stable at different temperatures [25 °C-100°C] and at different pH ranges [5-9]. It is partially pure as indicated by SDS-PAGE, with molecular weight approximately 10 kDa. It has no protease or phospholipase activity. It is a glycoprotein, with maximum absorbance at 280nm. It is non antigenic, with LD50 1.83 mg/ kg body weight. DNA extraction from mouse liver tissue and from hepatocellular carcinoma cell line [HEPG2] gave a single intact band after invitro incubation with Vlb, indicating that apoptosis is not involved in the cytotoxic mechanism. Small doses of Vlb induced lysis in breast, colon and hepatocellular carcinomas cell lines in tissue culture plates. Collagen Diseases pathology Intestinal lymphangiectasia in a patient with infantile systemic hyalinosis syndrome: a rare cause of protein-losing enteropathy. Alreheili, Khalid; Al Mehaidib, Ali; Alsaleem, Khalid; Banemi, Mohammad; Aldekhail, Wajeeh; Al Mayouf, Sulaiman M. King Faisal Specialist Hospital and Research Centre - Department of Pediatrics, Sections of Gastroenterology Annals of Saudi Medicine 2012; 32 (2): 206-208 (11 ref.) Keywords: Hyalin-metabolism; Protein-Losing Enteropathies-etiology; Diarrhea-etiology; Diarrhea-diagnosis; Syndrome; Lymphangiectasis, Intestinal-diagnosis Abstract: Infantile systemic hyalinosis [ISH] is a rare autosomal recessive disease. Typically, ISH patients present with progressive painful joint contractures, intractable diarrhea, hyperpigmented skin lesions, and perianal fleshy nodules. We report a case of a 19-month-old male child with atypical ISH presentation. His main clinical finding was protein-losing enteropathy due to intestinal lymphangectasia. This report is intended to enhance awareness about the gastrointestinal tract presentation of ISH. Colorectal Neoplasms complications Liver metastases in Egyptian patients with colorectal cancer: incidence and clinico-pathological predictors. El Wakil, Hesham M.; Ali Eldin, Fatma A.; Bakir, Amal S.M.; Abdel Kader, Nadia A.; Ellithy, Mahmoud A. E-mail:elsersy_n_a@yahoo.com Ain Shams University - Faculty of Medicine - Department of Clinical Oncology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 593-600 (19 ref.) IMEMR Current Contents Subject Index 28 Keywords: Neoplasm Metastasis; Carcinoembryonic Antigen-blood; CA- 19-9 Antigen-blood; Incidence; Prospective Studies Abstract: Carcinoma of the large bowel is the fourth commonest cancer worldwide. The most frequent site for metastasis is the liver. Overall 30% of patients develop liver metastasis during the course of their illness; of these, 23% to 47% are synchronous lesions. These data are based on western studies. No data are published on patients with colorectal cancer from Egypt. We aimed to assess the incidence of colorectal liver metastasis in Egyptian patients and to evaluate the differences in the clinico-pathological features and tumor behavior in patients with and without liver metastasis. One hundred forty eight patients were prospectively enrolled in the study. Patients were classified into metastatic group [n=78] and non metastatic group [n=70]. In the two groups macroscopic features compared including: tumor size [2 cm, 2-5 cm, and >5 cm], site of primary tumor, side of liver involved, clinical symptoms and liver profile. Carcinoembryonic antigen [CEA] and cancer antigen [CA19.9] levels were recorded. At microscopy, tumor differentiation, invasion and nodal status were evaluated. No difference was found in the distribution of the primary site and size of the tumor. Jaundice, hepatomegaly and ascites were significantly higher in patients with liver metastases. Patients with liver metastasis had higher levels of CEA, CA19.9, higher frequency of vascular invasion and nodal involvement. Common Bile Duct Neoplasms pathology Non-familial double malignancy of the colon and ampulla of vater: a case report and review of literature. Rajalingam, Rajesh; Javed, Amit; Gondal, Ranjana; Arora, Asit; Nag, Hirdaya H.; Agarwal, Anil K. G. B. Pant Hospital and Maulana Azad Medical College - Departments of Gastrointestinal Surgery and Pathology Saudi Journal of Gastroenterology [The] 2012; 18 (2): 143-145 (13 ref.) Keywords: Common Bile Duct Neoplasms-surgery; Colonic Neoplasms-pathology; Ampulla of Vater; Neoplasms, Multiple Primary-surgery; Colonic Neoplasms-surgery; Treatment Outcome Abstract: Apart from their association in familial and hereditary cancer syndromes, sporadic double malignancies of the gastrointestinal tract involving the ampulla of Vater and colon are extremely rare. Although synchronous resection of the two by adding a colectomy to a pancreaticoduodenctomy can be accomplished with minimal increase in the surgical morbidity, a few patients, however, are best managed by a staged resection. We report a case of sporadic double malignancy of the ampulla of Vater and right colon who despite the best attempts continued to bleed and remained malnourished and was successfully managed by staged right hemicolectomy followed by a pancreaticoduodenectomy. Competency-Based Education Determining and prioritizing competencies in the undergraduate internal medicine curriculum in Saudi Arabia. Almoollim, H. E-mail:hanialmoallim@hotmail.com Umm Alqura University - Medical College - Department of Medicine EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 656-662 (16 ref.) Keywords: Education, Medical, Undergraduate; Internal Medicine; Curriculum; Students, Medical; Knowledge Abstract: To determine knowledge and skills competencies in internal medicine for the undergraduate curriculum in Saudi Arabia, competencies were identified based on group work utilizing common textbooks. The Delphi Technique was used as a consensus method to determine and prioritize competencies in internal medicine. A group of 20 clinicians rated the identified competencies from 0-3 [0: no need to know, 1: interesting to know, 2: should know and 3: must know]. After formulating the results, a second Delphi round was conducted with 5 experts in internal medicine. A total of 1513 knowledge competencies and 189 skills competencies were determined and prioritized. The competencies corresponded to the 12 systems in internal medicine. All competencies rated 2.2-3.0 were produced separately and considered core competencies for the undergraduate internal medicine curriculum. Determining and prioritizing competencies should influence the curriculum reform process. IMEMR Current Contents Subject Index 29 Constipation etiology Etiological factors of constipation in the elderly, with emphasis on functional causes. Amir, A.A. E-mail:abdalaal.amir@yahoo.com University of Ahfad - Department of Medicine EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 708-711 (4 ref.) Keywords: Constipation-diagnosis; Disease Management; Constipation-diet therapy; Constipation-drug therapy; Laxatives-therapeutic use; Dietary Fiber Abstract: Constipation is a particularly troublesome complaint in the elderly yet it is usually considered to be a simple management issue. Therefore physicians' lack of interest in and inadequate training about the etiology of constipation may contribute to their inability to manage the problem of constipation effectively. Constipation can become a chronic problem, refractory to management, and most likely the result of lifelong patterns of bowel and dietary habits and laxative use, along with the interaction of pathophysiological and perhaps senescent changes of gut motility. This article reviews the types and causes of constipation and the management of the problem in the elderly. Coronary Angiography methods Left radial artery approach for coronary artery intervention. Zafar Ul Islam; Iqbal, Tahir; Javed, Asim Armed Forces Intitute of Cardiology PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 336-339 (10 ref.) Keywords: Radial Artery; Coronary Vessels; Verapamil Abstract: To determine the success rate of left radial artery approach for coronary intervention. Descriptive study. Armed Forces Institute of Cardiology/ National Institute of Heart Diseases Rawalpindi. Study Period spanned from 15 January 2010 to 15 July 2010. The study was conducted on a total of 41 patients, out of these 41 patients, 25[61%] had undergone diagnostic coronary angiography using left radial artery approach and 16[39%] underwent percutaneus coronary intervention. Left radial artery route was selected after Positive Allen Test. Injection Verapamil 5mg was given through side connection of radial artery sheath to prevent spasm. No conversion to femoral artery route was done, establishing 100% success rate, without any bleeding or haematoma. Left radial artery approach for coronary angiography and percutaneus intervention in convenient and safe for the patient and almost free from major access site complication. Coronary Artery Bypass methods Surgery for chronic total occlusion of the left main coronary artery. Yu, Lei; Gu, Tianxiang; Shi, Enyi; Jiang, Chunli China Medical University - The First Affiliated Hospital - Department of Cardiac Surgery Annals of Saudi Medicine 2012; 32 (2): 156-161 (30 ref.) Keywords: Myocardial Ischemia-surgery; Treatment Outcome; Extracorporeal Circulation; Length of Stay; Myocardial Contraction; Retrospective Studies Abstract: Chronic total occlusion of the left main coronary artery [LMCA] is a rare condition, and the information on surgical experiences is limited. Although total occlusion of the LMCA is accompanied by well-developed collateral circulation, the condition of circulation is unstable during manipulation of the heart. We report our experience with revascularization in cases with total occlusion of the LMCA using the on-pump beating-heart [OnP-BH] technique. Retrospective case review of patients treated at The First Affiliated Hospital of China Medical University over a 10-year period [1999 to 2009]. The on-pump coronary artery bypass grafting with the beating heart was applied to 8 patients with chronic total occlusion of the LMCA. The extracorporeal circulation period, intubation duration, intensive care unit stay period, discharge period, preoperative and postoperative treatments, and follow-up were observed. The mean IMEMR Current Contents Subject Index 30 extracorporeal circulation period was 80.4 [19.7] minutes. The mean intubation duration was 13.0 [4.6] hours. The mean intensive care unit stay period was 3.2 [0.7] days, and the mean discharge period was 16.8 [3.3] days. No perioperative myocardial infarction occurred. The mean follow-up period was 50.9 [34.8] months. All patients were asymptomatic, and no deaths were recorded during the follow-up period. The results of echocardiography showed improvement in the left ventricular function. The OnP-BH myocardial revascularization seems to be a valid alternative for chronic total occlusion of the LMCA. utilization Coronary artery bypass graft operation: the start and early experience of Assiut university hospital. Elhaish, Mahmoud Khairy; Kaoud, Sayed; Abdallah, Esam Eldin M. Assiut University - Faculty of medicine - Cardiothoracic Surgery Department Assiut Medical Journal 2011; 35 (1): 153-160 (11 ref.) Keywords: Hospitals, Teaching; Risk Factors; Outcome and Process Assessment [Health Care] Abstract: Coronary artery bypass grafting [CABG] surgery has been successfully introduced at Assiut university hospital. The purpose of this study was to encourage recommend other starting centers to do this by pass. In the initial feasibility trial 60 patients were selected to receive CABG, between January 2009 and December 2010, 55 of them underwent CABG with cardiopulmonary bypass and 5 patients were submitted to beating heart CABG. All patients were symptomatic for angina before surgery and had single or multivessel coronary artery disease. Overall the calculated preoperative risk for both groups was indicated by EUROSCORE. The patients were evaluated during operation, immediately postoperative during hospital stay by hemodynamic monitoring, serial ECGs, cardiac enzymes and echocardiography. Among 130 distal anastomoses, 55 were fashioned with single internal thoracic artery to bypass Left anterior descending artery [LAD] and 5 with radial artery to bypass left coronary branches. Saphenous vein was used in the remaining 70 anastomoses. A complete myocardial revascularization was achieved; an average of 2 grafts/patient was performed. There were two postoperative strokes [3%] and one case of renal impairment [1.7%]. Mean ICU and in patient-hospital length of stay were 3.4 +/- 2.2 and 11.9 +/- 5.8 days, respectively. Off pump coronary artery bypass grafting is an alternative method to conventional bypass grafting. As it is indicated in single vessel coronary disease, renal impairment and calcified aorta. In the overall, CABG surgery significantly had low incidence of complications resulting in a shorter ICU stay, hospital stay and lower mortality. Coronary artery bypass graft surgery in Assiut university hospital is well established technique with accepted results. The doctors at the hospital are dedicated to introduce new procedures for better treatment and quick recovery. Coronary Artery Disease Evaluation of stable coronary artery disease by multiple cardiac biomarkers. Khan, Dilshad Ahmed; Saeed, Mariam; Khan, Farooq Ahmed E-mail:dilshad56@yahoo.com Armed Forces Institute of Pathology - Pathology Department PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 391-396 (20 ref.) Keywords: Coronary Disease; Biological Markers; Atherosclerosis; C-Reactive Protein-diagnostic use; Peroxidase- diagnostic use; Pregnancy-Associated Plasma Protein-A-diagnostic use Abstract: Effective management of stable coronary artery disease [SCAD] relies on early detection of coronary atherosclerosis. The objective was to evaluate diagnostic accuracy and risk stratification of SCAD patients by high sensitivity C reactive protein [hs CRP], Myeloperoxidase [MPO] and Pregnancy Associated Plasma Protein-A [PAPP- A]. validation study was conducted at Pathology Department of the Army Medical College, in collaboration with Armed Forces Institute of Cardiology [AFIC/NIHD] Rawalpindi. Total 122 subjects consisting of 61 patients of SCAD and 61 angio-negative controls were included. The levels of biomarkers were measured before angiography by using kits provided by Siemens [UK] for hs CRP and Abbott for MPO on Immulite 1000 and Architect Analyzer respectively, whereas serum PAPP-A was measured by an ELISA based method using kit provided by IBL Germany. The mean age of the patients was 56.57 +/- 8.35 years and consisted of 53 [86.9%] males and 8 [13%] females. Area under curve [AUC] and 95% CI of hs CRP 0.817 [0.736-.881] was significantly higher than that of MPO 0.685 [0.594-0.766] [p=0.018] and PAPP-A 0.565 [0.472-0.655] [p<0.001] for the diagnosis of SCAD. Patients in the highest quartile of PAPP-A were at the highest risk for adverse events as PAPP-A had the highest Hazard Ratio [HR] of 3.4 [p=0.004], as compared to hs CRP 1.124 [p=0.191] and MPO 0.998 [p=0.176]. hs CRP has superior diagnostic ability for detection of SCAD than MPO whereas PAPP-A is a more reliable marker for risk stratification among the cardiac biomarkers. IMEMR Current Contents Subject Index 31 etiology Gender differences in the risk of coronary artery disease in Iran. Abbasi, S.H.; De Lean, A Ponce; Kassaian, S.E.; Karimi, A.A.; Sundin, O.; Soares, J.; Macassa, G. E-mail:abbasi.hesam@gmail.com Mid Sweden University - Department of Public Health Sciences Iranian Journal of Public Health 2012; 41 (3): 36-47 (32 ref.) Keywords: Sex Factors; Risk Factors; Coronary Angiography; Sex Distribution; Diabetes Complications; Hypertension-complications Abstract: Given gender differences in the risk of coronary artery disease [CAD], the present study sought to investigate these dissimilarities amongst patients who underwent angiography at a major, tertiary heart hospital in Iran. Between 2005 and 2010, 44,820 patients who underwent coronary angiography were enrolled in a registry. Pre- procedural data such as demographics, CAD risk factors, presenting symptoms, and laboratory tests, as well as post- procedural data were collected. The data were, subsequently, compared between the men and women. Out of the 44,820 patients [16,378 women], who underwent coronary angiography, 37,358 patients [11,995 women] had CAD. Amongst the CAD patients, the females were not only significantly older, less educated, and more overweight than were the males but also had higher levels of triglyceride, cholesterol, low-density lipoprotein, high-density lipoprotein, and fasting blood sugar [P< 0.001]. Of all the risk factors, hypertension and diabetes mellitus showed the strongest association in our female CAD patients [OR=3.45, 95%CI: 3.28-3.61 and OR=2.37, 95%CI: 2.26-2.48, respectively]. Acute coronary syndrome was more prevalent in the men [76.1% vs. 68.6%, P< 0.001], and chronic stable angina was more frequent in the females [31.4% vs. 23.9%, P< 0.001]. With respect to post-procedural recommendations, the frequency of recommendations for non-invasive modalities was higher in the females [20.1% vs. 18.6%, P< 0.001] Hypertension and diabetes mellitus had the strongest association with CAD in our female patients. In the extensive CAD patients, medical treatment was recommended to the women more often. Craniocerebral Trauma The effect of mild hypothermia on jugular venous bulb oxygen saturation and CSF glutamate in severe head trauma. Abdel Rahem, Mohamed G.; Atia, Alaa M.A.; Abu Elwafa, Zeinab M.; Ali, Mahmoud A.; Almaz, Mohamed G.; Ibraheem, Hany A.; Algamal, Sahar A.; Abdel Baseer, Mohamed A. Assiut University - Faculty of Medicine - Department of Anesthesia and Intensive Care Assiut Medical Journal 2011; 35 (1): 129-140 (25 ref.) Keywords: Glasgow Coma Scale; Hyperthermia, Induced-utilization; Glutamic Acid-cerebrospinal fluid; Jugular Veins; Neuroprotective Agents Abstract: Hypothermia has been used as a method of brain protection in patients with traumatic brain injury for many years. The protective effects of hypothermia are related to the inhibition of the excitatory amino acids [EAA] release including glutamate. The hypothermic decline of the cerebral metabolic rate of oxygen [CMRO[2]] is also another mechanism of brain protection because it maintains the aerobic metabolism of the brain. To study the effect of mild hypothermia on brain oxygenation and the release of the EAA glutamate in severe head trauma. Forty two patients [16 - 60 years old] with severe head trauma [Glasgow coma scale < 8] were classified according to the diagnosis by computed tomography into group 1 [global brain damage] [n=20] and group 2 [focal brain damage] [n=22] two cases in group 2 were died before completion of the study so they were excluded. The cerebrospinal [CSF] glutamate, the jugular venous bulb oxygen saturation, the jugular venous lactate, the Glasgow coma scale [GCS], the acute physiological and chronic health evaluation score [APACHE II] and the length of lCU stay and other hemodynamic variables were measured and recorded. Hypothermia decreased the cerebrospinal [CSF] glutamate, improved the jugular venous bulb oxygen saturation, decreased the jugular venous lactate, improved the Glasgow coma scale [GCS] and decreased the acute physiological and chronic health evaluation score [APACHE II], There were significant statistical differences [p < 0.001] in each group but there were no statistical significant differences between both groups . The length of ICU stay was shorter in the group 1 than in group 2 . Mild Hypothermia is one of the mechanisms of brain protections through decreasing the level of the neurotoxic cerebrospinal excitatory amino acid glutamate and by improving the cerebral oxygenation and preventing the anaerobic metabolism by decreasing the level of serum lactate. IMEMR Current Contents Subject Index 32 Craniofacial Abnormalities epidemiology Birth defects data from surveillance hospitals in hubei province, china, 2001 - 2008. Tu, Lh; Li, H.; Zhang, Hp.; Li, Xd; Lin, Jj; Xiong, CI Huazhong University of Science and Technology - Tongji Medical College - Family Planning Research Institute Iranian Journal of Public Health 2012; 41 (3): 20-25 (17 ref.) Keywords: Prevalence; Incidence; Sex Distribution; Age Factors; Mothers; Cleft Lip-epidemiology; Cleft Palate- epidemiology; Population Surveillance Abstract: To determine the prevalence and characteristics of birth defects in perinatal infants in Hubei Province during 2001-2008. The prevalence of birth defects in perinatal infants delivered after 28 weeks or more was analyzed in Hubei surveillance hospitals during 2001-2008. The incidence of birth defects in perinatal infants from 2001 to 2008 was 120.0 per 10,000 births, and was increased by about 41% from 81. 1 in 2001 to 138.5 per 10,000 births in 2008. The incidence in the first 4 years [2005-2008] was much higher than the latter four [2001-2004] [chi[2]=77.64, P <0.05]. The difference in prevalence between urban and rural was of no significance in 2008 [chi[2] =0.03, P >0.05], but that between male and female was significant [chi[2]=5.24, P <0.05], as the former prevalence was much higher. The prevalence of birth defects was slightly higher among mothers over 35 years old than those under 35 years old, but with no significance [chi[2]=1.98, P >0.05]. The two leading birth defects were cleft lip and/or palate and polydactyly, followed by congenital heart disease, hydrocephaly, external ear malformation and neural tube defects. The prevalence of congenital heart disease was rising. Eight years' birth defects data indicate that the birth defect rate was on the rise and the birth defects prevalence in Hubei province should be valued. Culture Media Comparison of the Bact/Alert blood culture system and manual culture method for detection of aerobic and facultative anaerobic bacterial contamination in platelet concentrates. Razjou, F.; Dabirmoghadam, A. High Institute for Research and Education in Transfusion Medicine - Blood Transfusion Research Center Scientific Journal of Iranian Blood Transfusion Organization Research Center [The] 2012; 8 (4): 265-271 (15 ref.) Keywords: Bacteria, Anaerobic-isolation and purification; Bacteria, Aerobic-isolation and purification; Blood Platelets-microbiology Abstract: For reducing bacterial contamination of platelets in the medium, PDA has approved the Bact/Alert for screening the platelet units. This study attempts to compare the Bact/Alert system and the manual culture method as far as the length of time in hours of detection is concerned. In this interventional and diagnostic study, 15 platelet units were selected randomly among 1332 units and inoculated with 10 CFU/ml of various bacteria including Streptococci, Serratia marcescens, Enterobacter cloacae, Corynebacterium diphteroid, Staphylococcus aureus and Staphylococcus epidermidis which normally contaminate platelet units. These units together with other platelet units in a blind way were tested by both Bact/Alert system and the manual method. Regarding the short expiration time of platelet units, if the length of time in hours in detection is considered as a basis for comparison, the Bact/Alert system is significantly superior to the manual method. The medium length of time in hours for detecting the aerobic bacteria by Bact/Alert system is 31 +/- 8 hours, compared with the manual method which is 61 +/- 11 hours. This shows that Bact/Alert system is nearly 2 times faster than the manual method. Bact/Alert culture system compared with the manual method is more rapid and accurate for detection of bacterial contamination thereby improving platelet safety. Regarding serious effects of these contaminations on platelet recipients, it is also necessary to try to reduce them by using GMP. Cyclophosphamide toxicity Biochemical evaluation of the protective impact of silymarin against cyclophosphamide- induced hepatotoxicity in rats. El Deib, Kamal M.; Ahmed, Mahgoub M.; Ahmed, Nermein Z. E-mail:dr_kamal_eldeib@hotmail.com National Organization for Drug Control and Research [NODCAR] - Molecular Drug Evaluation Department EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 291-310 (48 ref.) IMEMR Current Contents Subject Index 33 Keywords: Liver-pathology; Liver Function Tests-blood; Protective Agents; Silymarin-therapeutic use; Antioxidants; Treatment Outcome; Rats; Acid Phosphatase-blood; Galactosidases-blood; Acetylglucosaminidase-blood Abstract: This study was designed to investigate the ameliorative effect of silymarin on the hepatotoxicity induced by cyclophosphamide [CP] in female albino rats. The results revealed that cyclophosphamide induced marked increase in relative liver weight and serum levels of ALT, AST and decrease in serum albumin level which were normalized by silymarin administration. Pretreatment with silymarin significantly attenuated cyclophosphamide-induced increases in malondialdehyde [MDA] in the liver homogenate. The results revealed that the activities of lysosomal enzymes acid phosphatase [ACP], beta-N-acetyl glucosaminidase [beta-NAG] and beta- galactosidase [beta-GAL] were increased significantly in CP-treated animals while pretreatment by silymarin caused marked attenuation in the increased activities of the three enzymes. Cyclophosphamide significantly decreased reduced glutathione [GSH], glutathione-s- transferase [GST] and glutathione reductase [GR] levels in the liver homogenate, while pretreatment with silymarin blunted the decreased levels of GSH,GST and GR. Our results revealed the potential hepatoprotective effect of silymarin against cyclophosphamide-induced hepatotoxicity. So, it may be worthy to consider the beneficial use of silymarin as supplement with cyclophosphamide therapy. Cystadenoma, Mucinous pathology Mucinous cystadenoma in a horseshoe kidney: report of a case with review of literature. Menon,Varna; Prasad, Krishna; Mathew, Jayant T. E-mail:drvarni@yahoo.com Sohar Hospital - Department of Pathology KMJ - Kuwait Medical Journal 2012; 44 (1): 60-62 (6 ref.) Keywords: Cystadenoma, Mucinous-diagnosis; Kidney Neoplasms-pathology; Kidney Neoplasms-diagnosis; Kidney-abnormalities Abstract: Renal mucinous cystadenoma is very rare with five documented cases in medical literature. Out of these, two developed in horseshoe kidneys. The occurrence of mucinous cystadenoma in horseshoe kidneys is extremely rare and may represent a disorder, wherein such anomalous kidneys may have a tendency to have mucinous tumors taking origin from sequestrated segments of renal pelvic epithelium in the parenchyma. Surgical intervention and thorough histopathologic sampling is required for the diagnosis. It is important to be aware of mucinous cystadenomas while evaluating cystic masses occurring in horseshoe kidney. We report the case of a 52-year old lady who presented with vague abdominal discomfort and on evaluation was found to have a horseshoe kidney with left renal huge cystic lesion with wall enhancement on computerized tomography [CT] scan suggesting malignancy. She underwent left radical nephrectomy with excision of the isthmus. The histological examination revealed a mucinous cystadeno. Dalbergia anatomy and histology The biology of Egyptian woody perennials 4. dalbergia sissoo roxb. ex DC. Shaltout, Kamal H.; Keshta, Amr E. Tanta University - Faculty of Science - Botany Department Assiut University Bulletin for Environmental Researches 2011; 14 (2): 131-152 (81 ref.) Keywords: Plant Structures; Plant Diseases; Wood; Review literature as Topic Abstract: The present article is the fourth in a series of review articles deal with the biology of Egyptian woody perennials. Available literatures dealt with the biology of the invasive tree Dalbergia sissoo Roxb. ex DC. in Nile Delta was reviewed. The area of natural distribution is the foothills of the Himalayas from eastern Afghanistan through Pakistan and India to Nepal. Dalbergia sissoo was introduced to Egypt by Ibrahim Basha in the age of Mohamed Ali [1805-1848] for ornamental and timber purposes. This review includes the nomenclature and taxonomy of the plant, its distribution, morphology, habitat and environment, phytomass production, control measures, propagation and management, pests and diseases, economic uses and ecological importance. Ecotypic variability among its local populations needs further studies, particularly the physiological and genetical adaptations along the prevailing environmental conditions. IMEMR Current Contents Subject Index 34 Delivery of Health Care The future of health care delivery and the experience of a tertiary care center in Saudi Arabia. Alsanea, Nasser E-mail:nsanea@kfshrc.edu.sa King Faisal Specialist Hospital and Research Center - MBC 40 Colon and Rectal Section - Department of Surgery Annals of Saudi Medicine 2012; 32 (2): 117-120 (11 ref.) Keywords: Medical Records Systems, Computerized; Patient Education as Topic; Quality of Health Care Abstract: Five major technological changes will herald a new era in health care delivery around the World: digitalization of the personal health record, sharing of health care digital data across different platforms, applications and institutions, delivery of patient services via the internet, use of the digital media and social networking as a medium for education and preventive medicine and introduction of smart applications as counselors to prevent medical errors. The implications of such changes are huge. Saudi Arabia is not isolated from such important developments. This article explores the future of health care delivery with a special focus on the experience of a tertiary care center in Saudi Arabia that has led the wave in such changes regionally. Dengue Dengue fever - high time to convert crisis into opportunity. Ayyub, Muhammad Army Medical College PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 323-324 Keywords: Dengue Hemorrhagic Fever; Disease Vectors; Aedes epidemiology Dengue infection in Asia; a regional concern. Khan, Erum; Hasan, Rumina Aga Khan University - Department of Pathology and Microbiology JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 1-6 (35 ref.) Keywords: Disease Vectors; Disease Outbreaks; Dengue-prevention and control; Mosquito Control; Antibodies, Viral Densovirinae pathsogenicity Aedes aegypti re-emerging in Egypt: a review and what should be done? Heikal, Omar M.; El Bahnasawy, Mamdouh M.; Morsy, Ayman T.A.; Khalil, Hazem H.M. Military Medical Academy - Department of Tropical Medicine Journal of the Egyptian Society of Parasitology 2011; 41 (3): 801-814 (54 ref.) Keywords: Communicable Diseases, Emerging; Review Literature as Topics Abstract: Mosquitoes are main vectors of varieties of pathogenic agents affecting man and animals. There- emergencein Aswan and approach of Aedesaegypti, the vector of the Dengue hemorrhagic fever, Yellow fever and Chikungunya fever, which are encountered in Africa, needs to alert for this public health threat. The presence of Dengue and dengue hemorrhagic fever in Saudi Arabia is another issue. Dental Caries epidemiology Prevalence of dental caries among the primary school children of urban Peshawar. Umer, Andaleeb; Umer, Afsheen E-mail:andaleebumer@gmail.com IMEMR Current Contents Subject Index 35 Provincial health Services - Department of health JKCD - Journal of Khyber College of Dentistry 2011; 2 (1): 21-26 (21 ref.) Keywords: Prevalence; Schools; Students; Questionnaires; Child; Cross-Sectional Studies; Urban Population Abstract: To investigate the prevalence of dental caries among school children of Hayatabad from class one to class fifth, the dft and DMFT score and some factors causing dental caries. A cross sectional observational questionnaire based study was carried out in ten primary schools in Hayatabad, from class one to class fifth among 500 school children with main objective to investigate the prevalence of caries and calculate dft and DMFT score among these school children of Hayatabad, Peshawar. A questionnaire was designed to ask the students about their diets, tooth brushing habits and were examined for caries. Among 500 children examined, 72.4% were detected with caries. The mean dft score was found to be 0.7983, mean DMFT score to be 2.163 and prevalence per 100 children was 20.11. The study revealed that tooth brushing habits played very significant role in caries, where brushing habits were unsatisfactory, caries level was high and brushing habits were normal, then caries level was reduced. In this study 72.4% children were carries positive with peak group affected was 9 years. High in take of sugar and chocolate resulted in high caries index. Normal or above normal tooth brushing habits resulted in low caries index. Dental Casting Technique Comparison of stress distribution in two type of metal and non metal posts by photo elastic method. Jalalian, E.; Ale Taha N.; Meihami, A.; Sadegh, M.; Jalalian, S.H. Islamic Azad University - Dental School - Departmentof Prosthodontics Journal of Dental School - Shahid Beheshti University of Medical Sciences 2012; 29 (4): 250-259 (29 ref.) Keywords: Dental Stress Analysis; Metals; Dental Pulp Cavity; Epoxy Resins Abstract: Intrapulpal posts are used as retention for reconstructing of missed crown. Today fiber posts eliminated most of disadvantages of metal posts. The purpose of this study is a comparison of stress distribution in these types of posts [casting and Quartz fiber post] on root canals of teeth with photo elastic method. In this experimental study Quartz fiber and casting posts with length of 15mm and diameter of 0.9mm were used. Four epoxy resin models [10x20x40mm] were made that two of them include casting posts and two other include Quartz fiber posts. Then, cores were prepared for each model. Vertical force of 100N and oblique force with 30' and 150 N were applied on cores and isochromatic fringe patterns around post were recorded in the field of Polariscope. In the vertical loads the minimum cervical stress was observed in casting post that was 1.22 [in Quartz fiber post it was 2.65] But in apical region maximum stress was recorded in casting post that was 1.63 [in Quartz fiber post it was 1.38]. In the oblique load, casting post showd 1.39 stress in cervical that was the minimum [in Quartz fiber post it was 2.35] and in the apical region, casting post showed the maximum stress that was 1.68 [in Quarts fiber post it was 1] display more critical stress pattern [1.63]. In the vertical and oblique loads casting posts shows the maximum stress in the apical region that makes the worse fracture in tooth that couldn't be prepared but in Quartz fiber post maximum stress was in cervical region so it is more repairable. Dental Implant-Abutment Design Effect of platform switching on crestal bone stress distribution around 3i implants: a finite element analysis. Sahabi, M.; Habibzadeh, S.; Mirhashemi, F.S. Shahid Beheshti University of Medical Sciences - Dental School - Department of Prosthodontics Journal of Dental School - Shahid Beheshti University of Medical Sciences 2012; 29 (4): 242-249 (15 ref.) Keywords: Finite Element Analysis; Mandible; Molar; Tomography, X-Ray Computed; Dental Stress Analysis Abstract: Over the last few years, concept of platform switching has gained popularity for reducing degree of crestal bone resorption. Many researchers believe that, this theory can be used for improving stress distribution in implant- bone interface. The purpose of this three dimensional Finite Element Analysis [FEA] was to study and compare stress distribution in implant-bone interface and implant-abutment interface of 3i implants [Biomet 3i, USA] in mandibular molar area. For this FEA, computed tomography [CT] images of an adult human mandible was used to make the three- dimensional model of posterior edentulous mandible .The implant systems which used was the 3i system consisted of 3i fixtures: 4 and 5 mm in diameter and 11.5 mm in length, and 3i Certain abutment 4.1 and 5mm [Biomet 3i, USA]. This implant systems were assembled on the mandible model in 3 different designs : a platform-switched configuration; MODEL 4: 4-mm 3i fixture, 4.1-mm abutment; MODEL 5: 5-mm 3i fixture, 5-mm abutment; MODEL 6: 5-mm 3i fixture, 4.1-mm abutment, a platform-switched configuration. A linear static analysis was performed on the prepared 3D solid models with two different oblique load of 100 and 250 N in the lingobuccal direction with 15 degrees of inclination on the center of the abutment. Regardless of the implant system used, maximum Von Mises stresses in cortical bone IMEMR Current Contents Subject Index 36 around implants were lower in platform switched models compared to matching diameter implant-abutment. This effect was not related to the usage of larger implant diameters in these models. However, Von Mises stresses in implant- abutment interface were the lowest in models with larger implant diameter. The platform switching technique reduces the stress concentration in the area of crestal bone-implant interface and shifted it to the area of implant-abutment interface. In the present study, this stress reduction was not. Dental Pins Retention of creative pin placement vs. traditional method in human mandibular molar teeth [in vitro]. Rezvani, M.B.; Basir, M. Mohammadi; Moradi, Z.; Mollaverdi, F. Shahed University - Dental School - Department of Operative Dentistry Journal of Dental School - Shahid Beheshti University of Medical Sciences 2012; 29 (4): 268-273 (24 ref.) Keywords: Composite Resins; Dental Bonding; Mandible; Molar; Tensile Strength Abstract: Extensive caries restoration has always been considered as one of dental issues. To resolve this problem different methods have been suggested such as dentinal pins.Previous clinical studies revealed that the use of retentive pins, faces numerous risks [pulp exposure, dentin cracks, root perforations, etc]. Introducing of bonding and composite systems, resulted in minimized mechanical retention for cavity preparation. Advantages of amalgam restorations such as simplicity of use, better mechanical properties, suitable clinical longevity and being less costly sustained its use in practice. On the other hand, caries removal usually results in a cavity form with small undercuts. So if we fill these small undercuts with [Bonding and Composite], then insertion of pins in this base, could be considered as a safe way for obtaining retention. The purpose of this study was comparing the retention of creative pin placement [using composite] to the retention of traditional method. In this experimental study thirty sound human mandibular molar teeth free from decay and restoration were selected. The occlusal surface of samples was removed up to 3mm above CEJ. Teeth were divided in 2 groups: Group A : [N=15] T.M.S Minim pin inserted in dentin at 2mm depth. Group B: [N=15] One layer of composite [1mm] bond to flat occlusal surface of teeth and then the pin was inserted in it at 2mm depth so only 1mm of pin placed into dentin. Group C: [N=15] cylinders of composite were prepared [height=5mm, dimension= 8mm] and pin was inserted in them at 2mm depth. The retention of pins was determined under tensile force with Zwick universal testing machine and data was charted by Test Xpert. 10-11 program. Data were analyzed by variance analysis [ANOVA] and L.S.D test. The ANOVA showed: a statistically significant difference between all groups. [p< 0.05] The L.S.D test showed: - No significant difference between A and B. [p> 0.05] - Significant difference between A, B and C. [p< 0.05]. The highest tensile strength belonged to group A. there was no significant difference between group A and B. So by using this technique 1mm depth of pin in dentin can result as same retention as 2mm depth. The lowest tensile strength belonged to group C. Dexamethasone therapeutic use Effect of preoperative dexamethasone on postoperative pain, emesis and haemorrhage in tonsillectomy by dissection method. Khan, Muhammad Khalid Azam; Manzoor, Tahir; Qayyum, Asad; Raza, Syed Nusrat E-mail:sagukhagu@hotmail.com Combined Military Hospital Muzzaffarabad PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 397-400 (17 ref.) Keywords: Preoperative Care; Tonsillectomy; Postoperative Complications-prevention and control; Postoperative Hemorrhage-prevention and control; Pain, Postoperative-prevention and control; Postoperative Nausea and Vomiting- prevention and control Abstract: To compare the effect of single preoperative intravenous dose of dexamethasone on postoperative morbidity that is pain, episodes of emesis, and hemorrhage in patients undergoing tonsillectomy by dissection method with those who do not receive dexamethasone. Randomized control type. ENT Department Combined Military Hospital Rawalpindi, from Feb 2006 to Feb 2007. After getting informed consent a total of 60 patients who fulfilled the probability sampling. Group A received 0.25 mg/kg body weight [maximum 20 mg] of dexamethasone intravenously 10 minutes before start of operation while group B [control group] did not receive any steroid. Pain control had significant difference in both groups with better control rates in group A. Similarly, emesis control was significantly better in group A. There was no significant difference in secondary haemorrhage in the two groups. Single dose of dexamethasone given preoperatively significantly reduces the postoperative morbidity that is pain, episodes of emesis with no effect on secondary hemorrhage in patients undergoind tonsillectomy by dissection method. IMEMR Current Contents Subject Index 37 Diabetes Mellitus, Experimental drug therapy Hypoglycemic and anti apoptotic effect of garlic in streptozotocin induced diabetic rats. Mahmoud, Ahmed Mohamed; Abdalla, Ahlam M. E-mail:Okashaahmed@yahoo.com Minia University - Faculty of Medicine - Biochemistry Department EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 393-406 (27 ref.) Keywords: Garlic-drug effects; Blood Glucose; Plant Extracts; C-Peptide-blood; Catalase-blood; Glutathione-blood; Caspase 3-blood; Antioxidants; Rats; Male Abstract: Diabetes mellitus is caused by many factor include oxidative stress that leads to apoptosis of beta cells of the pancreas and so the antioxidant therapy strongly correlated with decrease risk of diabetes mellitus. The aim of the present study was to investigate the efficacy of an aqueous extract of raw garlic in controlling serum glucose, plasma c peptide of insulin, level of reduced glutathione and catalase activity in pancreatic tissue, also to estimate caspase 3 activity expression in pancreatic tissue in streptozotocin induced diabetic rats treated daily with garlic extract intraperitoneally [IP] for 6 weeks. This study was carried on 30 rats: grouped into 3 group. Group 1, the control normal group, was injected IP daily with 0.5 ml saline and group 2; diabetic group was injected with streptozotocin, 60 mg/Kg body weight [BWt] IP in 0.5 ml saline once and group 3; garlic-treated group, was injected IP daily with 500 mg/kg of the garlic extract 2 weeks before streptozotocin and 4 week after streptozotocin injection. There was a significant increase in blood glucose in streptozotocin group II [p = 0.001] as compared with control groups [331.3 +/- 16.15 vs 101.8 +/- 4.02 mg/dl] respectively and significantly decreased after treatment with garlic extract [161.5 +/- 5.28 mg/dl]. C peptide was significantly decreased in streptozotocin group II [p = 0.001] as compared with control groups [0.034 +/- 0.003 vs 0.053 +/- 0.001 ng/ml] respectively and significantly increased after treatment with garlic extract [0.046 +/- 0.003]. Catalase activity of pancreatic tissue was significantly decreased in streptozotocin group [p = 0.001] as compared with control groups [11.10 +/- 0.73 vs 25.7 +/- 0.55 U/gm tissue] respectively and significantly increased after treatment with garlic extract [20.3 +/- 0.66]. Reduced glutathione content of pancreatic tissue was significantly decreased in streptozotocin group [p = 0.001] as compared with control groups [0.67 +/- 0.055 vs 1.23 +/- 0.076 mg/g tissue] respectively and significantly increased after treatment with garlic extract [0.89 +/- 0.080 mg/g tissue]. Also it was observed that the expression of caspase 3 protein in the pancreatic tissue was decreased after garlic treatment using western blot technique. These results revealed that aqueous extract of raw garlic may have antioxidant and antiapoptotic activity that could be used in treatment of diabetes mellitus. Diabetes Mellitus, Type 1 Blood Influence of serum cortisol levels on glycemic control in children with type 1 diabetes. Mosbah, Amira A. Abdel Rahman; Abdel latif, Nahla A. Bahgat; Sorour, Ehab Ibrahim Cairo University - Faculty of Medicine - Department of Pediatric Medicine Journal of the Egyptian Society of Parasitology 2011; 41 (3): 777-784 (21 ref.) Keywords: Hydrocortisone-blood; Blood Glucose; Hemoglobin A, Glycosylated-blood; C-Peptide-blood Abstract: The association between plasma glucose [PG], HbAlc and serum cortisol levels in children with type 1 diabetes was investigated to determine the influence of serum cortisol on their glycemic control. A total of 45 children, aged 10-15 years, with type 1 diabetes for at least 3 years of diabetes were studied. Most of them did not have pancreatic beta-cell function. The cortisol levels among all patients were stratified according to fasting plasma glucose levels [50-99, 100-199, 200-299, and >/= 300mg/dL], and the HbAlc levels [<7.0, 7.0-7.9, 8.0-8.9, and >/=9%]. The mean fasting PG, HbAlc and serum cortisol levels were 174 +/- 97mg/dL, 7.7 +/- 1.3% and 23.04 +/- 16.6 ug/dl, respectively. The cortisol levels were highly correlated with PG levels [r =0.553, P<0.0001] and mildly correlated with HbAlc levels [r = 0.301, P =0.0192]. Patients with high PG levels gave significantly higher cortisol levels as compared to those with lower PG levels [18.4 +/- 7.3, 26.8 +/- 18.3, 31.4 +/- 17.0 and 36.3 +/- 17.2ug/dl, P =0.0009]. There were no significant differences in serum cortisol levels among patients stratified according to HbAlc levels [P = 0.1566] , however, patients with HbAlc levels >/= 9% had significantly higher cortisol levels than those with HbAlc levels <7% [32.6 +/- 14.4 vs. 21.8 +/- 11.3ug/dl,P=0.0291]. IMEMR Current Contents Subject Index 38 genetics Vitamin D binding protein gene polymorphisms and risk of type 1 diabetes mellitus among Egyptians. Mahmoud, Moushira A.; Ibrahim, Gehan H.; Fawzy, Manal S.; Atwa, Hoda A. E-mail:moushiraa@yahoo.com Suez Canal University - Faculty of Medicine - Medical Biochemistry Department EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 361-374 (35 ref.) Keywords: Risk Factors; Vitamin D-Binding Protein; Polymorphism, Genetic; Genotype Abstract: Type 1 diabetes [T1DM] is a multifactorial autoimmune disease in which both genetic predisposition and environmental factors participate in its development. Many cellular and epidemiological studies suggest a role for vitamin D in pathogenesis and prevention of T1DM. Polymorphisms of the genes involved in the metabolism of vitamin D may predispose to T1DM. Vitamin D-binding protein [DBP] is the main systemic transporter of vitamin D and is essential for its cellular endocytosis. There are two known polymorphisms in exon 11 of the DBP gene resulting in amino acid variants: GAT->GAG substitution replaces aspartic acid by glutamic acid in codon 416; and ACG->AAG substitution in codon 420 leads to an exchange of threonine for lysine. These DBP variants lead to differences in the affinity for vitamin D. Few published studies, about the correlation between these alleles and T1DM, yielded conflicting results. Therefore, we investigated the association of these polymorphisms with T1DM in Egyptian subjects. Unrelated 59 children with T1DM and 65 healthy controls were included in this study. The sequence of DBP exon 11, which contains both examined variants, was amplified by polymerase chain reaction [PCR]. Alleles and genotypes were determined using Restriction Fragment Length Polymorphism analysis [RFLP] . At codon 416 the frequency of Glu/Asp alleles was 64.4/35.6% in T1DM patients and 55.4/44.6% in controls [P >0.05]. At codon 420 the frequency of Thr/Lys alleles were 88.1/11.9% and 87.7/12.3% [P >0.05] respectively. Distributions of genotypes at both loci, and the common haplotypes constructed by them, were also very similar in both groups [P >0.05]. It could be concluded that the studied DNA polymorphisms in the DBP gene are not associated with T1DM in Egyptian patients. Diabetes Mellitus, Type 2 complications Glycemic control effect on diabetic neuropathy and antioxidants in type 2 diabetes mellitus. Abo Elfetoh, Noha M.; Tag, Lubna M.; El Baz, Mona A.; Ez Eldeen, Manal E. Assiut University - Faculty of Medicine - Department of Neurology and Psychiatry Assiut Medical Journal 2011; 35 (1): 43-52 (28 ref.) Keywords: Diabetic Neuropathies; Antioxidants; Malondialdehyde-blood; Nitric Oxide-blood; Blood Glucose; Oxidative Stress Abstract: To assess the relationship between glycemic control, the oxidative stress and antioxidant vitamin status and their influence on diabetic neuropathy. Thirty six type 2 diabetic patients with diabetic neuropathy were included in this study. They were classified into good and poor glycemic controlled groups [12 and 24 patients respectively]. All patients underwent multiple nerve conduction parameters including F wave latencies. Fasting serum glucose and glycosylated hemoglobin [HbAcl%], Lipogram, malondialdehyde [MDA], nitric oxide [NO] and antioxidants vitamin C and E plasma levels 'were determined. Poor glycemic controlled group recorded significant longer F wave latency of ulnar nerve, slower sensory conduction velocities of median nerve [P<0.05] and segmental motor conduction velocities of ulnar and median nerves [P <0.05; 0.01; 0.001], compared with that of good glycemic controlled group. Poor glycemic controlled group had significant rising oxidative stress markers [MDA] and reducing NO and vitamins [E and C] plasma level compared to that of good glycemic controlled group [P<0.001]. HbAlc% is significantly correlated with plasma MDA, vitamin C and E levels and segmental conduction velocities [P<0.001; 0.05]. Poor glycemic control is associated with high oxidative stress, lipid peroxidation and depletion of vitamins C and E plasma levels, that may be contributing to diabetic neuropathy progress. drug therapy Short term effect of glycemic and dyslipidemia control on nerve conduction study and antioxidants status in type 2 DM. Abo Elfetoh, Noha M.; Tag, Lubna M.; El Baz, Mona A.; Ez Eldeen, Manal E. Assiut University - Faculty of Medicine - Department of Neurology and Psychiatry Assiut Medical Journal 2011; 35 (1): 189-198 (33 ref.) IMEMR Current Contents Subject Index 39 Keywords: Blood Glucose; Dyslipidemias-blood; Neural Conduction; Antioxidants; Lipid Peroxidation; Nitric Oxide- blood; Diabetic Neuropathies Abstract: The importance of glycemic control in patients with diabetes is well known, but neurological studies suggest that dyslipidemia is actually a more significant contributor to diabetic neuropathy. Is to study the relationship between the degree of hyper glycemic and hyperlipidemic control on one hand and the degree of improvement in clinical, neurophysiological parameters, and level of oxidative stress markers and antioxidants in type 2 DM. Twenty four type 2 diabetics with hyperglycemia, dyslipidemia and diabetic neuropathy were included in this study. They received treatment for control of hyperglycemia and dyslipidemia for 3 months. Clinical assessment, nerve conduction, F-wave studies, lipid profile, oxidative stress markers as Plasma malondialdehyde [MDA] and antioxidant status [Nitric Oxide and vitamin C and E] were measured for each patient before, one and 3 months after beginning of treatment. They were classified according to percentage changes (PC) of glucosylated heamoglobin level [HbAlc%] into 2 groups. The first group had low PC of HbAlc % [ < 25%] and the second group had high PC of HbAlc %[ > 25%][n=11 and 13 respectively]. There were no significant differences in demographic and clinical data between both groups. Higher PC group had significant greater improvement compared to lower PC group in motor conduction velocity of median nerve [p = 0.017], serum triglyceride [p= 0.005], lipidperoxidation [MDA] and antioxidants levels [p= 0.0001 for each]. Efficient glycemic and dyslipidemia control significantly improved peripheral nerves function and antioxidant status. Diabetic Foot Surgical management of diabetic foot and role of UT [university of Texas] classification. Mishwani, Ahmad Hussain; Kiyani, Khalid Amjad Combined Military Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 367-371 (15 ref.) Keywords: Foot Ulcer; Diabetes Mellitus; Diabetes Complications; Negative-Pressure Wound Therapy; Staphylococcus aureus; Amputation; Disease Management Abstract: To evaluate the role of University of Texas Classification in the management of Diabetic foot. Descriptive study. Surgical unit II Combined Military Hospital Rawalpindi [2003 to 2008] and Department of Surgery Combined Military Hospital Peshawar [July 2008 to Jan 2010]. A total of 300 patients who reported to Surgical Department with a foot ulcer or infection and diagnosed to have Diabetes Mellitus were studied. Patients of both gender and age > 12 years were included. Patients of end stage renal disease, compromised immunity or on steroid therapy were excluded. Detailed history and clinical examination were recorded. Routine investigations including complete blood examination, urine routine examination, renal function tests, x-ray foot, chest x-ray, ECG and pus for culture and sensitivity were recorded. Lesions were classified according to University of Texas classification and treated accordingly. Majority of the patients were of 50 to 70 years ago group. Male to female ratio was 4:1. Big toe was the commonest site followed by fore foot and heel. Patients were classified according to UT classification. Patients were managed with antibiotics, dressings, incision and drainage, debridement, vacuum assisted closure [VAC] with or without skin grafting and amputations of different types. Staphylococcus aureus was the commonest isolate. Our study has shown that UT classification is an effective system of assessing the severity of diabetic foot at the time of presentation and planning its management. Amputation rates, time of healing and morbidity increases with increasing stage and grade. microbiology A study of the microbiology of diabetic foot infections in a teaching hospital in Kuwait. Al Benwan, Khalifa; Al Mulla, Ahmed; Rotimi, Vincent O. E-mail:drbanwan@gmail.com Al-Amiri Hospital - Department of Microbiology Journal of Infection and Public Health 2012; 5 (1): 1-8 (15 ref.) Keywords: Diabetic Foot-drug therapy; Diabetes Complications-drug therapy; Coinfection-drug therapy; Anti- Bacterial Agents-therapeutic use; Drug Resistance, Microbial; Gram-Negative Bacteria-drug effects; Gram-Positive Bacteria-drug effects; Microbial Sensitivity Tests Abstract: The purpose of this study was to determine the microbiological profile of diabetic foot infections [DFIs] and assess the antibiotic susceptibility of the causative agents. Data were obtained from a retrospective analysis of DPI samples collected from June 2007 to July 2008. Specimens were cultured using optimal aerobic and anaerobic microbiological techniques, and antibiotic susceptibility testing was performed according to the methods recommended by the Clinical and Laboratory Standards Institute [CLSI]. Extended-spectrum beta-lactamase [ESBL] production was measured using the double disk synergy test and the ESBL Etest. A total of 440 patients were diagnosed with DFIs during this period, and a total of 777 pathogens were isolated from these patients with an average of 1.8 pathogens per lesion. We isolated more Gram-negative pathogens [51.2%] than Gram-positive pathogens [32.3%] or anaerobes [15.3%]. Polymicrobial infection was identified in 75% of the patients. The predominant organisms isolated were IMEMR Current Contents Subject Index 40 members of the Enterobateriaceae family [28.5%], Pseudomonas aeruginosa [17.4%], Staphylococcus aureus [11.8%], methicillin-resistant S. aureus [7.7%], anaerobic Gram-negative organisms [10.8%], and Enterococcus spp. [7%]. Vancomycin was the most effective treatment for Gram-positive bacteria, and imipenem, piperacillin-tazobactam and amikacin were the most effective treatments for the Gram-negative bacteria. In conclusion, DFI is common among diabetic patients in Kuwait, and most of the cases evaluated in this study displayed polymicrobial etiology. The majority of isolates were multi-drug resistant. The data gathered in this study will be beneficial for future determinations of empirical therapy policies for the management of DFIs. 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved. Diabetic Retinopathy epidemiology Frequency of diabetic retinopathy in a tertiary care hospital using digital retinal imaging technology. Aamir, Azizul Hasan; Jan, Sanaullah E-mail:drahaamir@gmail.com Hayatabad Medical Complex - Department of Diabetes, Endocrinology and Metabolic Diseases JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 29-33 (12 ref.) Keywords: Retina-pathology; Telemedicine; Hospitals; Mass Screening-methods; Diabetic Retinopathy-diagnosis Abstract: The objective of this study was to determine the frequency of diabetic retinopathy in a tertiary care hospital using digital retinal imaging technology. This descriptive study was carried out in the department of Diabetes, Endocrinology and Metabolic Diseases, Hayatabad medical complex Peshawar. Patients referred from outpatient department, general practitioners and from private clinics were included and after taking their basic demographic data were referred to the department of Diabetes for Fundus Photograph using Canon CR1 non-mydriatic digital retinal camera. Photographs were analyzed first by Endocrinologist and later by an Ophthalmologist to assess the severity of retinopathy. Two thousand one hundred and twenty three patients with type 2 diabetes were evaluated clinically followed by fundus photography by retinal digital imaging. The frequency retinopathy and maculopathy was 32.03% and 6.31% respectively [both retinopathy and maculopathy 38.34%]. Three seventy four patients [17.6% patients] received laser treatment for prevention of blindness. Screening for Diabetic retinopathy using digital camera is a useful technique and detects DR effectively in diabetic patients in a tertiary care setting. This technique is useful in mass screening and can detect, reduce and prevent blindness due to diabetes in our population. Disability Evaluation Profile difference between male and female psychiatric patients seeking certificate of disability. Balhara, Yatan Pal Singh; Gauba, Deepak; Deshpande, Smita N. E-mail:ypsbalhara@gmail.com Lady Hardinge Medical College and SSK Hospital - Department of Psychiatry and De-addiction Oman Medical Journal 2011; 26 (6): 410-415 (34 ref.) Keywords: Mental Disorders; Intellectual Disability; Schizophrenia; Dementia; Bipolar Disorder; Obsessive- Compulsive Disorder Abstract: Neuropsychiatric disorders are one of the major contributors to the global burden of disease and disability. Issue of disability in psychiatric disorders has been studied across multiple studies in India. However, there are no reports on the profile and nature of disability among those seeking disability certificates. The current study aims at understanding the socio-clinical profile of patients seeking disability certificate in a tertiary care hospital in India. The study was carried out in the Department of Psychiatry of a tertiary care multispecialty teaching hospital. A chart review of the records of the patients referred for disability evaluation over a one year period was conducted. The disability was assessed using IDEAS. In between group comparisons were carried out for male and female subjects for different sociodemographic variables, IDEAS total score and individuals item score using independent sample t test [parametric test] and Mann Whitney-U test [non parametric test]. Additionally, Spearman's rank order correlation was calculated to establish the level of correlation between total IDEAS score and score on individual items of the scale. The subjects were diagnosed to have been suffering from mental retardation 107 [61.8%], schizophrenia 54 [31.2%], dementia 5 [2.9%], bipolar affective disorder 4 [2.3%] and obsessive compulsive disorder 3 [1.7%] as per ICD-10. Male and female subjects differed significantly on the global IDEAS score. The total score was significantly higher for male subjects compared to female subjects. The difference was statistically significant for "self care" and interpersonal activities items of the scale with male subjects having higher disability scores. The current study provides some important insights into profile of disability certificate seeking individuals in India. IMEMR Current Contents Subject Index 41 Drug Resistance physiology Malaria drug resistant: current situation with reference to Saudi Arabia [review]. Al Harthi, Saeed A. E-mail:sasharthi@uqu.edu.sa Umm Al-Qura University - Faculty of Medicine - Department of Parasitology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 553-564 (58 ref.) Keywords: Malaria-epidemiology; Review Literature as Topic; Drug Resistance-genetics Abstract: Malaria is a chronic disease caused by parasitic protozoa of plasmodia species. Four plasmodium species are causing malaria to human [P. vivax, P. ovale, P. ma-lariae and P.falciparum]. Malaria classifies as one of the most serious diseases in tropical and subtropical countries and p. falciparum represents the major cause of death by malaria species. Approximately 40% of the world population resides in areas of active malaria transmission. Treatment and prophylaxis measures are important to reduce morbidity and mortality rate of infection. In last two decades, a significant number of malaria drug resistance cases [mainly P. falciparum] were reported in endemic areas against choroquine components. Parasite showed enormous amount of antigenic variation under immune pressure leading to emergence of vaccine resistant strains. Similarly, under drug pressure it allows mutations to settle in the target genes. It is becoming more and clearer that with the continuous exposure to a drug, the parasite accumulates more and more number of mutations in these genes. Artemisinin is the only available drug that is globally effective. This review concentrates on the current situation of malaria drug resistance including epidemiological distribution, the mechanism of how the malaria resists certain drugs and the role of recent advances facilities in molecular biology to evaluate the impact on drug resistance of new drug-based strategies in Saudi Arabia. Dyslipidemias epidemiology Frequency of dyslipidemias in diabetic patients at combined military hospital Multan. Mehmood, Faisal; Ahmed, Shakeel; Alamgir, Waseem; Ali, Syed Khawar Military Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 354-357 (17 ref.) Keywords: Diabetes Mellitus; Cross-Sectional Studies; Glucose; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Triglycerides Abstract: To determine the frequency of dyslipdemias in diabetic patients at Combined Military Hospital Multan. Cross sectional observational. Department of Medicine, Combined Military Hospital Multan from February 2007 to August 2007. Diabetic patients aged between 30-70 years of either gender and having diabetes for >5 years were included in the study. Patients with co-existent hypothyroidism, chronic renal failure, nephritic syndrome, familial hypercholesteremic syndromes, already on lipid lowering drugs, anti-hypertensive drugs, using beta blockers or thiazide diuretics, obese patients with BMI > 30 and those using alcohol were excluded. Blood samples after overnight 10 hours fasting were taken for plasma glucose, serum total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides. Frequency of dylipideamias was analysed using Statistical Package for Social Sciences [SPSS] version 10. Mean age of 200 diabetic patients included in the study was 51 +/- 9.47 years [range 34-70 years] and male to female ratio of 1.21:1. Mean fasting plasma glucose levels of the diabetic patients was 8.2 +/- 2.2 mmol/L. Out of 200 patients, dyslipideamia was present in 163 [81.5%] patients. Hypertrglyceridemia was present in 150[75%] patients, raised LDL-cholesterol in 126 [63%] patients, decreased HDL-cholesterol in 119 [59.9%] patients, and raised levels of total cholesterol in 89 [44.5%] of the patients. Diabetic patients have a high frequency of dyslipidemias especially raised triglycerides, therefore lipid profile is to be checked routinely and its management be given equal importance in addition to glycemic control. IMEMR Current Contents Subject Index 42 Echinococcosis diagnosis Echoguided pair technique in diagnosis and treatment of abdominal hydatid cystic disease in Egyptian patients: clnical and ultrasonographic follow up. El Kady, Nabeel; Ramzy, Iman; El Garem, Hasan A.; Abdel Haleem, Hanan; El Bahnasawy, Mamdouh M. Cairo University - Faculty of Medicine - Department of Tropical Medicine Journal of the Egyptian Society of Parasitology 2011; 41 (3): 527-542 (58 ref.) Keywords: Abdomen-ultrasonography; Echinococcosis, Hepatic-therapy; Follow-Up Studies Abstract: The introduction of the percutaneous puncture, aspiration, injection of scolecidal agent and reaspiration [PAIR] technique is gaining an increasing acceptance in diagnosis and treatment of abdominal cystic hydatid disease [CHD]. Thirty-three patients [12 male and 21 female with age between 15 and 70 years] had 46 cysts in liver, spleen and kidneys [75.7%, 18.2% and 6.1% respectively]. Puncture, aspiration, injection of 95% sterile alcohol for 20 minutes and reaspitation [PAIR] was used for treatment of hydatid cysts of different types and sizes. Follow up both clinically and ultrasonographically was done over a period of 2 years. The commonest ultrasound picture was type la [overall echofree] in 80.4%, commonly in the liver [75.7%] mainly in the right lobe [88%]. Improvement of symptoms had occurred its 85% within 3 weeks. As regards ultrasound follow up of 41 non-complicated cysts within the 1[st] six months, was disappearance of 5 cysts, 34 reduced in size and 36 showed different grades of solidification. After 1.5 year 10 more cysts disappeared while the pseudotumour appearance was shown in remaining 26 cysts. Ultrasound follow up of the 5 infected cysts revealed complete cure within a period of 8-16 weeks in 4 of them. The last patient discontinued drainage therapy and was referred to surgery. This makes ultrasound cure reaching 97%. Minor complications were skin reaction only in 2 patients [6%]. No fatal anaphylaxis cyst recurrence or rupture into the peritoneal cavity or bleeding from renal or splenic puncturing. PAIR technique under ultrasonographic guidance is the first choice method for treatment of abdominal CHD especially in the developing countries and inoperable hydatid cysts. Education, Medical Medical education in Saudi Arabia: a review of recent developments and future challenges. Telmesani, A.; Zaini, R.G.; Ghazi, H.O. E-mail:telmesan@gmail.com Umm Al Qura University - Faculty of Medicine EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 703-707 (20 ref.) Keywords: Schools, Medical; Curriculum; Problem-Based Learning; Accreditation; Private Sector Abstract: Medical education has been changing rapidly in Saudi Arabia. Within a decade, the number of medical colleges increased from 5 medical schools with traditional disciplined-based curricula to 21 medical colleges with varied curricula ranging from the traditional to more innovative, problem-based, community-oriented programmes. The private sector has started investing in higher education generally and medical education in particular. Also other government sectors that provide advanced health services have started established new medical colleges. The expansion of quantity in medical education has been associated with a drive for greater quality assurance. Accreditation of higher education institutes began with the establishment of the National Commission for Academic Assessment and Accreditation in 2005. This review focuses on documenting developments in Saudi medical education up to 2008 and discussing the future potential and challenges facing the sector. Education, Medical, Graduate Brain drain: a harsh reality, international migration of Pakistani medical graduates. Imran, Nazish; Azeem, Zahra; Haider, Imran Ijaz; Bhatti, Muhammad Riaz E-mail:nazishimrandr@gmail.com Kind Edward Medical University - Mayo Hospital - Department of Child and Family Psychiatry JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 67-72 (21 ref.) Keywords: Clinical Competence; Foreign Professional Personnel; Emigration and Immigration-trends; Socioeconomic Factors; Delivery of Health Care; International Cooperation Abstract: To explore final year students and fresh graduates' intentions to train abroad, identify the influencing factors for this decision and understand their attitudes towards conditions in Pakistan and abroad. Following informed IMEMR Current Contents Subject Index 43 consent, respondents were asked to complete a self administered structured questionnaire to collect demographic and educational information, their plans for post graduation training abroad, factors influencing decision to migrate abroad or stay in Pakistan as well as attitudes towards prospects in Pakistan and abroad. Data was entered and analyzed by SPSS 17.0. Among the 275 respondents, 176 [60.4%] intended to go abroad for postgraduate training. Professional excellence [25.5%], easier career settlement [10.2%] and financial prosperity [7.6%] were some of the goals respondents wish to achieve through training abroad while required process of certifications i.e exams and tests [37.5%], expenses [24.4%] and visa problems [21.5%] were identified as barriers for migration abroad. Agreement among various groups [general public, patients, healthcare institutions, academic community] considering doctors trained abroad as more qualified than doctors trained in society and government attitude towards doctors as well as living standards in Pakistan. Positive attitudes were identified towards doctors' status, living standards, and ability to cope with working conditions, political and social circumstances abroad. A significant percentage of medical graduates intend to migrate abroad for post graduate training. Apart from better economic prospects, unhelpful view towards conditions in Pakistan also contribute for increasing trend of migration among physicians from our homeland. Education, Medical, Undergraduate history Undergraduate medical education in Bahrain. Imam, Amjad E-mail:amjadi@agu.edu.bh Arabian Gulf University Bahrain Medical Bulletin 2012; 34 (1): 5-6 (10 ref.) Keywords: Education, Medical, Undergraduate-statistics and numerical data; Curriculum; Schools, Medical; Program Evaluation Enamel Microabrasion Comparative evaluation of tooth enamel abrasion induced by different toothpastes. Yaghini, J.; Mogharehabed, A.; Kaveh, M.; Mousazadeh, H.; Madani, M. Isfahan University of Medical Sciences - Dental School - Department of Periodontics Journal of Dental School - Shahid Beheshti University of Medical Sciences 2012; 29 (4): 274-282 (31 ref.) Keywords: Dental Enamel; Toothpastes; Tooth Abrasion Abstract: Tooth brushing along with a toothpaste is the most frequent and important method in managing a healthy oral hygiene. However, using such products also has its side-effects and shortcomings. Considering the large range of toothpastes available and the insufficiency of proper researches in this area in Iran, this study was designed to evaluate the abrasiveness of a toothpaste for sensitive teeth and a whitening one with two similar Iranian brands. This was an invitro experimental study. Four groups of enamel samples consisting of each 6 specimens were prepared and embedded in acrylic blocks. The initial surface profile for each specimen was calculated using a profilometer. The samples undertook the wear phase in a V8 Cross Brushing machine using toothbrushes and a toothpaste solution. The samples were then dried and the surface profile was again calculated. The variation of the first and second profilometer calculations demonstrate the amount of wear for each specimen. Data was analyzed using the SPSS program by means of One way ANOVA and Repeated Measure ANOVA tests. The amount of wear recorded for the 4 experimental groups was significantly different [p=0.039]. However, the two by two comparision tests showed that the Iranian brands did not appear to have a significant difference with their foreign counterparts [p>0.05]. The only difference was apperant between the two Iranian brand groups. According to the present study, it seems that there is no significant difference in the abrasive properties of the Iranian and foreign made toothpastes. However, similar researches considering different effects of toothpastes and especially in more clinical conditions and by utilizing different measurement methods appears to be necessary in Iran. Endometriosis diagnosis Scar endometriosis - case reports of two patients. Batool, Sadiqa; Kazmi, Kashif Raza; Hussain, Capt Sameed Combined Military Hospital IMEMR Current Contents Subject Index 44 PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 481-482 (12 ref.) Keywords: Cicatrix; Cesarean Section Enterocolitis, Pseudomembranous complications Clinical predictors of fulminant colitis in patients with clostridium difficile infection. Girotra, Mohit; Kumar, Vivek; Khan, Javaid M.; Damisse, Pamela; Abraham, Rtika R.; Aggarwal, Vikas; Dutta, Sudhir K. The Johns Hopkins University - Division of Gastroenterology - Department of Medicine Saudi Journal of Gastroenterology [The] 2012; 18 (2): 133-139 (28 ref.) Keywords: Enterocolitis, Pseudomembranous-mortality; Corynebacterium Infections-mortality; Age factors; Colectomy; Leukocytosis; Predictive Value of Tests; Retrospective Studies Abstract: Clostridium difficile infection [CDI] can affect up to 8% of hospitalized patients. Twenty-five percent CDI patients may develop C. difficile associated diarrhea [CDAD] and 1-3% may progress to fulminant C. difficile colitis [FCDC]. Once developed, FCDC has higher rates of complications and mortality. A 10-year retrospective review of FCDC patients who underwent colectomy was performed and compared with randomly selected age- and sex-matched non-fulminant CDAD patients at our institution. FCDC [n=18] and CDAD [m=49] groups were defined clinically, radiologically, and pathologically. Univariate analysis was performed using Chi-square and Student's t test followed by multivariate logistic regression to compute independent predictors. FCDC patients were significantly older [77 +/- 13 years], presented with triad of abdominal pain [89%], diarrhea [72%], and distention [39%]; 28% had prior CDI and had greater hemodynamic instability. In contrast, CDAD patients were comparatively younger [65 +/- 20 years], presented with only 1 or 2 of these 3 symptoms and only 5% had prior CDI. No significant difference was noted between the 2 groups in terms of comorbid conditions, use of antibiotics, or proton pump inhibitor. Leukocytosis was significantly higher in FCDC patients [18.6 +/- 15.8/mm[3] us 10.7 +/- 5.2/mm[3], P=0.04] and further increased until the point of surgery. Use of antiperistaltic medications was higher in FCDC than CDAD group [56% vs 22%; P=0.01]. Our data suggest several clinical and laboratory features in CDI patients, which may be indicative of FCDC. These include old age [>70 years], prior CDI, clinical triad of increasing abdominal pain, distention and diarrhea, profound leukocytosis [>18,000/mm[3]], hemodynamic instability, and use of antiperistaltic medications. Epstein-Barr Virus Infections Myriad presentations of a common viral infection. Khan, Muhammad Babar; Iftikhar, Raheel; Iqbal, Zuhaib Military Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 486-487 (7 ref.) Keywords: Herpesvirus 4, Human; Infectious Mononucleosis; Lymphocytes Escherichia coli Infections diagnosis Clinical and bacteriologic correlates of the PapG alleles among uropathogenic escherichia coli strains isolated from cases of adult urinary tract infection. Zamanzad, Behnam; Karimi, Ali; Nafisi, Mohammad Reza; Shirzad, Hedayatollah Shahre-kord University of Medical Sciences - Faculty of Medicine - Cellular and Molecular Research Center KMJ - Kuwait Medical Journal 2012; 44 (1): 26-29 (17 ref.) Keywords: Escherichia coli Infections-genetics; Escherichia coli-isolation and purification; Urinary Tract Infections- microbiology; Urinary Tract Infections-diagnosis; Alleles; Adhesins, Escherichia coli-genetics Abstract: To study the distribution of papG gene in uropathogenic Escherichia coli [E.coli] strains isolated from adult urinary tract infection [UTI] and the relationship between the different classes of papG gene and patients, sex, hospitalization and their clinical forms of UTI. Laboratory study. Inpatient and outpatient settings with laboratory investigation. Genotyping of papG, the adhesion gene of E. coli P fimbriae, may predict clinical outcomes of UTI. A total of 182 urinary E .coli strains were analyzed by multiplex PCR method for detection of papG gene. Patients, sex, hospitalization and their clinical forms of UTI were also evaluated. The distribution of papG gene in uropathogenic IMEMR Current Contents Subject Index 45 E.coli strains and the relationship between papG gene and clinical features of the patients. Multiplex PCR method was performed for detection of papG gene in uropathogenic E.coli strains isolated from adult urinary tract infections The prevalence of pap operon in the uropathogenic isolates was 36.2%. The prevalence of papG gene classes II and III in uropathogenic isolates was 23.1% and 6.6% respectively. None of the isolates had class I genotype. PapG classes II and III were predominant in patients with pyelonephritis and cystitis respectively. There was no significant relationship between the presence of papG alleles, sex and hospitalization of the patients. PapG gene is likely to play an important role in pathogenesis of uropathogenic strains of E.coli in adult nosocomial UTIs. Detection and genotyping of this gene may contribute to improving the management of UTI. Exercise Effect of exercise on serum iron, blood haemoglobin and cardiac efficiency. Choudhary, Sunita; Rajnee; Binawara, Bijendra Kumar E-mail:choudharysunita55@yahoo.com Sardar Patel Medical College - Department of Physiology JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 13-16 (18 ref.) Keywords: Iron-blood; Hemoglobins-chemistry; Hemodynamics; Blood Pressure Abstract: The aim of present study was to assess the impact of exercise in trained and untrained exercise performers on serum iron, blood haemoglobin and cardiac efficiency through quantified exercise on Harvard Steps. The present study was carried out on 13 male medical students and compared it with 10 male athletes in the age group of 18 to 25 years at Dr. Sampurnanand Medical College, Jodhpur. The biochemical parameter was serum iron and hemodynamic parameters measured were hemoglobin, pulse rate and blood pressure in both the groups after overnight rest and after quantified bout of exercise for 5 minutes on Harvard step. Serum iron fell from pre-exercise level and was more marked [P<0.01] in untrained. After exercise there was significant rise [P<0.001] of hemoglobin and pulse rate in untrained [P<0.001]. A significant increase in systolic blood pressure in case of untrained boys [p<0.01] and athletes [p<0.001] was observed. Whereas decrease in diastolic blood pressure was observed in both the groups but decrease in diastolic blood pressure were more marked in athletes [P<0.001]. Exercise induces improvement in hemodynamic status. Factor XIIIa genetics Molecular study of coagulation factor XIII-A among patients with inherited factor XIII-A deficiency. Tamaddon, G.H.; Kazemi, A.; Rastgari, G.H.; Ala, F.; Hejazi, S.H. Zahedan University of Medical Sciences Scientific Journal of Iranian Blood Transfusion Organization Research Center [The] 2012; 8 (4): 298-305 (23 ref.) Keywords: Factor XIII Deficiency; Polymorphism, Restriction Fragment Length Abstract: Factor X[1] is the last enzyme in the clotting cascade. The gene of A chain is located on chromosome 6. Deficiency of factor XIII in autosomal recessive conditions occurs at a frequency of 1 in 2 million general population. The aim of this study was to detect the mutations of subunit A in both patients and carriers. In this study we have investigated the molecular basis of inherited FXIII deficiency among patients from 21 unrelated Iranian families. Mutation were detected by amplifying each exon. Those exons exhibiting the presence of hetero duplex formation sensitive gel electrophoresis, were selected for direct sequencing. After sequencing, detected mutation was carried out by restriction fragment length polymorphism [RFLP]. All patients having entered the study had mutations. Twelve patients had homologues substitution of TGG->CGG in exon 4, 1 insertion mutation occurring in exon 7 triple G, 2 patients demonstrated mutation exon 9 ATG-> AAG, 3 patients had substitution of CGG-> CAG in exon 10, and 3 patients showed a homologue subsituation mutation in exon 15 GCC->GTC. Our findings suggest that the activity of enzyme is highly dependent on the core domain. Changes in charge, amino acid tail and conformation lead to decreased enzyme activity. Also tetrameric structure is calcium related. It seems that changes of amino acid sequence convert enzyme stability. IMEMR Current Contents Subject Index 46 Familial Mediterranean Fever diagnosis Limping child septic arthritis, or familial mediterranian fever?. Aytekin, Mahmut N.; Akelma, Zalfikar; Mete, Emin E-mail:nedimaytekin@hotmail.com Fatih University Hospital - Department of Orthopedics and Traumatology Medical Journal of Islamic World Academy of Sciences 2012; 20 (1): 31-32 (7 ref.) Keywords: Arthritis, Infectious-diagnosis; Diagnosis, Differential Abstract: Acute limping child is one of the most important problems of pediatric emergency, which demands great caution. Here represented a case diagnosed first with sinusitis, followed by septic arthritis, and appendicitis and finally diagnosed with the Familial Mediterranean Fever [FMF]. The aim of this report is to remind clinicians to suspect FMF in the case of acute limping child. Fetal Membranes, Premature Rupture Comparison of management outcome of induction of labor with expectant management for term prelabor rupture of membranes. Tariq, Seema; Tanveer, Shamaila; Nousheen, Javaria Combined Military Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 466-469 (20 ref.) Keywords: Labor, Induced; Treatment Outcome; Dinoprost-therapeutic use; Pregnancy Outcome; Oxytocin- therapeutic use Abstract: To compare the management outcome of induction of labor with expectant management in patients with term prelabor rupture of membranes [PROM]. Randomised control trial [RCT] Department of Obstetrics and Gynaecology Combined Military Hospital Gujranwala, and Department of Obstetrics and Gynaecology Combined Military Hospital Peshawar, from Dec 2006 to June 2008. The study was carried in maternity wards and labour rooms of both the hospitals. One hundred and fifty patients fulfilling the inclusion criteria were selected for this study. They were divided into two groups [A and B, 75 each]. Patients in group A were induced with tablet placed in posterior vaginal fornix. Group B patients were managed expectantly for 24 hours. Fetal heart rate was monitored one hourly and maternal vital signs were monitored six hourly. The mean duration between PROM to onset of active labor in group A was 8.6 +/- 1.7 hours and in group B was 9.3 +/- 1.2 hours. The mean duration between PROM to delivery in group A was 16.2 +/- 1.5 hours and in group B was 21.9 +/- 1.2 hours. In group A, 68 [90.7%] patients delivered by SVD and 7 [9.3%] patients by LSCS. In group B, 67 [89.3%] patients delivered by SVD and 8 [10.7%] patients by LSCS. In group A, 6 [8%] patients developed chorioamnionitis and 10 [13.3%] patients in group B. In group A, there were 3 [4%] cases of neonatal sepsis and 4 [5.3%] patients in group B. Management outcome of induction of labor in term prelabor rupture of membranes is better than expectant management. Fetomaternal Transfusion Fetomaternal transfusion as a cause of severe fetal anemia causing early neonatal death: a case report. Ahmed, Masood; Abdullatif, Mohammad E-mail:duaamasood68@yahoo.com Sultan Qaboos University Hospital Oman Medical Journal 2011; 26 (6): 444-446 (13 ref.) Keywords: Erythroblastosis, Fetal; Stillbirth; Fetal Death; Hydrops Fetalis; Cardiotocography; Anemia Abstract: Fetomaternal hemorrhage refers to the entry of fetal blood into the maternal circulation before or during delivery. Very small amount of fetal red cells are normally detectable in all pregnancies. Massive fetomaternal bleed is very rare and even rarer is the resultant severe anemia causing early neonatal death, despite an uneventful normal pregnancy until the end. Antenatal fetomaternal hemorrhage is a pathological condition with a wide spectrum of clinical variation. Secondary to the resultant anemia, fetomaternal hemorrhage may have devastating consequences for the fetus such as neurologic injury, stillbirth, or neonatal death. The Presentation is frequently without an evident precipitating factor. Recognition may become apparent only after injury has occurred, if at all. The most common IMEMR Current Contents Subject Index 47 antenatal presentation is decreased fetal activity and a heightened index of suspicion is warranted in cases of persistent maternal perception of decreased fetal movements. Fluid Therapy Good for old as well as young: oral rehydration therapy [ORT]. Greenough, William B. E-mail:wgreeno2@jhmi.edu Johns Hopkins University - Division of Geriatric Medicine - Department of Medicine KMJ - Kuwait Medical Journal 2012; 44 (1): 1-2 (8 ref.) Keywords: Cholera-drug therapy; Diarrhea-prevention and control; World Health Organization; Cholera-mortality; Treatment Outcome Foreign Bodies radiography Non opaque foreign body aspiration in children: should we be more vigilant and proactive? Ahmad, Naseer; Ashfaq, Mohammad; Javed, Mohammad; Khan, Qaisar E-mail:naseerent@yahoo.com Khyber Teaching Hospital - Department of ENT and Head and Neck Surgery JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 102-105 (15 ref.) Keywords: Bronchoscopy; Emergency Service, Hospital; Radiography, Thoracic; Treatment Outcome Abstract: To study the frequency of symptoms, composition and complications of clinically suspected non radio- opaque foreign body aspiration; which is a difficult diagnostic challenge resulting in delayed referral for bronchoscopy. This descriptive analysis of 400 cases of foreign body aspiration was done in the department of ENT and Head and Neck surgery. Lady Reading Hospital Peshawar from 2003-2006. One hundred cases were selected with presumptive diagnosis of foreign bodies in tracheobronchial tree. The inclusion criteria were not witness and non radio-opaque foreign bodies. We reviewed their hospital record to ascertain history diagnosis and treatment. Age, sex, location in tracheobronchial tree, witnessed or un-witnessed events, symptoms, radio graphic findings, anatomical abnormalities noted at endoscopy and complications were recorded. Radio opaque foreign bodies were excluded from the study. A total of hundred cases were included. Age range was from 2-5 years. Males were 70% and females were 30%. Delay in presentation was from 10 days to 4 years. Common symptoms at presentation were cough 55% and asthma 20%. Radiological findings were abnormal in 90% of cases. Upon bronchoscopy 70% were positive for foreign body and 30% were negative. Peanuts [30%] and whistles [28%] were the commonest foreign bodies. No death occurred in this study and minor complications of the procedure were only 15%. Aspiration of foreign bodies in children can lead to serious morbidity if not recognized and treated in time; hence early referral is essential. Fractures, Ununited etiology Analysis of causes and treatment modality in non-union of long bones diaphyseal fractures. Malik, Zaka Ullah; Mahmood, Khalid; Ahmed, Nauman Tasneem; Khan, Amanat; Tariq, Shahrukh; Naqvi, Shahid Hussain Combined Military Hospital - Orthopaedic Department PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 433-437 (20 ref.) Keywords: Fractures, Ununited-therapy; Fractures, Bone-therapy; Fractures, Bone-surgery; Femoral Fractures; Ulna Fractures; Radius Fractures; Humeral Fractures; Tibial Fractures; Treatment Outcome; Fracture Fixation, Intramedullary; Bone Nails; Bone Plates Abstract: The purpose of this study was to analyze the causes of nonunion leading to modification in treatment modalities in long bones diaphyseal fractures. Descriptive Study. Combined Military Hospital Quetta, Combined Military Hospital Sialkot, Pakistan, from 5th Sep 2005 to 26th Dec 2008. Non-healing long bones diaphyseal fractures > 6 months were included with exclusion of pathological fractures, delayed union < 6 months. Patients general profile and fracture details with non-union causes were recorded. Old failed surgery with re-do surgical intervention was analyzed. Infected cases were treated with removal of implant, thorough debridment, appropriate antibiotics followed by delayed IMEMR Current Contents Subject Index 48 stabilization while non-infected cases with stable fixation and bone grafting. Out of fifty six patients, tibial fractures were maximum 17[30.4%], femur 16[28.6%], radius ulna 15[26.6%], and humerus 8[14.3%]. Most patients were young 37[66.07%] and male 48[85.7%]. Road traffic accident caused 43[76.8%] fractures. Causes of non-union were high energy trauma 37[66%], insufficient stabilization 31[55.4%], followed by smoking, soft tissue interposition, poor nutrition, NSAIDs, broken implants, infection, intact fellow bone, multiple segment fracture, repeated manipulation, chronic illness and neurovascular impairment in descending order. Plates failed more than K nails. Complications like superficial and deep infection, neuroprexia and delayed healing settled with bone healing in mean time 4.76 months. Nonunion of long bones diaphyseal fractures can be prevented by avoiding causative agents, early intervention, tissue protection and stable fixation. Interlock nailing is best for femur, good for tibia, may be useful in humerus but not suitable for radius and ulna. Bone graft accelerates healing process. Early re do surgery must be considered because of manageable rate of complications. Fresh Water chemistry Chemical and biological assessment for Egyptian surface freshwater environment with reference to human activities. El Khayat, Hanaa M.M.; Mostafa, Bayomy B.; El Deeb, Fatma A.; Ragab, Fawzy M.; Tantawy, Ahmed A.; Ismail, Nahed M.M.; El Said, Khalil M.; Mahmoud, Kadria M.A. Theodor Bilharz Research Institute - Department of Environmental Research and Medical Malacology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 715-728 (26 ref.) Keywords: Fresh Water-analysis; Metals, Heavy-analysis; Seasons; Sodium-analysis; Potassium-analysis; Calcium- analysis; Human Activities Abstract: The Egyptian freshwater was assessed in the River Nile, branches, main canals and certain drainages in eight Governorates, over eight successive seasons starting from spring 2008. Chemical assessment was made through ten parameters and the biological one was made through macro-invertebrates information. Results showed that means of Cd, Pb, Cu, Hg, Mn, Fe, Ni, Na, K and Ca varied in watercourses seasonally within somewhat narrow ranges, which may exceed the level of concern but with some elevations in branches, Rayahs and canals during certain seasons. Sites showed chemical levels over the permissible one or those gain total points </= 6.3 according to the biological assessment indicate that very poor habitat or those of Hilsenhoff Biotic Index [HBI] equal to 7-10 indicate that organic pollution were observed in all the studied watercourses reflecting hazard non point source pollution. Damietta branch in the region of Damietta city characterized with elevations in the concentration of most chemicals examined. The percentages of sites that showed chemical level over the permissible one were 70.56% for K, 54.08% for Cu, 50.08% for Na, 22.08% for Cd, 11.36% for Fe, 5.6% for Pb, 1.92% for Ni, 1.12% for Mn, 0.16% for Ca and at last 0.0736% for Hg. The biological assessment was more able to define more polluted sites than did the chemical one. Human activity data revealed that each of the drains, Giza and Qalyubia canals showed the highest item conduction [animal or plant waste, macroscopic pollution and presence of bridges or barriers] and this was co parallel with their highest pollution recordation. Ganglioneuroma diagnosis Extra-adrenal retroperitoneal ganglioneuroma. Al Hammadi, Adhoob Abdul Aziz; Hameed, Tariq; Mohammed, Sayed Shubbar; George, Sara Mathew; Abdul Naseer, Mohammed; Al Hadad, Zainab; Sabt, Sajeda E-mail:dr.amoob_alhammadi@hotmail.com Salmaniya Medical Complex - Oncology and Hematology Department Bahrain Medical Bulletin 2012; 34 (1): 41-43 (13 ref.) Keywords: Ganglioneuroma-pathology; Ganglioneuroma-surgery; Immunohistochemistry; Treatment Outcome; Ganglioneuroblastoma Abstract: Ganglioneuromas are benign tumors that originate from primordial neural crest cells. We report a retroperitoneal ganglioneuroma arising from the left paraspinal region. A twenty-year old woman presented with left lumbar pain. Neurological workup was normal. Imaging revealed a left paraspinal retroperitoneal mass measuring 9.74 x 6.19 x 4.30 centimeters. Complete surgical removal was uneventful. During follow-up, left lumbar pain improved and imaging showed no evidence of the disease. IMEMR Current Contents Subject Index 49 Gastric Bypass adverse effects Diagnostic computerized tomography sign in Petersen's space hernia after laparoscopic roux- en-Y gastric bypass. Iskandar, Maher Maurice; Ismail, Zahraa Ahmad; Al Summait, Basel Abdul Aziz E-mail:drmaherisk@yahoo.com Ministry of Health - Mubarak Al-Kabeer Hospital - Department of Surgery KMJ - Kuwait Medical Journal 2012; 44 (1): 69-70 (7 ref.) Keywords: Hernia-radiography; Hernia-diagnosis; Tomography, X-Ray Computed; Laparoscopy Abstract: Petersen's space hernia [PSH] is a well-known complication of laparoscopic roux-en-Y gastric bypass [LRYGB] in up to 7% of cases. This led the surgeons to close this defect during surgery. We report the case of a young lady, 25 years old with a body mass index [BMI] of 55 kg/m[2] who had LRYGB in October 2004 with antecolic roux limb, without closing the Petersen's space [PS]. Two years later she presented with vague abdominal complaints, which drew our attention to the occurrence of this type of internal bowel herniation through the PS. routine laboratory investigation and upper endoscopy failed to reveal the problem. However, computerized tomography [CT] scan of the abdomen showed one of the major signs of internal herniation, namely, rotation by 180 degrees of the superior mesenteric vein [SMV] counterclockwise upon the superior mesenteric artery [SMA]. This hernia was reduced surgically through small laparotomy wound after a failed trial to do it laparoscopically. The PS defect was repaired and closed. Gastrostomy methods Percutaneous endoscopic gastrostomy tube placement for end-stage palliation of malignant gastrointestinal obstructions. Teriaky, Anouar; Gregor, Jamie; Chande, Nilesh E-mail:ateriaky@uwo.ca London Health Sciences Centre - Victoria Hospital - Division of Gastroenterology Saudi Journal of Gastroenterology [The] 2012; 18 (2): 95-98 (17 ref.) Keywords: Intestinal Obstruction-surgery; Intestinal Obstruction-etiology; Intubation, Gastrointestinal-methods; Palliative Care-methods; Retrospective Studies; Intubation, Gastrointestinal-instrumentation; Gastrostomy- instrumentation; Treatment Outcome Abstract: Decompression of malignant gastrointestinal obstructions is an uncommon indication for percutaneous endoscopic gastrostomy [PEG] tubes. The purpose of this study is to determine the efficacy of venting PEG tubes in relieving nausea and vomiting and assessing complications associated with tube placement. This study is a retrospective chart review of patients with PEG tubes placed to decompress malignant gastrointestinal obstructions between January 2005 and September 2010 by the gastroenterology service at our institute. Patient demographics, symptom relief, procedural complications, diet tolerability and home palliation were reviewed. Seven PEG tubes were inserted to decompress malignant gastrointestinal obstructions. The mean patient age was 62 years [range 37-82 years]. The underlying primary malignancies were small intestine [1], appendiceal [1], pancreatic [2], and colon [3] cancer. Gastric outlet obstruction was present in 3 [43%] patients while small bowel obstruction occurred in 4 [57%] patients. There was relief of nausea and vomiting in 6 [86%] patients. Procedural complications were present in 1 [14%] patient and involved superficial cellulitis followed by peristomal leakage. Patients with gastric outlet obstruction continued to have limited oral intake while patients with small bowel obstruction tolerated varying degrees of oral nutrition. Six [86%] patients were discharged home after PEG tube placement, but only 2 [33%] were able to undergo end-stage palliation at home without re-admission for hospital palliation. Venting PEG tubes significantly reduce the symptoms of nausea and vomiting in patients with metastatic gastrointestinal obstruction due to primary gastrointestinal malignancies. Complications associated with tube placement were minimal. IMEMR Current Contents Subject Index 50 Geologic Sediments analysis Investigation of the heavy metal contamination of the sediments from the yellow river wetland nature reserve of Zhengzhou, China. Cheng, Q.; Wang, W.; Wang, H.; Ang, W.; Zhao, Z. E-mail:chengqingli@ncwu.edu.cn North China University of Water Resources and Electric Power - Institute of Environmental and Municipal Engineering Iranian Journal of Public Health 2012; 41 (3): 26-35 (32 ref.) Keywords: Metals, Heavy-analysis; Geologic Sediments-chemistry; Rivers Abstract: Heavy metal pollution in the sediment of the Yellow River draws wide attention in the recent years. The Yellow River wetland nature reserve of Zhengzhou is one of the major wetlands of the river and located at the beginning of the lower reach. In this article, we aimed to investigate the degree and the sources of the metal pollution in the reserve. Metals as Cu, Pb, Cr, Cd and Mn in the sediment were monitored using flame atomic absorption spectrometry. The index of geo-accumulation [I[geo]] and the modified degree of contamination [mC[d]] were developed to evaluate individual metal pollution and overall enrichment impact of the elements. Compared with sediment quality guidelines, the effect of Cr and Pb are more serious than others. I [geo] values show Pb pollution are moderate at the Xinzhai, Langchenggang and Nansutan sites, and mC[d] analysis indicate the whole contamination at the Wantan, Langchenggang and Nansutan sites was low. Principal component analysis indicated that the first factor was Cu, Mn and Cd, mainly from soil erosion and the irrational use of phosphate fertilizers; the second Pb from fossil fuel burning; and the third Cr from weathering process. We conclude that Pb contamination is serious in the reserve, and the main sources of the metal are crude oil consumption and coal combustion of the brick kilns around. We also draw a conclusion that it is vital to evaluate contamination degree with both individual elements and overall average. Granulocyte Colony-Stimulating Factor therapeutic use Effect of granulocyte colony-stimulating factor on liver injury induced by CCL4: a correlation between biochemical parameters and histopathology results. Qujeq, Durdi; Abassi, Roya; Faeizi, Farideh; Parsian, Hadi; Tahhery, Hassan; Halallkhor, Sohhrab E-mail:d.quieq@mubabol.ac.ir Babol University of Medical Sciences - Cellular and Molecular Biology Research Center [CMBRC] KMJ - Kuwait Medical Journal 2012; 44 (1): 46-49 (13 ref.) Keywords: Liver-injury; Liver-drug effects; Carbon Tetrachloride; Liver-anatomy and histology; Prospective Studies; Rats, Wistar Abstract: To determine whether granulocyte colony-stimulating factor [G-CSF] could reverse liver damage in the model of acute liver injury induced by carbon tetrachloride [CCL4]. Prospective, using experimental animal model of acute and chronic liver injury. Babol University of Medical Sciences, Babol, Iran. We established an animal model of liver damage by administration of CCL4 [1 ml/kg, IP]. Two hours later the animals were treated with G-CSF [100 microg /kg body weight, IP] . On the 28[th] day, rats were scarified. Malondialdehyde [MDA] was determined using diagnostic kits following recommendations of manufacturer of the kits. Serial 5 micro m thick liver sections were stained with haematoxylin-eosin and Masson,s trichrome and examined. Reduction in serum albumin and total protein levels [1.24 +/- 0.16 and 3.22 +/- 0.21 g/ dl, respectively] were 2.58 +/- 0.19 and 6.82 +/- 0.30 g/dl, respectively reversed by G-CSF treatment. CCL4-induced increase in serum AST, ALT, and ALP activities and MDA and hydroxyproline levels were significantly suppressed by G-CSF treatment. G-CSF stimulates liver repair and may be clinically beneficial in restoring liver damage. There was a positive correlation [p < 0.05]between histopathological and biochemical parameters. Guillain-Barre Syndrome Frequency of axonal variants of guillain-barre syndrome in Pakistan. Khan, Muhammad Babar; Muhammad, Wasem Wali; Nawaz, Khuram Haq; Ahmad, Imran; Yousaf, Muhammad Ali; Ahmad, Nadeem; Rathore, Farooq Azam; Ahmad, Khalil Military Hospital IMEMR Current Contents Subject Index 51 PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 358-363 (28 ref.) Keywords: Electromyography; Neural Conduction; Axons Abstract: To determine the frequency of axonal variants in our patients of Guillain-Barre Syndrome. Descriptive study. Department of Neurology, Military Hospital, Rawalpindi and Armed Forces Institute of Rehabilitation Medicine [AFIRM] from 01 Jan 2009 to 30 Jul 2010. Forty adult patients meeting the National Institute of Neurological Disorders and Stroke criteria for Guillain-Barre Syndrome [GBS] were consecutively enrolled in the study. Patient's data, detailed history, examination and electrophysiological studies were carried out and recorded on predesigned proforma. All patients were examined and reviewed by Consultant Physicians and neurologists. Electromyography and Nerve conduction study testing was done by experienced electro-physiologists. Axonal variants of Guillain-Barre Syndrome constituted 16[40%] in our study. The variants of Guillain-Barre syndrome were acute inflammatory polyradiculoneuropathy [AIDP] in 24[60%] patients followed by acute motor axonal neuropathy [AMAN] in 12[30%] and acute motor sensory axonal neuropathy [AMSAN] in 4[10%] patients. We report a high frequency of the axonal variants of Guillain-Barre Syndrome in Pakistan. Head and Neck Neoplasms virology Head and neck cancer association to CIAP-2 expression due to human papillomavirus-16 [HPV- 16] infection. Mansour, Amal; Helmy, Hussein; Ali, Marwa; Kassim, Samar E-mail:amal.bary@gmail.com Ain Shams University - Faculty of Medicine - Medical Biochemistry Department EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 343-360 (32 ref.) Keywords: Human Papillomavirus 16-genetics; Polymerase Chain Reaction-methods; Sensitivity and Specificity Abstract: It was relevant to assess the impact of a HPV-16 [human papillomavirus-16] which is a high-risk genotype on head and neck cancers and its relation to CIAP-2 expression [Cellular Inhibitor of apoptosis-2]. Tissue samples were taken from patients diagnosed as head and neck cancer. All samples were subjected to qualitative polymerase chain reaction [PCR] analysis for HPV, qualitative and semi-quantitative reverse transcription polymerase chain reaction [RT-PCR] of CIAP-2. There was a significant association between HPV-16 and CIAP2 positivity and head and neck tumors. CIAP-2 expression in malignant tissues was highly associated with HPV-16 infection at sensitivity 73.9 % and absolute specificity. Health Behavior psychology Individual differences in behavioral reactions to H1N1 during a later stage of the epidemic. Gaygisiz, Ummugulsum; Gaygisiz, Esma; Ozkan, Turker; Lajunen, Timo Gazi University - Department of Infectious Diseases and Clinical Bacteriology Journal of Infection and Public Health 2012; 5 (1): 9-21 (26 ref.) Keywords: Influenza A Virus, H1N1 Subtype; Personality; Health Knowledge, Attitudes, Practice; Influenza, Human- epidemiology; Pandemics; Questionnaires Abstract: Previous studies regarding individuals' behavioral reactions to the H1N1 epidemic have been conducted nearly exclusively on the pre-pandemic phase of the epidemic or when the vaccine was not available. The prevalence and correlates of behavioral reactions to the H1N1 epidemic in Turkey were investigated by surveying 1045 respondents. The results indicate that behavioral responses can be divided into three classifications: recommended protective behaviors, avoidance behaviors, and ineffective behaviors. The frequency of recommended behaviors was higher than other behaviors, and respondents perceived these behaviors to be more effective. Recommended behaviors were predicted by the following factors: age, being female and married, the individual's beliefs in the effectiveness of the behavior, the perception that one's own behavior influences the infection risk, and the personality factors [Activity] and [Impulsive Sensation Seeking.] Avoidance behaviors were predicted by the following factors: marital status, having small children, beliefs in the effectiveness of the behavior, mistrust of the government's ability to manage the epidemic, State Anxiety, and [Impulsive Sensation Seeking.] Ineffective behaviors were predicted by the following factors: lower socio-economic status, marital status, the presence of chronic illness, the perceived effectiveness of the behavior, and State Anxiety. This study demonstrates that different types of behavioral reactions to IMEMR Current Contents Subject Index 52 the epidemic have different contributing factors and that these differences should be taken into account in public health interventions. 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved. Health Expenditures Financial burden of health care expenditures: Turkey. Sulku, S. Nur; Bernard, D. Minbay E-mail:nursulku@gazi.edu.tr Gazi University - Economics and Management Sciences Faculty - Department of Econometrics Iranian Journal of Public Health 2012; 41 (3): 48-64 (17 ref.) Keywords: Cost of Illness; Insurance, Health; Health Care Reform; Poverty Abstract: In this study, we examine whether and to what extent the health insurance system in Turkey provided adequate protection against high out of pocket expenditures in the period prior to [The Health Transformation Programme]. Furthermore, we examine the distribution of out of pocket expenditures by demographic characteristics, poverty status, health service type, access to health care and self-reported health status. We employ the 2002/03 National Household Health Expenditure Survey data to analyze financial burden of health care expenditure. Following the literature, we define high burdens as expenses above 10 and 20% of income. We find that 19% of the nonelderly population were living in families spending more than 10% of family income and that 14% of the nonelderly population were living in families spending more than 20% of family income on health care. Furthermore, the poor and those living in economically less developed regions had the greatest risk of high out of pocket burdens. The risk of high financial burdens varied by the type of insurance among the insured due to differences in benefits among the five separate public schemes that provided health insurance in the pre-reform period. Our results are robust to three alternative specifications of the burden measure and including elderly adults in the sample population. We see that prior to the reforms there were not adequate protection against high health expenditures. Our study provides a baseline against which policymakers can measure the success of the health care reform in terms of providing financial protection. Health Promotion history Perception of health promotion in Unani medicine. Lone, Azad H.; Ahmad, Tanzeel; Anwar, Mohd; Sofi, G.H.; Imam, Hashmat E-mail:drazad2008@gmail.com National Institute of Unani Medicine - Department of Medicine Medical Journal of Islamic World Academy of Sciences 2012; 20 (1): 1-5 (16 ref.) Keywords: Medicine, Unani; Perception; History of Medicine Abstract: The Unani system of medicine is an age-old, time-tested system of medicine dating back 5000 years to Greece. Like any other form of medical science, Unani medicine strives to find the best possible ways by which a person can lead a healthy life with the least or zero sickness. Unani scholars believe that diseases can be kept at bay by using clean and fresh water, breathing clean air and consuming fresh food. Likewise, a balance should be maintained between the mind and the body so that the metabolic process can take place easily and the body waste evacuated. Unani medicine believes in promotion of health, prevention of diseases and cure through regimental and diet therapies. Heart Rate, Fetal ST analysis of the fetal ECG, as an adjunct to fetal heart rate monitoring in labour: a review. Kazmi, Tahira; Radfer, Forough; Khan, Sultana E-mail:kazmitahira@yahoo.com Khoula Hospital - Department of Obstetrics and Gynecology Oman Medical Journal 2011; 26 (6): 459-460 (12 ref.) Keywords: Review Literature as Topic; Fetal Distress; Pregnancy Outcome; Cerebral Palsy; Cardiotocography IMEMR Current Contents Subject Index 53 Hemangioma Mucosal venous hemangiomas of the oral cavity - an analysis of 43 cases and literature review. Qiam, Fahad; Khan, Muslim; Qiam ud Din E-mail:fahadqiam87@hotmail.com Khyber College of Dentistry - Department of Oral and Maxillofacial JKCD - Journal of Khyber College of Dentistry 2011; 2 (1): 16-20 (33 ref.) Keywords: Mouth Neoplasms; Review Literature as Topic; Vascular Malformations Abstract: To study the gender predilection, age group and affected site distribution of Mucosal venous hemangiomas of the oral cavity in patients reporting to Department of Oral and Maxillofacial Surgery at Khyber College of Dentistry, Peshawar, Khyber Pakhtunkhwa. Forty three patients were included in this descriptive study after a diagnosis was confirmed on the basis of clinical examination and "Blanching" test, carried out at Department of Oral and Maxillofacial Surgery at Khyber College of Dentistry, Peshawar, Khyber Pakhtunkhwa over a period of 3 years and 3 months. All patients with only mucosal hemangiomas were considered and those with intra-osseous, intramuscular, with or without soft tissue extensions of the condition, were excluded from the sample. Pertinent variables such as age, gender and affected site were noted and analyzed using Microsoft Excel 2007. Majority of the patients in this study were male [62.8%] whereas females constituted the remaining 37.2% of the sample. 11-20 years was the most prevalent age group whereas 41-50 years was the least prevalent age group in this study. Amongst the study sample, the tongue was found to be the most affected site, comprising 32.6% of cases and the maxillary gingival was the least affected site, accounting for only 2.3% of our study samples. Mucosal venous hemangiomas show a marked male predilection in our study sample. Patients falling in 11-20 year age range are affected mostly by the condition and the tongue is the most common affected site in patients from Khyber Pakhtunkhwa. Hemianopsia diagnosis Homonymous hemianopia due to occipital arteriovenous malformation. Qamar ul Islam E-mail:qamarullislam@hotmail.com Pakistan Air Force Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 483-485 (7 ref.) Keywords: Intracranial Arteriovenous Malformations; Arteriovenous Malformations; Magnetic Resonance Imaging Hepatitis B epidemiology Frequency of hepatitis B and C in patients visiting outpatient department of District Head quarters Hospital Lakki. Khan, Muhammad Ismail; Muhammad, Mumtaz E-mail:mumtaz_kmc@yahoo.com Mufti Mehmood Teaching Hospital - Department of ENT JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 55-60 (39 ref.) Keywords: Hepatitis C-epidemiology; Hepatitis B Surface Antigens; Hepatitis C Antibodies; Urban Population; Enzyme-Linked Immunosorbent Assay; Rural Population; Mass Screening Abstract: To find out the frequency of hepatitis B and C among the patients visiting out patient department. A total of 1443 subjects were screened for HBs Ag and anti-HCV in this descriptive study conducted from 1[st] January 2008 to 31 December 2008 in out patient department [OPD] District Headquarter Hospital Lakki. Patients of either sex and more that 15 years of age were screened for both hepatitis B and C. Patients with evidence of hepatitis B or C in the past were excluded. The HBs Ag and Anti-HCV screening was performed through Immunochromatographic [ICT] method. All sera showing reactivity were then confirmed with Enzyme Linked Immunosorbent Assay [ELISA]. The information of the patients was recorded on a proforma and analyzed. The frequency of hepatitis B was found to be 175 [12.12%] with a male predominance of 138 [14.97%]. Prevalence of hepatitis C was 58 [4.0%] with a male predominance 39 [4.22%], whereas in 5 [0.35%] cases both hepatitis B and c were present. Highest frequency of HBs IMEMR Current Contents Subject Index 54 Ag was detected in the settled area of the district while anti HCV was positive in high proportions in the frontier region [FR]. Overall prevalence of hepatitis was more common in rural population than the urban population. Hepatitis B is more common than hepatitis C in District Lakki. The high frequency of hepatitis needs to launch a major public awareness program and preventive measures to prevent its further spread. Hepatitis B Surface Antigens blood Clinical implications of HBsAg quantification in patients with chronic hepatitis B. Vigano, Mauro; Lampertico, Pietro University degli Studi di Milano - Ospedale San Giuseppe, l[st] Division of Gastroenterology - Hepatology Unit, Fondazione Ca Granda IRCCS Ospedale Maggiore Policlinico Saudi Journal of Gastroenterology [The] 2012; 18 (2): 81-86 (42 ref.) Keywords: Hepatitis B, Chronic-blood; Hepatitis B, Chronic-drug therapy; DNA, Viral-blood; Interferon-alpha- administration and dosage; Polyethylene Glycols-administration and dosage; Hepatitis B virus-metabalism; Antiviral Agents-therapeutic use Abstract: Quantification of serum hepatitis B surface antigen [HBsAg] helps the management of patients with chronic hepatitis B virus [HBV] infection. Median HBsAg levels differ significantly during the natural history of HBV infection, progressively declining from immune tolerance to inactive phase. The combination of an HBsAg <1000 lU/mL and HBV DNA <2000 lU/mL at a single time point accurately identifies true inactive carriers. During antiviral treatment, HBsAg levels decline more rapidly in patients under peg-interferon [Peg-IFN] than in those under nucleos[t]ide analogues [NUC], and in responders to peg-IFN compared to non responders suggesting that a response-guided therapy in both HBeAg-positive and -negative patients treated with Peg-IFN could improve to cost-effectiveness of this therapeutic approach. Given the low rates of HBsAg clearance on NUC therapy, new studies to test whether Peg-IFN and NUC combination fosters HBsAg decline in long-term responders to NUC, are being explored. genetics Identification of hepatitis B virus surface antigen [HBsAg] genotypes and variations in chronic carriers from Isfahan province, Iran. Norouzi, M.; Ghorashi, S.A.; Abedi, F.; Nejatizadeh, A.; Ataei, B.; Malekzadeh, R.; Alavian, S.M.; Judaki, M.A.; Ghamari, S.; Namazi, A.; Rahimnia, R.; Khedive, A.; Jazayeri, S.M. Iranian National Institute for Genetic Engineering and Biotechnology Iranian Journal of Public Health 2012; 41 (3): 104-111 (13 ref.) Keywords: Hepatitis B Surface Antigens-isolation and purificalion; Genotype; Carrier State; Mutation-genetics; Polymerase Chain Reaction Abstract: Hepatitis B virus [HBV] gene and protein variations are frequently been seen in chronic patients. The aims of study were to determine the genotypes as well as the patterns of variations distribution in chronically-infected patients from the central part of Iran. The surface gene was amplified, sequenced and subsequently aligned using international and national Iranian database. All strains belonged to genotype D, subgenotype Dl and subtype ayw2. Of all 62 mutations occurred at 39 nucleotide positions, 31 [50%] were missense [amino acid altering] and 31 [50%] were silent [no amino acid changing]. At the amino acid level, 30 substitutions occurred, however, 3 were in positions 122 and 127, corresponded to subtypic determination. 22 [73%] out of 30 amino acid mutations occurred in different immune epitopes within surface protein, of which 12 [54.54%] in B cell epitopes in 10 residues; 5 [45.45%] in T helper epitopes in positions; 5 [22.73%] in inside CTL epitopes in 4 residues. The distribution of amino acid mutations as well as the ratio between silent and missense nucleotide mutations showed a narrowly focused immune pressure had already been on the surface protein in these patients, led to the emergence of escape mutants in these patients. Hepatitis B Vaccines Active-passive immunization effectiveness against hepatitis B virus in children born to HBsAg positive mothers in Amol, north of Iran. Yahyapour, Yousef; Karimi, Mohammad; Molaei, Hamid Reza; Khoddami, Esmaeil; Mahmoudi, Mahmoud E-mail:uyahyapoor@yahoo.com Tehran University of Medical Sciences [TUMS] - Infection and Tropical Research Center Disease Oman Medical Journal 2011; 26 (6): 399-403 (36 ref.) IMEMR Current Contents Subject Index 55 Keywords: Hepatitis B-prevention and control; Immunization; Vaccination; Immunization, Passive; Infectious Disease Transmission, Vertical; Hepatitis B virus; Hepatitis B Surface Antigens; Hepatitis B Antibodies Abstract: HBV infection is a contagious disease that may transmit vertically from mothers to their neonates or horizontally by blood products and body secretions. Over 50% of Iranian carriers have contracted the infection perinatally, making this the most likely route of transmission of HBV in Iran. This study assesses the serologic markers of HBV in children born to HBsAg positive mothers who received HBIG and 3 doses of HBV vaccine. To evaluate the effectiveness of vaccination against HBV, a study was conducted on 95 Children, born to hepatitis B surface antigen [HBsAg]-positive mothers, who had received Hepatitis B Immune Globulin and HBV vaccines during 2004- 2008. All children were tested for the presence of HBsAg, anti- HBs and anti-HB core antigen [anti-HBc]. Among an estimated 30000 pregnant women during the five year study, about 130 [0.42%] were HBV carriers. Ninety-five children from these mothers were enrolled in this study. Only one child [1.1%] was HBsAg positive, while 88.4% of children were Anti-HBs Positive. Eleven children [11.6%] were exposed to HBV as shown by the presence of anti-HBc. A significant difference was observed between the children's age and Anti-HBs [p=0.0001]. Passive-active immunoprophylaxis of high risk babies was highly efficacious in preventing perinatal transmission of the HBV carrier state. Also, evaluation of serologic markers in HBV infected people is important for designing the strategies for disease control. Hepatitis C epidemiology Prevalence of hepatitis C virus infection and human immunodeficiency virus in a cohort of Egyptian hemophiliac children. Abdelwahab, Magy S.; El Raziky, Nona S.; Kaddah, Normine A.; Abou Elew, Heba H. E-mail:magywahab@yahoo.com Cairo University - Department of Pediatric Hematology Annals of Saudi Medicine 2012; 32 (2): 200-202 (18 ref.) Keywords: HIV Infections-epidemiology; Hemophilia A-complications; Hemophilia A-virology; Prevalence; Hemophilia B-complications; Hemophilia B-virology; Enzyme-Linked Immunosorbent Assay; Cross-Sectional Studies Abstract: The risk of blood-borne infections, especially hepatitis C virus [HCV] and human immunodeficiency virus [HIV] infection still remains in developing countries among children receiving blood products as hemophiliacs, but the risk is not known in Egypt. The objective of this study was to detect the prevalence of HCV and HIV infection among hemophiliac children to know the magnitude of the problem and determine potential risk factors. This was a cross- sectional study conducted on 100 hemophiliac children that assessed the liver clinically and by laboratory tests. All children were screened for HCV and HIV antibodies by enzyme-linked immunosorbent assay. Those with positive HCV antibody titre were tested by polymerase chain reaction [HCV-PCR]. Forty were positive for HCV antibodies with 19 children [47.5%] HCV-PCR positive as well. The mean age, average frequency of bleeds/year, dose of replacement therapy/year and alanine aminotransferase [ALT] levels were significantly high in HCV-antibody and PCR positive patients as compared to HCV antibody and PCR negative ones. None of our patients had clinical evidence of hepatic involvement or was co-infected with HIV HIV infection does not appear to be a current health problem in Egyptian hemophiliac children though the prevalence of HCV infection is still high. Hepatitis C, Chronic complications Screening for metabolic liver diseases crucial to increase SVR to patients with CHC. El Badawy, Reda M.; El Defrawy, Manal; El Henawy, Ahmed; Morsy, Mahmoud M.; Ramadan, Ibrahim Ghoneam Benha University - Faculty of Medicine - Departments of Hepatology, Gastroenterology and infectious diseases Journal of the Egyptian Society of Parasitology 2011; 41 (3): 729-736 (32 ref.) Keywords: Metabolic Diseases-diagnosis; Liver Function Tests-blood; Abdomen-ultrasonography; Retrospective Studies Abstract: Liver diseases and its complications is common health problem worldwide. The emergence of metabolic disorders as a cause after exclusion of viral hepatitis nowadays is important. This is retrospective study on 200 patient's age range from 6 months to 18 years old [50 females and 150 males]. The patients divided into 2 groups according to age < 5 years and >5 years and all investigations done was collected and statistically processed. Abdominal enlargement was observed in 166/200 of all patients, 48/166 [67.6%] in patients <5 years old and 118/166 [91.5%] in patients >5years old with statistical significant, jaundice was present in 34/200 of patients, 23/34 [32.4%] in IMEMR Current Contents Subject Index 56 patients <5 years old and 11/34 [8.5%] in patients >5 years old, with statistical significant difference, CBC was normal in 58/200 of all age groups. 10/58 [14.1%] in patients <5 years old, 48/58 [73.2%] in patients <5 years old, with statistical significant difference and abnormal CBC in 142/200 [61/142, 62.8%] in age group > 5 years old, 81/142 [85.9%] in age group <5 years. Metabolic disorders was normal in 124/200 of all age groups, 23/124 [32.4%] in patients <5 years old. Metabolic disorders was abnormal in 76/200 of all, 48/76 [67.6%] in patients >5 years old and 28/76 [21.7%] in patients < 5 years old, with statistical significant difference and for both age groups. The sensitivity of modalities used in the diagnosis of liver disease was as follow for US, study of metabolic profile, abnormal liver functions and abnormal CBC, 83.1%, 65.2%, 61.6% and 66.1% consequently. drug therapy Peginterferon alfa-2b and ribavirin therapy in Kuwaiti patients with chronic hepatitis C virus infection. Al Enzi, S.A.; Ismail, W.A.; Alsurayei, S.A.; Ismail, A.E. Ministry of Health - Farwaniya Hospital - Department of Medicine EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 669-678 (47 ref.) Keywords: Interferon-alpha-therapeutic use; Polyethylene Glycols-therapeutic use; Ribavirin-therapeutic use; Retrospective Studies; Treatment Outcome; Genotype; Viral Load Abstract: Few studies have been conducted in the Eastern Mediterranean region on chronic hepatitis C virus [HCV] infection with reference to genotypes. We investigated the response to standard combination therapy [pegylated interferon/ribavirin] of different genotypes of HCV in Kuwaiti patients and factors that could be associated with sustained virological response [SVR]. The records of all Kuwaiti patients treated for chronic HCV between January 2003 and May 2009 were retrospectively identified and reviewed. Of 108 patients studied, 27.8% were infected with genotype 1, 25.0% with genotype 3 and 47.2% with genotype 4. Overall, 64.8% of patients achieved SVR, 25.9%, were non-responders and 9.3% were relapsers. Baseline viral load and alanine aminotransferase level in addition to early virological response to pegylated interferon-based therapy may serve as a decision tool for clinicians to identify patients who are unlikely to achieve SVR. Herbal Medicine Knowledge, attitudes and awareness of community pharmacists towards the use of herbal medicines in Muscat region. Duraz, Anas Younis; Khan, Shah Alam E-mail:shahalamkhan@yahoo.com Oman Medical College Oman Medical Journal 2011; 26 (6): 451-453 (10 ref.) Keywords: Health Knowledge, Attitudes, Practice; Pharmacists; Questionnaires Abstract: This study aims to investigate the knowledge and attitudes among pharmacists in Oman towards the specific use and knowledge of herbal drugs. The study was conducted on 100 pharmacists employed in Oman. The data was collected using two self- administered questionnaire containing 7 and 11 closed ended questions in each, respectively. The mean age of pharmacists was 32.6 [SD=5.6] years. The majority of pharmacists were interested in herbal information and their herbal information mainly comes from their previous classes during college. Most of them have belief on the effectiveness of herbal products. Pharmacists were more knowledgeable on specific therapeutic indications of herbal products rather than on other areas such as drug- herb interaction or side effects. In summary, Pharmacists need to be informed on the therapeutic indications, drug interactions, dose, active constituent and precautions of herbal products. Concerned bodies must also provide them with regular continuing education programs apart from putting their effects to incorporate relevant topics in herbal medicine in pharmacy curriculum. HIV Infections epidemiology Using surveillance data for action: lessons learnt from the second generation HIV/AIDS surveillance project in Pakistan. Emmanuel, F.; Adrien, A.; Athar, U.; Imran, M.; Reza, T.; Blanchard, J. E-mail:faran_emmanuel@yahoo.com IMEMR Current Contents Subject Index 57 University of Manitoba - Agriteam Consulting Ltd, Canada, and Centre for Global Public Health - HIV/AIDS Suiveillance Project EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 712-718 (19 ref.) Keywords: Acquired Immunodeficiency Syndrome-epidemiology; Population Surveillance; Acquired Immunodeficiency Syndrome-prevention and control; Prevalence; HIV Infections-prevention and control; National Health Programs; HIV Seropositivity; Program Evaluation Abstract: Although many countries are now collecting useful, high-quality HIV surveillance data, more efforts are put into the collection of data than into ensuring it is deployed effectively. The Canada-Pakistan HIV/ AIDS surveillance project has strengthened and expanded the existing national AIDS control programme surveillance system in Pakistan through a comprehensive estimate of the size and location of some of the most at-risk populations [sex workers and injection drug users] and annual assessments of their sociodemographic characteristics, behaviours and HIV prevalence. The country now uses second generation surveillance data at a broad level to lobby for policy change, mobilize resources, improve programming and measure the success of prevention through an integrated national effort. This article aims to share the experiences and lessons learnt in the development of a second generation surveillance system for HIV/AIDS in Pakistan. Homeless Youth psychology Health status and risk factors of street children in Beni-Suief city. Mohamed, Amel Abdel Azim; Labeeb, Shokria Adly; El Hafnawy, Tamer Mohamed; Mohamed, Asmaa Ghareeb Beni-Suief University - Technical Institute of Nursing - Community Health Nursing Department Assiut University Bulletin for Environmental Researches 2011; 14 (2): 109-130 (32 ref.) Keywords: Child Welfare; Questionnaires; Biological Markers; Smoking; Substance-Related Disorders; Risk Factors; Violence; National Health Programs Abstract: The magnitude of street children problem is escalating, and this is related to increasing levels of poverty especially in developing countries. The aim of this study was to highlight the problem of street children in Beni-Sueif city, with emphasis on the health and social status of these children through assessing the health status of these children and identifying the most common risk factors influencing their physical, psychological, and social health. The study was conducted on 101 street children in Beni-Sueif city. Data collection tools included an interview questionnaire form, a physical assessment sheet, and a lab sheet for stool and urine analysis, hemoglobin level and viral Hepatitis B and C markers. The results revealed that their age ranged between 7 and 16 years. The majority were current smokers, used addictive substances, and all had aggressive behavior. The most common physical problems were underweight, angular stomatitis, and teeth decay. All had positive stool analysis, 86.1% were anemic, and 24.8% had positive viral hepatitis markers. The predictors of addiction were male sex, longer duration in the street, and smoking. Age was the predictor of being hepatitis B or C positive. Street children are mostly males who quit or never attended schools, and with untoward family circumstances. The majority are indulged in smoking, substance abuse, and violence. They suffer both physical and psychological problems. It is recommended to study the magnitude of the problem at a national level. The role of NGOs must be fostered. Screening programs are needed for these children. Hypothyroidism epidemiology Prevalence of sub clinical hypothyroidism in school children [6-11 years] of Dera Ismail Khan. Ramzan, Muhammad; Ali, Irshad ; Ramzan, Faiqah; Ramzan, Faiza; Ramzan, Muhammad Haris E-mail:dr.ramzan49@gmail.com Peshawar Medical College - Department of Biochemistry JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 22-28 (25 ref.) Keywords: Obesity-metabolism; Child; Cross-Sectional Studies Abstract: To determine the prevalence of sub clinical hypothyroidism [hyperthyrotropinemia] in obese school children. This cross-sectional study was carried out in Department of Chemistry, Gomal university, Dera Ismail Khan, from June 2007 to August 2010 including eight primary schools of Dera Ismail Khan having mixed population with some of the wards belonging to high socioeconomic group. Thorough clinical examination excluded those suffering from chronic health problems. Height and weight of each child was taken according to standard anthropometric procedures. Body mass index and body mass status of each study subject was calculated according to Quetelet's IMEMR Current Contents Subject Index 58 Index and WHO criteria respectively. a total of 83 school children [6-11 years] were randomly selected among 1336 children. The sample included 23 [27.71%] normal weight children and 60 [72.28%] obese. Gender wise distribution of the sample was 48 [57.83%] boys and 35 [42.16%] girls. Free Thyroxin [FT] and Thyroid Stimulating Hormone [TSH] were measured using radioimmunoassay. Hyperthyrotropinemia was the most commonly observed thyroid hormone dysfunction [8.43%] in the whole sample [n=83] and 8.33% in obese children compared with 3-8% in general population of the United States. Sub clinical hypothyroidism is the most common finding in the childhood obesity. The prevalence of sub clinical hypothyroidism in the present study is 8.43% in the whole sample [n=83] compared with 3- 8% in general population of the United States. It is suggested that all the obese children expressing minimum organ abnormalities be investigated to prevent the irreversible problems over the course of many years. Immunoglobulins, Intravenous therapeutic use Experience with polyclonal immunoglobulin therapy in poly trauma patients with severe sepsis. Janjua, Sarfraz Khan; Hussain, Raja Mushtaq; Mohsin, Syed Tariq; Iqbal, Azhar; Mishwani, Ahmad Hussain; Atif, Muhammad; Hashim, Rizwan; Mehmood, Khalid Combined Military Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 345-349 (18 ref.) Keywords: Immunoglobulins-therapeutic use; Multiple Trauma-drug therapy; Sepsis-drug therapy Abstract: To evaluate the effects of intravenous immunoglobulin therapy on progression of severe sepsis in patients of poly trauma. Quasi-experimental study. Combined Military Hospital Peshawar from June 2008 to Dec 2009. Forty six patients of poly trauma with severe sepsis were included. Along with the standard management i.e., surgical management, fluid resuscitation, antibiotics, analgesics, ionotropic, ventilatory and nutritional support, IVIG 5% [intravenous immunoglobulin] was infused over a period of 6 hours and repeated for three consecutive day. Sequential Organ Failure Assessment [SOFA] score was used to assess the progress in all the patients. At the time of enrolment mean SOFA score was 5.41 +/- 1.127 and on the 15th day it was 1.62 +/- 2.24, mean age was 39.21 +/- 10.26 years. Thirty four patients [73.91%] developed gram negative sepsis and eighteen patients [39.13%] developed septic shock. Mean duration of stay in ICU and on of these patients was 30.43%. The IVIG administration, when used along with the standard management appears to improve significantly the prognosis in patients of poly trauma with severe sepsis. Infant, Newborn growth and development Placental alkaline phosphatase activity and its relation to foetal growth and nutrition in appropriate and small for gestational age newborns at term. Mosbah, Amira A. Abdel Rahman; Abdel Latif, Nahla A. Bahgat; Sorour, Ehab Ibrahim; El Halaby, Alaa F. Cairo University - Faculty of Medicine - Department of Pediatric Journal of the Egyptian Society of Parasitology 2011; 41 (3): 745-752 (25 ref.) Keywords: Alkaline Phosphatase-blood; Gestational Age; Birth Weight; Fetal Blood; Blood Glucose Abstract: The placental alkaline phosphatase [PAP] activity progressively rises as pregnancy advances, possibly, because of its increasing synthesis by placental tissue. The present study examined the relationship between placental alkaline phosphatase activity and the biochemical indices of foetal nutrition [cord blood glucose, albumin] and growth [neonatal birth weight]. Placental and umbilical cord blood samples were collected from 56 term deliveries 30 of them were appropriate for gestational age [AGA] and 26 were small for gestational age [SGA] and prepared for placental alkaline phosphatase assay, glucose and albumin estimations using standard procedures. The birth weights of the neonates at term were taken and recorded. Correlation analyses of the data obtained show significant positive relationships between PAP and cord blood glucose, albumin and birth weight in AGA newborn [r[2] = 0.86, 0.71, 0.68 p<0.05] and [r[2] = 0.69, 0.81, 0.73 p<0.05] in SGA newborn but no significant relationship with gestational age, also there was significant statistical difference between both groups in level of PAP, glucose and albumin. IMEMR Current Contents Subject Index 59 Influenza, Human complications Clinical experience with severe 2009 H1N1 influenza in the intensive care unit at King Saud Medical City, Saudi Arabia. Mady, A.; Ramadan, O.S.; Yousef, A.; Mandourah, Y.; Amr, A.A.; Kherallah, M. E-mail:afmady@hotmail.com King Saud Medical Complex Journal of Infection and Public Health 2012; 5 (1): 52-56 (14 ref.) Keywords: Influenza, Human-epidemiology; Influenza, Human-mortality; Influenza A Virus, H1N1 Subtype; Intensive Care Units; Osellamivir-therapeutic use; APACHE; Antiviral Agents-therapeutic use; Hospital Mortality; Retrospective Studies; Risk Factors Abstract: The objective of this study was to describe the epidemiological characteristics, clinical features, treatment, and outcome of 2009 H1N1-infected patients who were admitted to the intensive care unit [ICU] at King Saud Medical City [KSMC] in Riyadh, Kingdom of Saudi Arabia.: Retrospectively, we collected demographic data as well as data on the clinical presentation and risk factors for 86 patients who were admitted to the ICU with H1N1 influenza A. The APACHE IV System was used to assess the severity of the illness. The overall hospital mortality was calculated and correlated with the use of steroids and the time of oseltamivir administration. The mean age of the patients was 40.8 years. Mortality increased steadily with increasing APACHE IV score. Patients who received steroids had a mortality rate of 47% compared with 23% for patients who were not treated with steroids; this difference was significant, with a P value of <0.01. The late administration of oseltamivir was associated with a mortality rate of 82% compared with 28% in the context of early oseltamivir administration; this difference was significant, with a P value of <0.01. Patients who were admitted to the ICU with severe 2009 H1N1 infection were young and had a relatively high severity-of-illness score. The late administration of oseltamivir was associated with a 12-fold increase in mortality. Steroid use was associated with a 3-fold increase in mortality. 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved. Insulin Resistance Effects of L-carnitine on inducible nitric oxide synthase, insulin like growth factor-1 gene expression and insulin receptor substrate-1 in kidney tissues of insulin resistant rats induced by high fructose feeding. Mahfouz, Mohamed H.; Mohamed, Ehab K. E-mail:mhesham5@yahoo.com National Institute of Diabetes and Endocrinology, [NIDE] - Department of Biochemistry EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 273-290 (56 ref.) Keywords: Animal Experimentation; Rats; Receptor, IGF Type 1; Insulin-Like Growth Factor I; Carnitine- administration and dosage; Nitric-Oxide Synthase Abstract: Metabolism of high dietary fructose induces insulin resistance and metabolic adaptation including changes in gene expression. The present study was designed to elucidate the effects of L-Carnitine [CA] on the renal alterations as well as gene expression such as inducible Nitric Oxide Synthase [iNOS]. Insulin-like Growth Factor-1 [IGF-1], insulin receptor substrate-1 [IRS-1] in kidney tissues of rats fed on high fructose diet. 24 male Wister rats of body weight 120- 160 g were divided into 3 groups of 8 rats each . Group 1 received control diet, while group 2 and 3, rats received high fructose diet [60 g/100 g diet]. Group 3, after 2 weeks of fructose feeding animals were treated with CAR [300 mg/kg body weight/day i.p]. At the end of the experimental period [30 days], serum levels of glucose, insulin, Triacylglycerol [TG] and cholesterol were determined. Renal contents of cholesterol, triacylglycerol, Malondialdehyde [MDA] and nitric oxide products were determined . Gene expressions of iNOS, IGF-1 as well as IRS-1 were also assayed in kidney tissues of the experimental rats feed on high fructose diet. Rats fed on high fructose diet showed disturbance in insulin action and formed an animal model of insulin resistance. Fructose fed rats showed increase in renal gene expression of iNOS and decrease in both IGF-1 mRNA and IRS-1 receptor compared to control rats. The administration of CA to rat model of insulin resistance, mitigated the adverse effects of fructose load. Thus the observed abnormalities in gene expression associated with fructose feeding were brought to near-normal levels as compared with untreated rats. L- carnitine normalized the serum and renal lipid alterations as well as gene expression [iNOS, IGF-1] and IRS-1 in this nutritional experimental model. IMEMR Current Contents Subject Index 60 Interleukin-4 genetics Association of interleukin-4 polymorphisms with multiple sclerosis in southeastern Iranian patients. Arababadi, Mohammad Kazemi; Mosavi, Reza; Ravari, Ali; Teimori, Hossein; Hassanshahi, Gholamhossein Rafsanjan University of Medical Science - Faculty of Medicine - Department of Microbiology, Hematology and Immunology Annals of Saudi Medicine 2012; 32 (2): 127-130 (24 ref.) Keywords: Polymorphism, Genetic; Multiple Sclerosis-genetics; Multiple Sclerosis-immunology Abstract: Immune system-related factors are important in the pathogenesis of multiple sclerosis [MS]. Interleukin 4 [IL-4] as a helper T cell [2TH] cytokine is involved in the regulation of immune responses. Hence, this study was designed to explore the association between MS and polymorphisms in the -590 region of IL-4. A descriptive study at Rafsanjan University of Medical Sciences, Rafsnajan from September 2009 to August 2010. Blood samples were collected from 100 MS patients and 150 healthy controls on EDTA precoated tubes. DNA was extracted and analyzed for IL-4 polymorphisms using restricted fragment length polymorphism in patients and controls. Demographic data were also collected by a questionnaire that was designed specifically for this study. We observed a significant difference in the C/C, T/C, and T/T genotypes of the -590 region of IL-4 between patients with MS and healthy controls [P<.001]. We conclude that functional polymorphisms of IL-4 possibly play a crucial role in the pathogenesis of MS. Intestinal Obstruction therapy Role of water soluble contrast agents in assigning patients to a non-operative course in adhesive small bowel obstruction. Al Wadani, Hamid; Al Awad, Naif Ibrahim; Hassan, Khairi Ahmed; Zakaria, Hazem Mohamed; Al Mulhim, A. Abdul Mohsen; Alaqeel, Faten O. E-mail:hazakaria@yahoo.com Dammam University - King Fahd Hospital of the University - Department of Surgery Oman Medical Journal 2011; 26 (6): 454-456 (18 ref.) Keywords: Intestinal Obstruction-radiography; Prospective Studies; Diatrizoate Meglumine-diagnostic use; Diatrizoate Meglumine-therapeutic use; Laparotomy; Contrast Media-diagnostic use; Contrast Media-therapeutic use; Intestine, Small-radiography Abstract: Adhesive small bowel obstruction [SBO] is a common surgical emergency. It is estimated that at least 60% of SBO are due to post-operative adhesions. Water soluble contrast agents [gastrografin] have been used to identify patients who might be treated non-operatively. This study aims to determine the role of gastrografin in adhesive intestinal obstruction patients. In this prospective study, 27 patients admitted between 1[st] August 2004 and 1[st] July 2006 with clinical signs suggestive of postoperative adhesive SBO met the inclusion criteria. After intravenous hydration, nasogastric tube insertion and complete suctioning of the gastric fluid, 100 ml of gastrograsfin was given and plain abdominal radiography was taken 6 hours and 24 hours if the contrast is not seen in the colon. Those in whom the contrast reached the colon in 24 hours were considered to have partial SBO and started oral intake. If gastrografin failed to reach the colon in 24 hours and the patient did not improve in the following 24 hours, laparotomy was performed. Conservative treatment was successful in 31 cases [91%] and 3 [9%] required operation. Patients treated conservatively had short hospital stay [mean=4 days] and tolerated oral feeding with no morbidity or mortality. Oral gastrografin helps in the management of patients with postoperative adhesive SBO. IMEMR Current Contents Subject Index 61 Iodine urine Reply. Cakir, Evrim E-mail:evrimcakir@mynet.com Diskapi Yildirim Beyazit Training and Research Hospital - Department of Endocrinology and Metabolism Annals of Saudi Medicine 2012; 32 (2): 214 (1 ref.) Keywords: Diet; Milk; Fishes Response to comments on urine iodine excretion in patients with euthyroid nodular disease . Elnour, Abdelsalam E-mail:abdalsalam@hotmail.com University of Dammam Annals of Saudi Medicine 2012; 32 (2): 213-214 (6 ref.) Keywords: Thyroid Nodule-pathology; Smoking-adverse effects Jaw Neoplasms etiology Etiology and pattern of swellings in mandible and maxilla. Khan, Ali Akhtar; Hasnain, Muhammad Ali Zul; Shafi Ullah; Shah, Irfan; Khan, Muzaffar; Ahmed, Waseem PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 409-412 (21 ref.) Keywords: Mandibular Neoplasms-etiology; Maxillary Neoplasms-etiology; Maxilla-abnormalities; Mandible- abnormalities; Dental Caries; Odontogenic Cysts; Odontogenic Tumors Abstract: To determine the etiology and pattern of swellings in the mandible and maxilla. A descriptive study. This study was conducted at Oral and Maxillofacial Surgery Dept, Armed Forces Institute of Dentistry Rawalpindi for two years from December 2004 to December 2006. Three hundred and fifty patients with swellings in the jaws reporting to AFID were included in this study. After history, clinical examination and radiographic evaluation, patients were registered. All patients whether admitted to hospital or treated as outdoor patients in oral surgery clinic were included. Swelling of the parotid region, nasal and para nasal sinuses and neck were not included. In majority 131 [37.42%] the patients were of age between 21 to 30 years [mean 25.5 years]. Males were affected more than females with ratio 1.3:1. The most common swellings found were inflammatory which accounted for 138 cases [39.42%] due to odontogenic reasons i.e. caries and non vital teeth. The most frequent site involved was mandible which accounted for 202 cases [57.71%]. In 111 cases [31.71%] the treatment modality used was incision and drainage followed by antibiotics. Caries and non-vital teeth were cause of the most common inflammatory swellings. The predominant site of swellings was the mandible. Every person must visit a dentist for oral examination six monthly so that early lesions in mandible and maxilla can be detected and treated more conservatively. Jejunal Diseases complications Complicated jejunal diverticulitis: a challenging diagnosis and difficult therapy. Schloericke, Erik; Zimmermann, Markus S.; Hoffmann, Martin; Kleemann, Markus; Laubert, Tilman; Bruch, Hans Peter; Hildebrand, Phillip E-mail:e.schloericke@gmx.de University of Schleswig-Holstein, Campus Luebeck - Department of Surgery Saudi Journal of Gastroenterology [The] 2012; 18 (2): 122-128 (25 ref.) Keywords: Diverticulum-complications; Jejunal Diseases-diagnosis; Diverticulum-diagnosis; Diverticulum-surgery; Jejunal Diseases-surgery IMEMR Current Contents Subject Index 62 Abstract: In contrast to diverticulosis of the colon, jejunal diverticulosis is a rare entity that often becomes clinically relevant only after exacerbations occur. The variety of symptoms and low incidence make this disease a difficult differential diagnosis. Data from all patients who were treated in our surgical department for complicated jejunal diverticulitis, that is, gastrointestinal hemorrhage or a diverticula perforation were collected prospectively over a 6-year period [January 2004 to January 2010] and analyzed retrospectively. The median age among the 9 patients was 82 years [range: 54-87]. Except for 2 cases [elective operation for a status postjejunal peridiverticulitis and a re-perforation of a diverticula in a patient s/p segment resection with free perforation], the diagnosis could only be confirmed with an exploratory laparotomy. Perforation was observed in 5 patients, one of which was a retroperitoneal perforation. The retroperitoneal perforation was associated with transanal hemorrhage. Hemodynamically relevant transanal hemorrhage requiring transfusion were the reason for an exploratory laparotomy in 2 further cases. In one patient, the hemorrhage was the result of a systemic vasculitis with resultant gastrointestinal involvement. A singular jejunal diverticulum caused an adhesive ileus in one patient. The extent of jejunal diverticulosis varied between a singular diverticulum to complete jejunal involvement. A tangential, transverse excision of the diverticulum was carried out in 3 patients. The indication for segment resection was made in the case of a perforation with associated peritonitis [n=4] as well as the presence of 5 or more diverticula [n=2]. Histological analysis revealed chronic pandiverticulitis in all patients. Median operating time amounted to 142 minutes [range: 65-210] and the median in-hospital stay was 12 days [range: 5-45]. Lethality was 0%. Major complications included secondary wound closure after s/p repeated lavage and bilateral pleural effusions in one case. Signs of malabsorption as the result of a short bowel syndrome were not observed. Minor complications included protracted intestinal atony in 2 cases and pneumonia in one case. Median follow-up was 6 months [range: 1-18]. Complicated jejunal diverticulitis often remains elusive preoperatively due to its unspecific clinical presentation. A definitive diagnosis can often only be made intraoperatively. The resection of all diverticula and/or the complete diverticula-laden segment is the goal in chronic cases. The operative approach chosen [tangential, transverse excision vs segment resection] should be based on the extent of the jejunal diverticulosis as well as the intraoperative findings. Juvenile Hormones adverse effects Combined effect of three insect growth regulators on the digestive enzymatic profiles of callosobruchus maculatus [coleoptera: bruchidae]. Khatter, Najat Aly; Abuldahb, Faten Farid E-mail:najat.khatter4@gmail.com King Abdul Aziz University - Faculty of Science for Girls - Department of Biology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 765-776 (43 ref.) Keywords: Digestive System-enzymology; Pest Control-economics; Pyridines; Phenylurea Compounds-therapeutic use; Fatty Acids, Unsaturated-therapeutic use Abstract: Insect growth regulators [IGRs] are insecticides that mimic insect produced hormones by regulating developmental process. They have little or no mammalian toxicity, and are considered reduced-risk insecticides that are often exempt from tolerance requirements of regulatory agencies. IGRs, especially, chlorfluazuron, hydroprene and hexaflumuron [benzoylphenylurea] are currently studied because of possibility of using in stored products protection. Many of IGRs compounds used in insect pests control are known to affect digestive enzymes. Chlorfluazuron, hydroprene and hexaflumuron were tested topically at doses of 0.25%, 0.5% and1% for chlorfluazuron and hydroprene and 0.5, 1 and 2microg/ml of hexaflumuron to investigate its effects on the activities of the digestive enzymes protease, amylase and lipase in Callosobruchusmaculatus larvae, which were affected by IGRs individually and in combination. When combined, the effect was more severe at low concentration. There were statistically significant differences [P</= 0.05] in enzyme activities in combined and individual treatments. Combination three IGRs caused a two-fold decrease in enzyme activity even at reduced concentration. Clear dose-response relationships were established with respect to enzyme activity. A synergistic effect of IGRs was found by combination of low doses. These effects are most pronounced in early instars. Kidney Failure, Chronic A comparison of serum cystatin C and creatinine with glomerular filtration rate in Indian patients with chronic kidney disease. Kumaresan, Ramanathan; Giri, Padmanaban E-mail:kumaresanr@pmu.edu Periyar Maniammai University - Clinical Research Department IMEMR Current Contents Subject Index 63 Oman Medical Journal 2011; 26 (6): 421-425 (38 ref.) Keywords: Glomerular Filtration Rate; Cystatin C-blood; Creatinine-blood Abstract: There is no literature available on the performance of cystatin C in Chronic Kidney Disease [CKD] patients of Indian population based on age group. Hence, this study is aimed to compare the diagnostic performance of serum cystatin C and creatinine with measured glomerular filtration rate [GFR] and estimated GFR [eGFR] in subjects of Indian origin. The study was carried out at Tiruchirappalli, South India during the period of September 2010 to march 2011. One hundred and six CKD patients [82 males, 24 females] were enrolled and categorized into three groups based on age. The eGFR was calculated using Cockcroft-Gault [CG] and Modification of Diet in Renal Disease [MDRD] formulae. Serum cystatin C was measured with a particle-enhanced nephelometric immunoassay [PENIA] method. GFR was measured using 99mTC - diethylene triamine penta aceticacid [DTPA] renal scan method. Serum cystatin C showed significant correlation with measured GFR in all the three groups [r=-0.9735, r=-0.8975 and r=- 0.7994 respectively] than serum creatinine [r=-0.7380, r=- 0.6852 and r=-0.5127 respectively]. Serum cystatin C showed a high correlation with measured GFR in young and older patients with CKD than creatinine. Thus, cystatin C is a good alternative marker to creatinine in CKD patients. Lepidium sativum Antibacterial activity of lepidium sativum and allium porrum extracts and juices against some gram positive and gram negative bacteria. Akrayi, Hero F.S.; Tawfeeq, Jwan D. E-mail:hero_ferhad@yahoo.com University of Salahaddin - College of Education - Biology Department Medical Journal of Islamic World Academy of Sciences 2012; 20 (1): 10-16 (18 ref.) Keywords: Onions; Anti-Bacterial Agents; Plant Extracts-therapeutic use; Gram-Positive Bacteria; Gram-Negative Bacteria Abstract: The antibacterial effect of ethanolic and aqueous extracts of medicinal plants Lepidium sativum [cress garden] and Allium porrum [leek], in addition to their juices, was investigated on Gram negative and Gram positive bacteria [Klebsiella pneumoniae, Proteus, Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus mutans]. All bacteria under this study were obtained from human infections from Hawlery Ferkary Hospital in Erbil City - Iraq, by using the well diffusion technique. It was observed that the extracts of both plants had an inhibitory effect on all the bacteria under study, except Klebsiella pneumoniae, whereas the juices of both plants did not have any effect on these bacteria. The minimum inhibitory concentration [MIC] of L. sativum extracts was determined and it was 3% for Klebsiella pneumoniae and Proteus, whereas other bacterial species were sensitive to all concentrations of the extracts. The MIC of ethanolic extract of A. porrum was 8% for S. aureus and 9% for P. aeruginosa, whereas K. pneumoniae and Proteus were insensitive to all concentrations in contrast to S. mutans that was sensitive to all concentrations. The MIC of aqueous extract ofAlllium porrum did not affect K. pneumoniae and Proteus in contrast to other bacteria. Leprosy rehabilitation Medical rehabilitation of leprosy patients discharged home in Abia and Ebonyi states of Nigeria. Enwereji, Ezinne Ezinna; Ahuizi, Eke Reginald; Iheanocho, Okereke Chukwunenye; Enwereji, Kelechi Okechukwu E-mail:hersng@yahoo.com Abia State University - College of Medicine - Department of Community Medicine Oman Medical Journal 2011; 26 (6): 393-398 (28 ref.) Keywords: Rehabilitation; Aftercare; Delivery of Health Care; Health Services Research; Acquired Immunodeficiency Syndrome-prevention and control; HIV Abstract: To examine the extent to which medical coverage is available to discharged leprosy patients in communities. Evidence has shown that after care services, follow-up visits and national disease prevention programs are important components of medical rehabilitation to leprosy patients discharged home after treatment. Denying them accessibility to these services could expose them to multiple disabilities as well as several disease conditions including HIV/AIDS. These adverse health conditions could be averted if health workers extend healthcare services to discharged leprosy patients. This study was conducted to examine the extent to which discharged leprosy patients have access to healthcare services in the communities. All 33 leprosy patients who were fully treated with multidrug therapy [MDT] and discharged home in the two leprosy settlements in Abia and Ebonyi States of Nigeria were included IMEMR Current Contents Subject Index 64 in this study. The list of discharged leprosy patients studied and their addresses were provided by the leprosy settlements where they were treated. Also, snowball-sampling method was used to identify some of the leprosy patients whose addresses were difficult to locate in the communities. Instruments for data collection were questionnaire, interview guide and checklist. These were administered because respondents were essentially those with no formal education. Analysis of data was done quantitatively and qualitatively. Findings showed that 20 [60.6%] of discharged patients did not receive health programs like HIV/AIDS prevention or family planning. Also, follow-up visits and after-care services were poor. About 14 [42.4%] of the patients live in dirty and overcrowded houses. On the whole, discharged patients were poorly medically rehabilitated [mean score: 4.7 +/- 1.1 out of total score of 7]. Denying discharged leprosy patients opportunity of accessing health care services could increase prevalence of infectious diseases including HIV/AIDS among them. There is need to extend national prevention programs, follow-up visits, after-care services and free treatment to discharged patients in the communities. Leptin blood Correlation between leptin and chronic periodontitis. Sattari, M.; Khajeh Noori, B.; Mozeh, M.B.; Mehrmofakham, S.H.; Mollahosseini, M. Haji; Yeganeh, F. Shahid Beheshti University of Medical Sciences - Iran center for Dental Research and Medical School - Department of Immunology Journal of Dental School - Shahid Beheshti University of Medical Sciences 2012; 29 (4): 283-289 (18 ref.) Keywords: Chronic Periodontitis; Gingiva; Enzyme-Linked Immunosorbent Assay; Interleukin-6; Inflammation Abstract: One important function of leptin is the regulation of immune or inflammatory responses. Moreover, in a recent study no correlation between leptin and periodontal diseases was found. Therefore the aim of this study is to determine the correlation between leptin concentration and chronic periodontitis. In this analytical study, 20 healthy gingival tissue samples [control group] and 20 gingival tissues with advanced and moderate chronic periodontitis [case group] and 20 blood samples were taken from 20 patients. Patients were consisted of 55% females and 45% males with average age of 42.25 yrs. Tissue samples were cultured for 72 hours. In the case of blood samples, the serum was immediately collected. Then ELISA was used for detecting of leptin and IL-6 in supernatant fluids of explant cultures and leptin in serum samples. Statistical analysis was made by Paired T-test and Wilcoxon signed Ranks test. There was no leptin in gingival samples of both cases and control groups. The mean concentration of IL-6 in control and case groups was 81.08 +/- 36.72 and 90.35 +/- 29.71 pg/ml, respectively. Statistical analysis has shown no difference between case and control groups regarding IL-6 concentration. It is concluded that leptin does not have any role as an inflammatory protein in chronic periodontitis and regarding the absence of leptin in all of gingival samples, we could not consider gingiva as a possible source of leptin. Lettuce microbiology Evaluating the efficiency of lettuce disinfection according to the official protocol in Iran. Yarahmadi, M.; Yunesian, M.; Pourmand, M.R.; Shahsavani, A.; Mubedi, I.; Nomanpour, B.; Naddafi, K. Tehran university of Medical Sciences - School of Public Health - Department of Environmental Health Engineering Iranian Journal of Public Health 2012; 41 (3): 95-103 (46 ref.) Keywords: Disinfection-methods; Enterobacteriaceae; Hypochlorous Acid; Detergents Abstract: The objective of this study was to evaluate the efficacy of Sanitization of Lettuce according to the protocols set forth by Iranian Ministry of Health and Medical Education for reducing populations of total coliform, fecal coliform, and helminth eggs present on lettuce. In the present study, we determined the load of total coliform, fecal coliform, and parasites of lettuce. The lettuce was sanitized by protocol of Iranian Ministry of Health and Medical Education. The protocol consists of 3 levels to disinfect the fruits and vegetables. The procedure was as follows: first washing stage. The leaves of leafy vegetables washed with tap water, second stage, separation of helminth eggs by 3 to 5 droplets of detergent per liter for 5 min; third stage, disinfection of vegetables by calcium hypochlorite solution [with 200 mg/1 free chlorine] for 5 min; and finally the disinfected vegetables were washed with tap water. The average initial levels of total coliform and fecal coliform in the samples were 3.36 Iog[10]cfu/g and 2.31 log[10]cfu/g, respectively. Helminth eggs were not detected in any of the samples tested. The efficiency of total coliform and fecal coliform removal were 78.1% [0.75 Iog[10]cfu/g] and 79.6% [0.67 Iog[10]cfu/g], respectively, after washing. This increased up to 94.8[1.44 IMEMR Current Contents Subject Index 65 Iog[10]cfu/g] and 98.5% [1.90 log[10]cfu/g] after the use of detergent. Chlorine disinfection rose these amounts up to 98.3% [2.18 Iog[10]cfu/g] and 100% [2.31 Iog[10]cfu/g], respectively. By applying the protocol large parts of microorganisms existing on lettuce have indeed been removed. Leukemia, Myelogenous, Chronic, BCR-ABL Positive genetics Philadelphia chromosome positive acute myeloid leukemia: a rare hematological disorder: a case report. Jameel, Abid E-mail:ajameel199@yahoo.com Hayatabad Medical Complex - Department of Medical Oncology JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 111-114 (12 ref.) Keywords: Philadelphia Chromosome; Immunophenotyping; Microscopy, Electron, Scanning Transmission; Survival Analysis; Cytarabine-analogs and derivatives Abstract: Philadelphia chromosome positive [Ph-positive] acute myeloid leukemia [AML] is an extremely rare and aggressive disease constituting approximately 1-3% of all de-novo AML cases. This disorder has many features distinct from chronic myeloid leukemia [CML] in blast crisis [CML-BC] and is therefore considered a distinct entity. Patients with Ph-positive AML have lower peripheral basophilia, lower bone marrow cellularity and lower myeloid/erythroid ratio. Presentation is acute with a short history and these patients are less likely to have splenomegaly. Outcome of the disease is poor and median overall survival is 6-9 months. This disease shows resistance to conventional chemotherapy protocols. We have identified two cases of Ph-positive AML amongst all de- novo AML patients diagnosed in our unit from January 2006 to December 2010. Both were treated with two courses of Cytarabine and Daunorubicin followed by Imatinib Mesylate [IM] 600 mg orally daily. Patient no.1 did not respond to two cycles of chemotherapy as well as IM 600 mg daily and died after 5 months. Patient no.2 had a complete hematologic response after two cycles of chemotherapy along with IM and remained in full hematological remission with IM 600 mg daily maintenance for 7 months after diagnosis. After 7 months he had a relapse and died after 2 months of relapse. Combination of AML type of chemotherapy and maintenance with IM provides short term remission while allogeneic stem cell transplant [ASCT] may achieve long term survival in a few patients. Leukemia, Promyelocytic, Acute genetics Impact of FLT-3 mutations on clinical features and response to the therapy in acute promyelocytic leukemia patients. Rostami, S.; Abroun, S.; Noruzinia, M.; Ghavamzadeh, A.; Moghaddam, K. Ali Tarbiat Modares University of Medical Sciences Scientific Journal of Iranian Blood Transfusion Organization Research Center [The] 2012; 8 (4): 242-250 (27 ref.) Keywords: fms-Like Tyrosine Kinase 3-genetics; Mutation-genetics; Prognosis; Receptors, Retinoic Acid-genetics; Arsenicals-therapeutic use; Treatment Outcome Abstract: FLT3 mutations are associated with poor outcome in acute myeloblastic leukemia [AML] patients. Only limited information is available about effects of FLT3 mutation on Acute Promyelocytic Leukemia [APL]. We investigated the prevalence and impact of FLT3 mutations on the clinical characteristics and the response to treatment in APL patients treated with arsenic trioxide [As[2]O[3]]. Blood samples were collected from 115 untreated APL patients and genomic DNA was extracted by the salting-out method. FLT3-ITD and FLT3-D835 mutations were investigated by PCR-RFLP. Mann-Whitney U test and Chi-square were used for data analysis. FLT3-ITD and FLT3-D835 mutations were detected in 16 [14%] and 13 [11%] of the patients, respectively. Both mutations were identified in two patients, so overall frequency of FLT3 mutations was estimated to be 23.5%. Patients positive for FLT3-ITD mutation had a higher rate of white cell counts [p= 0.005] and more frequent bcr3 type of PML/RARA fusion [p=0.04]. We have not found any significant association between FLT3-D835 mutation and the clinical characteristics of patients. Between the group with FLT3 Mutations and the group without, there was no significant difference in response to therapy. Complete remission induction with As[2]O[3] may be independent of FLT3 mutation status, so As[2]O[3] may be the first choice of APL especially in patients with FLT3 mutations. However, further studies on a large group of patients are necessary to confirm our findings. IMEMR Current Contents Subject Index 66 Levonorgestrel therapeutic use Levenorgestrel Intra utrine system [LNG IUS] in menorrhagia: a three years followup study. Utman, Naeema; Faheem, Fouzia E-mail:naeemautman@yahoo.com Lady Reading Hospital - Department of Obstetrics and Gynecology JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 79-83 (19 ref.) Keywords: Menorrhagia-drug therapy; Intrauterine Devices, Medicated; Contraceptive Agents, Female; Menstruation; Treatment Outcome Abstract: To find the role of Levenorgestrel Intra uterine system [LNG IUS] in menorrhagia in women over period of three years. This descriptive study was conducted in private setup and Gynaecology A unit, Lady Reading Hospital, Peshawar over a period of three years i.e., June 2004 to June 2007. The study population consisted of 60 women. All these women presented with heavy menstrual flow, having no contraindication for the device and consenting to Levonorgestrel Intra Uterine System after counseling. Those having organic cause for menorrhagia were excluded. Women were followed up at 6 week, 6 month and 12 month. The mean age of the sample was 35.98 +/- 7.66 years. In the sample, multipara were 86.66% [n=52] and nulliparous were 13.33% [n=8]; married were 91.66% [n=55] and unmarried were 8.33% [n=5]. The indication for the device were menorrhagia in 75% [n=45] cases; women having intrauterine contraceptive device previously and currently having menorrhagia in 16.6%[n=10] cases; and others 8.33%[n=5] cases [women who are unfit for general anesthesia or having other co-morbidity i.e., asthma, uncontrolled diabetes]. The acceptance rate was 80% [n=48] and discontinuation rate was 20% [n=12]. In these 12 cases, expulsion of device, pelvic inflammatory disease and no improvement in the condition was seen in cases, expulsion of device, pelvic inflammatory disease and no improvement in the condition was seen in 10%[n=6], 3.3%[n=2] and 6.6%[n=4] respectively. At follow up 3.3% [n=8] women had irregular period while 73.3% [n=44] were amenrroheic and 13.33% [n=8] women had regular period at the end of one year. Levonorgestrel IUS is one of the effective treatment modality which can be used for menorrhagia with reasonable efficacy. Liver Neoplasms therapy Undifferentiated sarcoma of the liver: a rare pediatric tumor. Shattaf, Aysha; Jamil, Altaf; Khanani, Muhammad Faisal; El Hayek, Muhammad; Baroudi, Mustafa; Trad, Omar; Ishaqi, Muhammad Kashif Tawam Hospital in affiliation with Johns Hopkins Medical School - Division of Pediatric Hematology and Oncology Annals of Saudi Medicine 2012; 32 (2): 203-205 (13 ref.) Keywords: Liver Neoplasms-pathology; Sarcoma-pathology; Combined Modality Therapy; Remission Induction; Treatment Outcome; Prognosis; Liver Neoplasms-surgery Abstract: Undifferentiated embryonal sarcoma of the liver [UESL] is an uncommon hepatic tumor of mesenchymal origin recognized as a unique clinicopathologic entity since 1978. UESL has historically been considered an aggressive neoplasm with an unfavorable prognosis. Survival has improved using recent multimodal approaches, designed for patients with soft tissue sarcomas at other sites. Several small series have reported survival of up to 70% of children. We report a case of a 12-year-old boy from the United Arab Emirates who relapsed after complete surgical resection and was then successfully treated with re-resection followed by chemotherapy and radiotherapy. With a follow-up of 5 years, he is well and asymptomatic, and is leading a healthy life. This case emphasizes the fact that these poorly prognostic tumors may benefit from post-surgery chemotherapy. This case illustrates the improved survival of UESL patients following the multimodality therapy with a relatively long follow-up. This is the first case of UESL reported in this region of the world. IMEMR Current Contents Subject Index 67 Lymphoma diagnosis Fine needle aspiration cytology in the evaluation of lymphoid lesions: a retrospective study of the utility of flow cytometry in conjunction with morphology. Raddaoui, Emad M. Said; Rabie, Lubna Sayage; Beissner, Robert S. E-mail:eraddaoui@yahoo.com King Saud University - College of Medicine - Department of Pathology, King Khalid University Hospital Annals of Saudi Medicine 2012; 32 (2): 137-142 (14 ref.) Keywords: Biopsy, Fine-Needle; Immunophenotyping; Flow Cytometry; Sensitivity and Specificity; Retrospective Studies Abstract: Fine needle aspiration [FNA] cytology, in conjunction with flow cytometry, is now widely used as a reliable and accurate method for the assessment of various lymphoid lesions, especially for lesions situated in odd locations where obtaining biopsy and monitoring for recurrence in previously diagnosed cases of lymphoma are difficult. The objective of this study was to determine the utility of FNA and immunophenotyping in the assessment of lymphoid lesions, and to find whether flow cytometry is more useful in the evaluation and subclassification of the small cell morphology group of lymphomas than in the large cell morphology group of lymphomas. Retrospective analysis of patients diagnosed with lymphoma over at a 5-year period. All 175 FNA cases were followed carefully either clinically or histologically for at least 5 years. We compared the utility of flow cytometry in the diagnosis of small cell morphology lymphomas to large cell morphology lymphomas. Flow cytometry was performed on 72 of 175 [41%] of FNA specimens clinically suspicious of lymphoma. The excisional follow-up biopsy was obtained in 78 of 175 [44.5%] cases. Based on cytomorphologic evaluation, 82 cases [47%] were considered negative, 34 cases [19%] were considered atypical, 32 cases [18%] were positive for NHL-small cell morphology, 21 cases [12%] were positive for non-Hodgkin lymphoma [NHL]-large cell morphology, 3 cases [2%] were positive for NHL, and 3 cases [2%] were nondiagnostic. Immunophenotyping utilizing flow cytometry was the diagnostic parameter in 28 of 32 cases [88%] of the NHL-small cell morphology group and in 11 of 24 cases [46%] of the NHL-large cell morphology/Hodgkin lymphoma group. Immunophenotyping by flow cytometry is more essential for the accurate evaluation and classification of small cell morphology than large cell morphology lymphoid lesions in FNA cytology. Magnesium Sulfate therapeutic use Magnesium sulphate therapy in eclampsia: a 5 years experience at a teaching hospital. Naz, Talat; Hassan, Lubna; Rafique, Isma E-mail:muqimsaadan@yahoo.com Khyber Teaching Hospital - Department of Obstetrics and Gynecology JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 84-90 (21 ref.) Keywords: Eclampsia-drug therapy; Eclampsia-complications; Seizures-drug therapy; Pregnancy; Treatment Outcome Abstract: To describe the presentation of eclampsia, its management and associated outcomes using magnesium sulphate [MgSO4], over a five years period at a tertiary care hospital. This descriptive study was conducted at Obstetrics and Gynecology Unit, Hayatabad Medical Complex, Peshawar from January 2004 to December 2008. Data was collected from all patients presenting with eclampsia. A total of 146 patients had eclampsia. Unbooked were 124 [84.93%]. Mean age 23 years +/- 5.3 years [range 18-38 years], primigravida were 69.17% [101 cases]. Antepartum fits in 72.6% [106 cases], intrapartum 14 [9.58%] and 27 [18.49%] postpartum. MgSO4 was used in all except 4 with oliguria, they were given diazepam. Recurrent fit occurred in only 20[13.69%]. MgSO4 toxicity occurred as respiratory depression in 9 cases, depressed tendon reflexes in 10 and decreased urine output in 13 cases Total deliveries were 23021, prevalence of eclampsia was 0.63%. Mode of delivery was Vaginal in 97 [66.43%], instrumental in 29 [19.98%] and cesarean section in 20 [13.69%] cases. There were 26[17.2%] stillbirths and 4 neonatal deaths. Complications included HELLP in 17 [11.64%], pulmonary complications in 17, renal failure in 7 [4.79%], DIC in 16[10.95%] and temporary blindness in 16 cases. Eleven [7.53%] maternal deaths occurred, causes included DIC in 1case, HELLP in 2, renal failure 1, cardiopulmonary failure in 2 and CVA [received deeply unconscious] in 5 cases. All were unbooked cases and with delay in reaching hospital. Eclampsia is common antenatally and in primigravidae, and a major cause IMEMR Current Contents Subject Index 68 of maternal morbidity and mortality in our region. It was effectively controlled with MgSO4, preventing recurrent fits and safe for both mother and fetus. Malaria prevention and control Pharmacokinetics of lumefantrine in healthy Pakistani volunteers. Jafery, Nusrat; Najmi, Muzammil Hassan Army Medical College - Pharmacology Department PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 427-432 (14 ref.) Keywords: Recurrence-prevention and control; Fluorenes; Chromatography, High Pressure Liquid; Ethanolamines; Pharmacokinetics; Human Experimentation Abstract: To study the pharmacokinetics of lumefantrine in healthy Pakistani volunteers so as to see the adequacy of the regimen in vogue for the treatment of malaria and prevention of recrudescence. Department of Pharmacology and Therapeutics, Army Medical College Rawalpindi, from December 2006 to December 2007. Quasi experimental study. Twelve healthy Pakistani male adult volunteers after informed consent participated in the study. Plasma concentration time profiles were measured after a single oral dose administration of 480mg of lumefantrine equal to four tablets of artemether -lumefantrine combination [Exafal]. After extraction of lumefantrine with hexane-diethyl ether [70:30v/v] from plasma, it was analysed by HPLC [High performance liquid chromatography] using a C18 reverse phase ODS stainless steel column and a mobile phase of acetonitrile-0.1 M ammonium acetate [90:10v/v] adjusted to pH 4.9 with detection at 335 nm. The median absorption half-life of lumefantrine was 4.5 hours, with Time to reach peak plasma concentration [Tmax] 8.5 hours, plasma clearance 2.44 l/h and terminal elimination half-life of 89.5 hours. The mean residence time [MRT] calculated ranged from 62.5 - 125.6 [mean 98.17 +/- 17.18] hours. The day seven plasma concentrations in all the subjects, less one, were more than the cut-off value of 0.28mg/l required to prevent the recrudescent infection. The overall pharmacokinetic profile of lumefantrine in Pakistani healthy volunteers appears to be comparable to other ethnic groups reported from various countries and the dose regimen used is adequate for the treatment and prevention of recrudescence. transmission Larval habitat, ecology, seasonal abundance and vectorial role in malaria transmission of Anopheles Arabiensis in Jazan Region of Saudi Arabia. Al Sheik, Adel A. E-mail:adelalsheikh@gmail.com Ministry of Health - The National Centre for Training and Research [Tropical Diseases] - The General Directorate of Health Affairs Journal of the Egyptian Society of Parasitology 2011; 41 (3): 615-634 (52 ref.) Keywords: Anopheles; Insect Vectors; Larva; Seasons; Ecology Abstract: Studies on the ecology and role in malaria transmission of the local anopheline fauna of An. arabiensis, was undertaken at the Red Sea coastal plain, the Tihama, in Saudi Arabia, an area of moderate malaria endemicity. Studies were carried out over a 13 months period from March 2007, by larval collection and by adult collection using pyrethrum knockdown [PKD], and CDC light-traps at 9 s sites. In total 479,520 mosquitoes of 14 species collected seven anopheles species were identified: An. gambiae s.l Giles, An. dthali Patton, An. pretoriensis Theobald, An. sergentii Theobald, An. multicolour, An. rhodesiensis rupicola Lewis, and An. turkhudi Liston. An. gambiae was the most predominant species. An. arabiensis Patton was identified by PCR as the only member of the An. gambiae complex present. A survey of mosquito breeding sites showed that suitable sites for both An. arabiensis and other anophelines existed all year round. Larvae of An. arabiensis, An. dthali and An. pretoriensis were found every month. In addition to the more typical breeding sites, An. arabiensis larvae were found in rock pools and in domestic water containers and tanks. An. arabiensis was the predominant anopheline species found resting in human habitations but despite its endophily, only 40% bloodmeals were of human origin. The source [s] of the remainder was [were] unknown. Despite its predominance in larval collections, few adult An., dthali and An. pretoriensis were caught in PKD, indicating a zoophilic preference. Other anophelines were rarely found. Sporozoite rate in An. arabiensis was 0.61%, based on 21posities. None was found in others. IMEMR Current Contents Subject Index 69 Malnutrition epidemiology A profile of nutritional status of under five year old children in internally displaced persons [IDPS] camp, Jalozai district Nowshera. Gul, Riaz; Kiramat, Aamir E-mail:riazgul_70@yahoo.com Kabir Medical College - Department of Community Medicine JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 43-47 (7 ref.) Keywords: Nutritional Status; Child Nutrition Disorders-epidemiology; Refugees Abstract: To analyze the degree of malnutrition in children under five years of age in IDPs camp of Jalozai, district Nowshera and to assess the ratio of malnourishment gender. The study was conducted at Jalozai camp, Nowshera for a period of three months duration. A sample of 100 children with age range six to fifty nine months [6 months to 59 months] with certain degree of malnutrition was selected according to the inclusion criteria. The data was gathered from the record of Primary Health care Centre Jalozai of Merlin [Medical Relief Lasting Health Care. Children were diagnosed as mild, moderate and severe degree malnutrition on the basis of their height and weight for their respective ages [Gomes and Harvard classification]. Standard weight charts were used for assessment. The data was analyzed by applying the descriptive statistics using SPSS version 10. Out of 100 malnourished children, 40 [40%] were boys and 60 [60%] were girls. Eight boys [20%] and 17 girls [28.3%] had mild while 32 [80%] boys and 43 girls [71.7%] had moderate malnutrition. Severe degree malnourished children were excluded from the study. Among 51 children of age between 6 and 23 months, 33 [63.7%] children were breast fed, 16 [31.3%] were bottle fed and 2 [4%] were both bottle and breastfed. 63 [63%] children were immunized completely, 34 [34%] partially and 3 [3%] children were not at all immunized. Prevalence of malnutrition increases for refugees and IDP's, and is more common in female as compared to male gender. Malocclusion, Angle Class III Characteristics of skeletal class III malocclusion and its associated dento alveolar compensation. Mehboob, Bushra; Rasool, Ghulam; Amin, Meyzgan E-mail:bushesmmm@hotmail.com Khyber College of Dentistry - Department of Orthodontics JKCD - Journal of Khyber College of Dentistry 2011; 2 (1): 13-15 (29 ref.) Keywords: Prognathism; Retrognathism Abstract: To determine the extent of contribution of the maxilla to the development of class III malocclusion and the associated dentoalveolar compensation in such patients. Pretreatment cephalometric radiographs of 45 patients were obtained from the records of Department of Orthodontics, Khyber College of Dentistry, Peshawar. Different landmarks namely Sella, Nasion, point A, point B, ANS, PNS, Gonion and Menton were identified and four angular measurements were recorded. Out of 45 patients, 24 were male and 21 female. It was found that 60% of patients had a prognathic mandible, 31% had a retrognathic maxilla, while in 9% of patients both maxilla and mandible were at fault. The dentoalveolar compensation was 93% in maxillary arch and 40% in mandibular arch. This study revealed that majority of class III patients suffered from mandibular protrusion and that maxillary incisors showed greater compensation as compared to mandibular incisors. Maxillary Neoplasms epidemiology Types of maxillary tumours and the resulting post-surgical defects in patients at a teaching hospital. Murad, Nida; Zakirullah; Ghani, Fazal Khyber College of Dentistry - Department of Oral and Maxillofacial Surgery JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 106-110 (26 ref.) IMEMR Current Contents Subject Index 70 Keywords: Postoperative Complications; Maxilla-surgery; Data Collection; Hospitals, Teaching; Treatment Outcome; Maxillary Neoplasms-surgery Abstract: To report the frequency of the types of maxillary tumours and the resulting post-surgical defects based on Aramany classification. Study design, duration and setting: This descriptive study was done during the period of 5 years [2005-11] at the Otorhinolaryngology and Head and Neck Surgery Unit, Khyber Teaching Hospital Peshawar. A pre-structured proforma was used for data collection. Data recorded included patients' age, gender, type of maxillary tumour, type of maxillectomy and approach for resection, Post-surgical defect based on Aramany classification for acquired maxillary defects, neck dissection, radiotherapy, and prosthetic rehabilitation. Data were computed for descriptive statistics including frequencies, percentages and mean values. Patients [n=53] had a male to female ratio of 1.7. Some 26.4% patients belonged to the age group of 31-40 years. Maxillectomy was done for inverted papilloma, a benign tumour in 1.9% patients as compared to malignant squamous cell carcinoma in 66% patients. Maxillary resection for fibrous dysplasia was done in 3.8% patients who were relatively younger. Maxillectomy in all cases was performed using Weber-Fergusson incision approach. Surgical resection resulted in Armanay calls I defect in 73.58% patients. In 92.5% patients a surgical obturator was provided to patients at the time of maxillectomy. Maxillectomy was mainly performed for resecting malignant tumours using Weber-Fergusson incision with the fitting of immediate surgical obturator. The resulting defect was mainly Aramany Class I defects. Mediastinal Emphysema diagnosis A neonate with spontaneous pneumomediastinum. Calisici, Erhan; Oncel, Mehmet Y.; Yurttutan, Sadik; Canpolat Fuat E.; Oguz, Serife Suna E-mail:aser27@gmail.com Zekai Tahir Burak Maternity Teaching Hospital Medical Journal of Islamic World Academy of Sciences 2012; 20 (1): 29-30 Keywords: Mediastinal Emphysema-radiography; Diagnosis, Differential Mesenchymal Stem Cells Mesenchymal stem cell; biology, application and its role in regenerative medicine. Fard, A. Dehghani; Saki, N.; Ahmadvand, M.; Maymand, M. Mahmoodinia; Mohammadi, M. Mosahebi; Soleimani, M. Tarbiat Modares University Scientific Journal of Iranian Blood Transfusion Organization Research Center [The] 2012; 8 (4): 304-320 (125 ref.) Keywords: Mesenchymal Stem Cell Transplantation; Cell Differentiation; Tissue Engineering Abstract: Mesenchymal stem cells have extensive potential to proliferate and differentiate into different cell lineages. Their differentiation capability in vivo and in vitro makes them ideal tools for tissue engineering and regenerative medicine. In the present study more than 100 recent published articles which are about isolation, culture and differentiation of MSCs were reviewed for application of MSC in regenerative medicine and tissue engineering. Clinical applications of MSCs seem to be in two distinctive lines: bio-scaffold design without immunological responses as well as multipotent stem cell without clinical obstacles. MSCs due to their capacity of self-renewability, multilineage differentiation and immune modulatory effects are of great therapeutic potential for cell and gene therapy of congenital and degenerative disorders. genetics Infection of MSCs by adenovirus expression system expressing NRF2 as a cytoprotective factor. Mohammadzadeh, M.; Halabian, R.; Mohammadipoor, M.; Kiani, A.A.; Gharehbaghian, A.; Amirizadeh, N.; Roudkenar, M. Habibi High Institute for Research and Education in Transfusion Medicine - Blood Transfusion Research Center Scientific Journal of Iranian Blood Transfusion Organization Research Center [The] 2012; 8 (4): 272-285 (34 ref.) Keywords: Mesenchymal Stem Cells-virology; Adenoviridae-genetics; Cytoprotection Abstract: Poor viability of Mesenchymal Stem Cells [MSCs] following transplantation is one of the major challenges in their therapeutic application. Manipulation of MSCs by the genetic engineering method is one of the strategies used to protect the cells against cytotoxic microenvironment. However, maintaining multi differentiation capacity of MSCs following manipulation is important. We investigated if the manipulation of MSCs with NRF2 affects the multi differentiation capacity. MSCs were isolated from bone marrow. NRF2 was isolated and TOPO cloned into the pENTR IMEMR Current Contents Subject Index 71 vector. The recombinant vector was transferred into pAD/CMV/V5-DEST vector by gateway technology. Recombinant adenovirus was produced in AD293 cells, followed by being infected into MSCs. Expression of NRF2 was verified by RT-PCR. The NRF2 engineered MSCs were exposed to stress conditions followed by the evaluation of the cells viability and apoptosis. Finally, NRF2 expressing MSCs differentiation into osteoblast and adipocyte lineages was studied. NRF2 was successfully expressed in MSCs. NRF2- MSCs differentiation into osteoblast and adipocyte lineages indicating overexpression of NRF2 does not affect the differentiation property of MSCs. Expression of NRF2, a well known cytoprotective factor, by using adenovirus expression system does not intervene in the differentiation capacity of MSCs. NRF2-MSCs might be applicable for stem cell-based cell therapy in future. Mitosporic Fungi immunology Interactions of spodoptera littoralis haemocytes following injection with the entomopathogenic fungi: Beauveria Bassiana and Nomuraea Rileyi. Meshrif, Wesam S.; Rohlfs, Marko; Hegazi, Mohamed A.M.; Barakat, Emad M.S.; Seif, Amal I.; Shehata, Magdi G. E-mail:wmeshrif@science.tanta.edu.eg Tanta University - Faculty of Science - Department of Zoology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 699-714 (51 ref.) Keywords: Beauveria-physiology; Hemocytes-ultrastructure; Microscopy, Electron; Phagocytosis Abstract: This study compared the cellular interactions of Spodopteralittoralis haemocytes with two virulence- different entomopathogenic fungi: Beauveriabassiana and Nomuraearileyi. Using light and transmission microscopy, five types of haemocytes namely, prohaemocytes [PRs], plasmatocytes [PLs], granulocytes [GRs], spherule cells [SPs] and oenocytoids [OEs] were identified in the 6[th] instar larvae. PRs and PLs were found in the haemopoietic tissue.Intra-haemocoelic injection of blastospores induced ultrastructural alterations in the cytoplasm and nucleiof circulating haemocytes of treated larvae. Different responses were observed in the populations of haemocyte types following injection with the tested fungi. The most important changes were the decrease of the numbers of GRs aiccompanied with increase inSPs at 12-48h following injection with B. bassiana, whereas,a decrease of PLs with a commitment increase inSPs and OEs were observed at most time intervals after injection with N. rileyi. Both fungi provoked a decrease of the total number of haemocytes at 48h followed by an increase at 72h post-injection. In vivo assay showed that the GRs and PLs actively phagocytised fungal blastospores. There was a time-dependent decrease and increase in the phagocytosis activity after injection of B. bassiana and N. Rileyi, respectively .In B. bassiana- injected insects, the numbers nodules increased significantly at 6-48h in comparison with the controls post-injection. In N. rileyi-injected insects, nodules increased significantly only at 72h post-injection.No cellular encapsulation was observed in any of the examined insects. Mitral Valve Prolapse Ventricular late potentials in patients with mitral valve prolapse. Khan, Muhammad Alamgir; Majeed, Imran; Farooq, Yasir Army Medical College PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 453-459 (18 ref.) Keywords: Tachycardia, Ventricular; Electrocardiography; Echocardiography; Exercise Test; Death, Sudden, Cardiac; Case-Control Studies; Death, Sudden Abstract: To determine frequency of ventricular late potentials in healthy individuals and in patients with mitral valve prolapse and to identify patients with Mitral Valve Prolapse at high risk of sudden death based upon ventricular late potentials. Case - Control study. The study was conducted in Army Medical College and Armed Forces Institute of Cardiology, Rawalpindi from March 2005 to February 2006. A total of 37 patients with mitral valve prolapse and 37 matching controls were included in the study. Patients with confirm diagnoses of mitral valve prolapse on echocardiography were selected. After recording their conventional ECGs, they underwent exercise tolerance test on treadmill. Signal averaged electrocardiogram of every patient was recorded using computer software for the presence or otherwise of ventricular late potentials. The data was entered into SPSS version 10. Descriptive statistics were used to calculate means and standard deviations while paired sample 't' test at confidence interval of 95% was used to compare mean values for statistical significance. Nine [24.32%] out of 37 cases and only 1 [2.7%] out of 37 controls had ventricular late potentials on their signal averaged electrocardiogram. Ventricular late potentials are useful non- invasive predictive markers of sudden cardiac death in patients with mitral valve prolapse. IMEMR Current Contents Subject Index 72 Morbidity Pattern of diseases among visitors to Mina health centers during the Hajj season, 1429 H [2008 G]. Alzahrani, Abdullah G.; Choudhry, Abdul Jamil; Al Mazroa, Mohammad A.; Turkistani, Abdul Hafiz M.; Nouman, Ghassan S.; Memish, Ziad A. E-mail:abdullahgz@gmail.com Ministry of Health - Field Epidemiology Training Program Journal of Infection and Public Health 2012; 5 (1): 22-34 (24 ref.) Keywords: Disease-ethnology; Delivery of Health Care-utilization; Delivery of Health Care-ethnology; Health Planning; Travel; Islam; Age Distribution; Sex Distribution-epidemiology Abstract: While performing the Hajj, hajjis face different risks related to the environment, their behaviors and their health conditions that can result in a variety of diseases. The objective of this study was to determine the pattern of diseases among pilgrims seeking medical services in Mina primary health care centers [PHCCs] during the Hajj season in 1429 [2008]. This is a descriptive study based on the medical records of a random sample of 4136 patients who attended 13 randomly selected Mina PHCCs from 8 to 12 Dhu-Alhijja, 1429 H [6-10 December 2008]. The majority of the patients were men [70.7%], and most of the patients were between 45 and 64 years of age [42.8%]. One-fifth [20.2%] of the patients suffered from multiple diseases. Respiratory diseases were the most common [60.8%], followed by musculoskeletal [17.6%], skin [15.0%] and gastrointestinal [13.1%] diseases. Diabetes, asthma and hypertension each constituted less than 3% of the total diseases. Respiratory diseases were the most common independent of nationality or the day of visit, while the frequency of the other diseases varied according to nationality and the day of visit. The most frequently prescribed drugs were analgesics, antipyretics, antibiotics and cough syrups. This study describes the pattern of diseases among pilgrims attending Mina PHCCs, which may aid in providing the best possible health care services to pilgrims. 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved. Motor Activity Physical activity profile of students in Mansoura University, Egypt. El Gilany, A.H.; Badawi, K.; El Khawaga, G.; Awadalla, N. E-mail:ahgilany@gmail.com Mansoura University - College of Medicine - Public Health Unit EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 694-702 (40 ref.) Keywords: Students; Universities; Questionnaires; Socioeconomic Factors Abstract: A cross-sectional study was carried out on 1708 students from Mansoura University, Egypt, to describe the pattern of physical activity, predictors of physical inactivity and perceived barriers to and benefits of physical activity. The International Physical Activity Questionnaire [IRAQ] was used to measure physical activity. Data were analysed according to the guidelines for data processing and analysis of the IRAQ. Perceived barriers to and potential benefits of physical activity were asked for. More than 11% of students were physically inactive. On logistic regression analysis, the independent predictors of physical inactivity were high socioeconomic standard of the family [OR 2.1], female sex [OR 1.8], medical education [OR 1.8] and non-membership in sports clubs [OR 1.6]. The most frequent barriers to physical activity were time limitation and lack of accessible and suitable sporting places. More than 70% of the participants stated that physical activity promotes and maintains health. Mullerian Ducts abnormalities Uterus didelphys with obstructed right hemivagina, ipsilateral renal agenesis and right pyocolpos: a case report. Dhar, Hansa; Razek, Yasser A.; Hamdi, Ilham E-mail:hansad2009@gmail.com Nizwa Hospital - Department of obstetrics and Gynecology Oman Medical Journal 2011; 26 (6): 447-450 (15 ref.) Keywords: Congenital Abnormalities; Kidney Diseases-congenital; Kidney-abnormalities; Dysmenorrhea; Vagina- abnormalities IMEMR Current Contents Subject Index 73 Abstract: Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis [OHVIRA Syndrome] is a rare congenital anomaly of the female genital tract. Uterus didelphys occurs when the midline fusion of the mullerian ducts is arrested, either completely or incompletely. Women with didelphic uterus may be asymptomatic and unaware of having a double uterus. They may present with complaints of dysmenorrhoea and dyspareunia. A 25 year old woman attending the infertility clinic at Nizwa regional referral hospital presented with history of dysmenorrhoea and foul vaginal discharge with right cystic pelvic mass. She was diagnosed as a case of double uterus with obstructed right hemivagina and right pyocolpos with ipsilateral renal agenesis after routine ultrasonography in the clinic followed by MRI. Excision of the right vaginal septum with drainage of 200 ml of purulent discharge was performed. She was relieved of her symptoms and conceived promptly after the surgical excision of the partial vaginal septum. Myocardial Reperfusion Injury drug therapy The effect of aminophylline versus milrinone on ischemia-reperfusion myocardial injury during open heart surgery. Abdel Aal, Fatma A.; Attya, Alaa M.A.; Mohareb, Ahmed M.; Youssef, Hamdy A.; Abdel Azeem, Hanan G.; Abdel Rahman, Khaled A. Assiut University - Faculty of Medicine - Anesthia and intensive care Department Assiut Medical Journal 2011; 35 (1): 53-66 (35 ref.) Keywords: Aminophylline-therapeutic uses; Milrinone-therapeutic uses; Comparative Study; Thoracic Surgery; Heart Arrest, Induced Abstract: Cardioplegic arrest during cardiopulmonary bypass [CPB] is essential for the majority of cardiac surgical procedures; Cardioplegia protects the myocardium by providing continuous or intermittent oxygen while simultaneously reducing cardiomyocyte oxygen demand, but it does not inherently increase the ischemic-reperfusion injury tolerance of the cardiomyocytes. Aminophylline and milrinone by their phosphodiesterase inhibitor and anti-inflammatory activity may decrease this type of injury. This study has been designed to compare between the protective effect of aminophylline and milrinone over the heart during open heart surgery for valve replacement with CPB. Sixty adult patients undergoing elective single valve replacement were randomized to receive aminophylline 5 mg/kg [n=20], milrinone 50 microg/kg [n=20], or normal saline as control group [n=20] through intravenous infusion 10 minutes before the aortic cross-clamping. The cardiac troponin I, inotrope score, duration of mechanical ventilation, and length of ICU stay and other hemodynamic variables were measured and recorded. There were no differences between the three groups with regard to clinical variables. Cardiac troponin I raised significantly after declamping in the three groups, however it was significantly lower in aminophylline and milrinone group compared to control group immediately after CPB and after 8 hours with no significant differences between aminophylline and milrinone group, inotrope score duration of mechanical ventilation and length of ICU stay showed no significant differences between the three groups. Administration of aminophylline or milrinone reduces the subclinical myocardial injury with no difference between both agents and with no effect on the hemodynamic parameters or short term clinical outcome in patients undergoing single valve replacement with CPB. Myoepithelioma pathology Low-grade malignant myoepithelioma arising in a pleomorphic adenoma: a rare case. Raddaoui, Emad; Al Hujaily, Ahmed S.; Al Dhahri, Saleh F. E-mail:eraddaoui@yahoo.com King Saud University - College of Medicine - Department of Pathology Annals of Saudi Medicine 2012; 32 (2): 209-212 (15 ref.) Keywords: Myoepithelioma-diagnosis; Adenoma, Pleomorphic-pathology; Adenoma, Pleomorphic-diagnosis; Salivary Gland Neoplasms-pathology Abstract: Malignant myoepithelioma is a very rare salivary gland tumor that can arise de novo or within a preexisting pleomorphic adenoma. We report a case of malignant myoepithelioma most probably arising in a pre-existing pleomorphic adenoma of the left parotid gland. The patient was a 60-year-old man who presented with a multinodular mass lesion over left side of the face and neck. He had undergone removal of a pleomorphic adenoma of the left parotid gland twice [8 and 22 years ago]. Histological examination showed locally concentrated highly invasive IMEMR Current Contents Subject Index 74 myoepithelial cells with bland-looking morphology and no evidence of mitosis or necrosis. Immunohistochemistry confirmed the myoepithelial differentiation [S-100+, SMA+] and a low Ki-67 labeling index [<5%]. Nasal Obstruction surgery Efficacy of submucosal diathermy in inferior turbinate hypertrophy. Ashoor, Abdul Aziz E-mail:ashoorabdul@gmail.com ENT Clinic Bahrain Medical Bulletin 2012; 34 (1): 18-20 (20 ref.) Keywords: Nasal Obstruction-etiology; Electrocoagulation; Treatment Outcome; Prospective Studies; Hypertrophy- surgery Abstract: To evaluate the efficacy of submucosal diathermy in inferior turbinate hypertrophy. ENT Outpatient clinic. t Prospective study. During four years [from May 2007 to April 2011], eighteen patients with inferior turbinate hypertrophy were diagnosed and scheduled for submucosal diathermy [SMD]. Before surgery, each patient has to pass the decongestant test. Under local anesthesia the turbinate were cauterized at 4-5 spotted areas of the turbinate using a monopolar with an isolated needle. Patients were followed-up for one year. Eighteen patients, 15 males and 3 females with a mean age of 34 year were included in this study. Fourteen had bilateral and 4 unilateral turbinate hypertrophy. Their main complaint was chronic nasal obstruction. The possible etiologies were vasomotor rhinitis, allergic rhinitis, idiopathic rhinitis or compensatory hypertrophy due to septal deviation. All patients underwent SMD under local anesthesia. Fifteen patients showed excellent improvement after one month of follow-up. Three patients with compensatory hypertrophy showed little improvement and they underwent a septal corrective surgery. Mean follow-up was 6.5 months. SMD is an effective technique to reduce turbinate hypertrophy. It is safe and has long-term positive outcome. Neuroblastoma enzymology Regulation of glutathione synthesising and recycling enzymes by xenobiotics in SH-SY5Y neuroblastoma cells. Gwarzo, M.Y. E-mail:mygwarzo@yahoo.co.uk Bayero University - Faculty of Medicine - Department of Chemical Pathology EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 375-392 (49 ref.) Keywords: Cells; Oxidative Stress; Glutathione; Antioxidants; Cell Line; Cell Culture Techniques-methods; Neuroprotective Agents; Blotting, Western-methods Abstract: Neurones are prone to oxidative stress and damage due to low levels of endogenous antioxidants [both protein and non protein molecules]. Hence, this work looked at the possibility of increasing the levels of antioxidants molecule in neuronal cell line. With such increase, it is thought possible that neuronal cell integrity could be improved in the face of oxidants assault. In this study ethoxyquin and t-BHQ induced gamma glutamyl cysteine ligase enzyme regulatory subunit [GLCR] and caused increase in intracellular glutathione level significantly. The increase of GSH was not accompanied by induction of GS or catalytic subunit of gamma glutamyl cysteine ligase at protein level. Co- administration of selenium as sodium selenite with other inducers of antioxidants further increased the level of intracellular glutathione. This provides a hope that inducers of endogenous antioxidants protein capable of passing blood-brain barrier might attenuate the progression of brain ageing due to genetic diseases associated with increased production of free radical. IMEMR Current Contents Subject Index 75 Noise, Transportation prevention and control A framework to protect urban districts from the traffic noise in Elkhoms city, Libya. Elazazi, Mohamed Abdel Wahab Mahmoud E-mail:mabdelwahab99@yahoo.com Assiut University - Faculty of Engineering - Architecture Engineering Department Assiut University Bulletin for Environmental Researches 2011; 14 (2): 1-14 (9 ref.) Keywords: Urbanization; Cities; Noise, Transportation-adverse effects Abstract: Similar to several cities all over the world, the urban districts of Elkhoms city, Libya, suffer from traffic noise, which results mainly from the rapid urbanization and extension towards the highways. The influence of this noise affects negatively different activities and uses within the city structure: residential, educational and health. This paper aims to propose a framework to address the traffic noise problems in Elkhoms city. To attain this aim, the paper, firstly, discusses the nature of traffic problems and noise levels in Elkhoms city. Afterwards, the researcher demonstrates the procedures of the traffic noise mitigation, which can be applied at two levels: planning and architectural. At planning level, the attenuation takes place at the noise sources such as urban and arterial roads. The applications at the architectural levels focus on the noise receiver; buildings in this case which represent the last protected line from noise. Later, the researcher carries out several measures to evaluate the influence of planning and architectural applications to reduce the noise levels in Elkhoms city. The paper ends with a number of planning and architectural criteria which should be taken into account to reduce the influence of traffic noise. Obesity epidemiology Current prospectus on obesity in Bahrain and determination of percentage body fat range. Hubail, Amal R.; Culligan, Kevin G. E-mail:kculligan@rcsi-mub.com Royal College of Surgeons in Ireland-Bahrain - School of Medicine Bahrain Medical Bulletin 2012; 34 (1): 21-25 (24 ref.) Keywords: Adipose Tissue; Body Mass Index; Prospective Studies; Cross-Sectional Studies; Prevalence Abstract: Obesity and its related disorders are becoming an overburden on healthcare systems worldwide. To evaluate the current status of obesity in Bahrain and predict percentage body fat. Shopping mall in Bahrain. Prospective cross-sectional study. Four hundred fourteen volunteers were recruited; each provided informed consent. A range of physical measurements were collected from each individual and used to calculate the parameters obtained. The average body mass index [BMI] for males was 28.2 kg/m[2] and for females was 28.6 kg/m[2]. This increased with age, showing a biphasic increase for females. Linear transformation of BMI data showed greater significance in correlating BMI versus percent body fat. However, prediction equations for calculation of percent body fat were more accurate without linear transformation of data. Percent body fat ranges for Bahrain, corresponding to BMI categories were derived. Prevalence rates for obesity in Bahrain are higher than predicted and are increasing at a higher rate than the global average. This mirrors the alarming increase in the prevalence of Type 2 Diabetes Mellitus in Bahrain. genetics Association of genetic polymorphisms of glutamate decarboxylase 2 and the dopamine D2 receptor with obesity in Taiwanese subjects. Chen, Ke Chang; Lin, Yi Chen; Chao, Wen Chii; Chung, Hsieh Kun; Chi, Su Sheng; Liu, Wen Sheng; Wu, Wen Tung Tian-Sheng Memorial Hospital - Department of General Surgery Annals of Saudi Medicine 2012; 32 (2): 121-126 (35 ref.) Keywords: Polymorphism, Genetic; Receptors, Dopamine D2-genetics; Glutamate Decarboxylase-genetics; Body Mass Index; Genetic Predisposition to Disease; Retrospective Studies; Case-Control Studies Abstract: It has been proposed that glutamate decarboxylase 2 and the dopamine D2 receptor are involved in the brain reward cascade to increase carbohydrate craving and cause eating disorders. We investigated the association between the polymorphisms of the CAD2 and DRD2 genes and obesity with a higher body mass index [BMI] in IMEMR Current Contents Subject Index 76 Taiwanese patients. A retrospective, case-control study at Antai Tian-Sheng Memorial Hospital from 1 January to 31 December 2009. Of 300 subjects enrolled in the study, 132 were obese [BMI>30 kg/m[2]] and 168 controls were not obese [BMI</=24 kg/m[2]. The polymorphisms of GAD2 [+61450 C/A], [+83987 T/A] and DRD2 [S311C] were characterized, respectively, by polymerase chain reaction-restriction fragment length polymorphism. The genotype and allele frequencies of the polymorphisms in this study were statistically analyzed. The genotype and allele frequencies of the GAD2 [+83987 T/A] and DRD2 [S311C] were significantly different between cases and controls [P=.001 for both]. The frequencies of TT genotype and T allele of the GAD2 [+83987 T/A] as well as the frequencies of Ser/Cys genotype and Cys allele of DRD2 [S311C] were higher in cases compared to controls [P=.034 and .036 for both]. The study demonstrated a statistically significant difference in the frequency of the GAD2 [+83987 T/A] and DRD2 [S311 C] genes between cases and controls in Taiwanese subjects. Octreotide therapeutic use Therapeutic applications of octreotide in pediatric patients. Al Hussaini, Abdulrahman; Butzner, Decker E-mail:aa_alhussaini@yahoo.com King Fahad Medical City - Chlidren's Hospital - Department of Pediatrics Gastroenterology, Heapatology and Nutritition Saudi Journal of Gastroenterology [The] 2012; 18 (2): 87-94 (70 ref.) Keywords: Octreotide-administration and dosage; Pancreatic Pseudocyst-drug therapy; Gastrointestinal Hemorrhage-drug therapy; Hemostatics-therapeutic use; Treatment Outcome Abstract: We report our experience with the use of octreotide as primary or adjunctive therapy in children with various gastrointestinal disorders. A pharmacy database identified patients who received octreotide for gastrointestinal diseases. Indications for octreotide use, dosing, effectiveness, and adverse events were evaluated by chart review. A total of 21 patients [12 males] , aged 1 month to 13 years, were evaluated. Eleven received octreotide for massive gastrointestinal bleeding caused by portal hypertension-induced lesions [n=7], typhlitis [1], Meckel's diverticulum [1], and indefinite source [2]. Blood transfusion requirements were reduced from 23 +/- 9 mL/kg [mean +/- SD] to 8 +/- 15 mL/kg [P<0.01]. Four patients with pancreatic pseudocyst and/or ascites received octreotide over 14.0 +/- 5.7 days in 2 patients. In 3 children, pancreatic pseudocyst resolved in 12 +/- 2 days and pancreatic ascites resolved in 7 days in 2. Three patients with chylothorax received octreotide for 14 +/- 7 days with complete resolution in each. Two infants with chronic diarrhea received octreotide over 11 +/- 4.2 months. Stool output decreased from 85 +/- 21 mL/kg/day to 28 +/- 18 mL/kg/day, 3 months after initiation of octreotide. The child with dumping syndrome responded to octreotide in a week. Adverse events developed in 4 patients: Q-T interval prolongation and ventricular fibrillation, hyperglycemia, growth hormone deficiency, and hypertension. Octreotide provides a valuable addition to the therapeutic armamentum of the pediatric gastroenterologist for a wide variety of disorders. Serious adverse events may occur and patients must be closely monitored. Operating Rooms Prevalence of bacterial contamination in general operating theaters in selected hospitals in the Gaza Strip, Palestine. Al Laham, Nahed A. E-mail:dr.allaham@hotmail.com Al Azhar University - Faculty of Applied Medical Sciences - Department of Medical Laboratory Sciences Journal of Infection and Public Health 2012; 5 (1): 43-51 (34 ref.) Keywords: Cross Infection-epidemiology; Cross Infection-etiology; Equipment Contamination; Bacteria-isolation and purification; Infection Control; Hospitals, Private-statistics and numerical data; Hospitals, Public-statistics and numerical data; Prevalence; Middle East Abstract: This study was conducted in general operating theaters at public and private hospitals in the Gaza Strip, Palestine to determine the prevalence of bacterial contamination of different objects. Swabs were collected from 21 items that were distributed over three categories [equipment, environment and personnel]. In total, 243 swabs were collected at pre- and post-operation stages and were cultured and identified using standard microbiological procedures. The results show that 24.7% of the swabs were contaminated with microorganisms. The equipment, environment and personnel were responsible for 45%, 48.3% and 6.7% of contamination, respectively. The rate [26.9%] of contamination in the post-operation samples was higher than in the pre-operation samples [22.6%], but the difference was not statistically significant. In addition, there was not a statistically significant increase in the prevalence of contamination in private [28.7%] compared to public hospitals [21.8%]. Of the seven bacterial genera that were IMEMR Current Contents Subject Index 77 recovered, the highest percentage belonged to Staphylococcus spp. [45.3%] followed by Enterobacter spp. [23.4%].This study reveals a moderate percentage of contamination in our public and private hospital general operating theaters, which may increase the risk factors for developing surgical-site infections. These observations justify more attention being paid to infection-control efforts in our hospitals. 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved. Orthodontic Wires Evaluation and Comparision of load deflection characteristics of superelastic nickel titanium orthodontic arch wires. Ebadifar, A.; Moradinejad, M.; Sadrnejad, S.K.H. Shahid Beheshti University of Medical Sciences - Dental School - Department of Orthodontics Journal of Dental School - Shahid Beheshti University of Medical Sciences 2012; 29 (4): 219-229 (16 ref.) Keywords: Nickel; Titanium Abstract: Ni-Ti alloys are widely used in orthodontics. The aim of this study was to evaluate and compare the load- deflection properties of Ni-Ti wires. In this experimental study, 65 Ni-Ti round wire [0.014 inch] from 13 different brands were subjected to a 3-bracket bending test at 37°c using an upper central bracket attached to rod in a manner the distance between the midpoint of brackets was 15.5mm. For each wire, the average force was determined at 1, 1.5, 2 and 2.5 deflections in unloading area. Then, SEM equipped with EDX system was used to asses element composition of each brand of wire. The drawing graphs had the overall shape of superelastic graphs;however, the amount of force applied by different wires at different deflections were significantly different, so 13 wires was divided to 4 categories according to their force delivary: high force [orthoforce], moderate force [Proflex, ORG, Ortho technology IMD, GAC and Force I], Low force [Smart' Nitanium' Nitinol SE, SE NITI, Rematitan Lite] and very low force [Imagination]. Additionally it was revealed that wires belong to one manufactory doesn't act similarly. The maximum and minimum Coefficient of Vriation belonged to Ortho Force and ORG, respectively. In element analysis, the ratio of Ni/Ti was not similar in different wire brands. It seemed likely that wires with higher Ti atomic percentage show lower load-deflection rate. It is revealed by this study that although studied wires almost showed superelastic graphs, the slope of the graph showed significant difference among the wires. So in this regard, the manufacturers' propagations are not reliable completely. The general recommendation is application of caution and precision in wire selection and attention to study results, element analysis and amount of crowding. Osteoarthritis Osteoarthritis among women in Bahrain: a public health audit. Asokan, G.V.; Hussain, Muna S. Hussain Abdullah; Ali, Eman J.M.; Awate, Rajendra V.; Khadem, Zahra K.A.; Al Safwan, Zainab A.M. E-mail:agv@health.gov.bh Ministry of Health - College of Health Sciences Oman Medical Journal 2011; 26 (6): 426-430 (26 ref.) Keywords: Risk Factors; Public Health; Body Mass Index; Menopause; Exercise; Age Factors Abstract: This study aims to train students on public health survey; correlate risk factors of osteoarthritis and to identify modifiable risk factors. Osteoarthritis survey was carried out among 420 Bahraini women, above 40 years of age, diagnosed of osteoarthritis, attending ministry of health facilities. Most cases in the study were from the age group of 50- 59 years with a mean age of 57. Osteoarthritis: of major joints alone was 74%; of generalized was 21% and of small joints of hands and feet alone was 5%. Within major osteoarthritis: 48% were knees alone; 51% were knee and hip and 2% were hip alone. Combinations of co-morbidities were found among 43%. History of diagnosed: diabetes in 10%, hypertension among 13% and hypercholesterolemia in 5% of cases. Half of the cases in the study were obese and 30% were overweight. Osteoarthritis of the Knee and the combination of the osteoarthritis of knee and hip was highest among obese followed by overweight cases. Menopause was found among 68%of patients. Patients on medication accounted for 85% and 75% were on Physiotherapy. Half of the sample had family history of osteoarthritis. While over 90% were less educated with odds ratio for being housewives at 3.085. The multivariate analysis of ordinal regression returned pseudo R2 of 30% for the model with the following significant variables: age, BMI, menopause status, exercise, chronic morbidities and family history of osteoarthritis. Overall, the proportion of major osteoarthritis of the weight bearing joints is very high. The modifiable risk factors identified from this study are sedentary lifestyle, obesity and overweight, as well as chronic morbidities. IMEMR Current Contents Subject Index 78 Osteoarthritis, Knee The association between osteoarthritis of the knee joint and chronic venous insufficiency of the legs. Al Omari, Wameedh R.S. E-mail:wrsalomari@yahoo.com Ibn Sinna Teaching Hospital - Rheumatology Division Bahrain Medical Bulletin 2012; 34 (1): 15-17 (18 ref.) Keywords: Venous Insufficiency; Varicose Veins; Leg-pathology; Comorbidity; Severity of Illness Index; Case- Control Studies; Prospective Studies Abstract: The possible association between osteoarthritis of the knee joint and chronic venous insufficiency of the legs needs to be investigated because some risk factors are common to both. To evaluate the association between knee osteoarthritis and chronic venous insufficiency of the legs. Case controlled prospective randomized study, non- blind. Setting: Outpatient clinic, Ibn Sinna Teaching Hospital, Iraq. Thirty patients with knee osteoarthritis and thirty control cases with no knee symptoms were evaluated clinically for chronic venous insufficiency. Knee osteoarthritis was significantly associated with leg edema [P value 0.002], varicose veins [P value 0.011] and abnormal leg veins [whether varicose veins alone or spider veins or both], [P values 0.02]. The presence of chronic venous insufficiency may contribute to the severity of osteoarthritis. An association does exist between knee osteoarthritis and chronic venous insufficiency of the legs. Further studies are needed to investigate the association including the possibility of pathogenic contribution. Osteoporosis Osteoporosis and periodontal disease: an update. Taj, Lubna; Almas, Khalid Former International Fellow in Advanced Periodontics JKCD - Journal of Khyber College of Dentistry 2011; 2 (1): 32-39 (69 ref.) Keywords: Periodontal Diseases; Aged; Bone Density; Postmenopause; Tooth Loss; Periodontitis; Diphosphonates- therapeutic use; Absorptiometry, Photon Abstract: The aim of the review is to evaluate the current status of relationship between osteoporosis and periodontal diseases. Now due to aging population in industrialized nations, osteoporosis is a common observation. Osteoporosis is the most common disease of middle-age and elderly people. Its main consequence is the increased risk of bone fractures and tooth loss. It is the thinning of bone tissue and loss of bone density over time. Osteoporosis is amongst the commonest chronic diseases in which bone becomes porous and more susceptible to fracture. It is estimated that on in three postmenopausal women and one in five men over the age of 50 years are affected. There are no symptoms in the early stages of the disease. Symptoms occurring late in the disease include bone pain or fracture. Osteoporosis may contribute to periodontal disease and ultimately tooth loss. Both of these diseases have been a public health concern because of the impact caused by bone fracture and tooth loss. Bone loss is a common feature of periodontitis and osteoporosis. The etiology of tooth loss is multifactorial, but one particular focus of interest has been whether osteoporosis is a contributory factor. Various researchers have addressed this question in studies of varying qualities. The weight of the evidence suggests that there is a significant relationship between the number of teeth present and skeletal bone mineral density. In this article the plausible link has been reviewed between periodontal disease and osteoporosis. It is hoped that the review would help dental professionals to deliver better treatment and comprehensive oral care to their patients. Thus, the elderly could live a healthier and more meaningful quality of life with the prevention of these diseases. Ovarian Neoplasms surgery Conservative surgery in patients with malignant ovarian germ cell tumours. Al Sayed, Magedy Mohamad; El Sayed, Ali Abdel Fattah; El Barbary, Taher Mostafa; Hamad, Osama Al Azhar University - Faculty of Medicine - Departments of Oncology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 737-744 (23 ref.) Keywords: Chemotherapy, Adjuvant-adverse effects; Follow-Up Studies; Fertility-radiation Effects; Combined Modality Therapy IMEMR Current Contents Subject Index 79 Abstract: Conservative surgery with adjuvant chemotherapy has made the preservation of fertility even in patient with advanced disease. The increase in cure rate has shifted to research for the long term menstrual reproductive and gynecologic outcome in these patients. The current study is retrospective for 25 cases of ovarian malignant germ cell tumor from January 2006 to January 2011, at El Hussian and Sayed Galal University Hospitals. The uterus and contralateral ovary were retained to preserve ovarian function with or without chemotherapy, followed up for two years. The mean age of most patients ranged from 15-28 years [average 21.5 years]. According to International Federation of Gynecology and Obstetrics, the histological subtypes were ten dysgerminoma [40%]. Five immature teratoma [20%], three endodermal sinus tumor [12%], four mixed germ cell tumor [16%] three embryonic cell tumours [12%]. Stage I: tumors 15 cases [60%], Stage II: tumors one case [4%], Stage III tumors 6 cases [24%], Stage IV tumors 3 cases [12%]. Adjuvant chemotherapy was administered to 15 cases 60% and followed up for two years. There were two recurrences, one died at 7[th] day postoperative of massive pulmonary embolism with past history of D.V.T, five healthy live births in the chemotherapy group without birth defects, and one infertility case 4%. Overweight epidemiology Regional variation in prevalence of overweight and obesity in Saudi children and adolescents. El Mouzan, Mohammad I.; Al Herbish, Abdullah S.; Al Salloum, Abdullah A.; Al Omar, Ahmad A.; Qurachi, Mansour M. E-mail:drmouzan@gmail.com King Saud University - Department of Pediatrics Saudi Journal of Gastroenterology [The] 2012; 18 (2): 129-132 (23 ref.) Keywords: Obesity-epidemiology; Prevalence; Cross-Sectional Studies; Body Mass Index-epidemiology Abstract: There are limited data on regional variation of overweight and obesity in the Kingdom of Saudi Arabia. Therefore, the aim of this report is to explore the magnitude of these variation in order to focus preventive programs to regional needs. Community-based multistage random sample of representative cohort from each region. the study sample was cross-sectional, representative of healthy children and adolescents from 2 to 17 years of age. Body mass index [BMI] was calculated according to the formula [weight/height[2]. The 2000 center for disease control reference was used for the calculation of prevalence of overweight and obesity defined as the proportion of children and adolescents whose BMI for age was above 85[th] and 95[th] percentiles respectively, for Northern, Southwestern and Central regions of the Kingdom. Chi-square test was used to assess the difference in prevalence between regions and a P value of <0.05 was considered significant. The sample size was 3525,3413 and 4174 from 2-17 years of age in the Central, Southwestern and Northern regions respectively. The overall prevalence of overweight was 21%, 13.4% and 20.1%, that of obesity was 9.3%, 6% and 9.1% in the Central, Southwestern and Northern regions respectively indicating a significantly-lower prevalence in the Southwestern compared to other regions [P<0.0001]. This report revealed significant regional variations important to consider in planning preventive and therapeutic programs tailored to the needs of each region. Pancreatic Neoplasms diagnosis Unusual, metastatic, or neuroendocrine tumor of the pancreas: a diagnosis with endoscopic ultrasound-guided fine-needle aspiration and immunohistochemistry. Eloubeidi, Mohamad A.; Tamhane, Ashutosh R.; Buxbaum, James L. E-mail:me75@aub.edu.Ib American University of Beirut - School of Medicine - Division of Gastroenterology and Hepatology Saudi Journal of Gastroenterology [The] 2012; 18 (2): 99-105 (27 ref.) Keywords: Biopsy, Fine-Needle; Ultrasonography, Interventional; Endoscopy, Digestive System; Pancreatic Neoplasms-pathology; Immunohistochemistry Abstract: To determine the yield of endoscopic ultrasound-guided fine-needle aspiration [EUS-FNA] in combination with immunostains in diagnosing unusual solid pancreatic masses [USPM] in comparison with pancreatic adenocarcinoma [ACP]. All EUS-FNA of solid pancreatic masses performed with a 22-gauge needle were included. Data on clinical presentations, mass characteristics, presence of pancreatitis, yield of tissue, and final diagnosis were compared between the two groups. On site cytopathology was provided and additional passes were requested to perform immunostains. Two hundred and twenty-nine cases with either adenocarcinoma or USPM were included. The median age of the cohort was 65 years. ACP [210/229, 92%] accounted for the majority of the cases. The USPM IMEMR Current Contents Subject Index 80 included neuroendocrine [NET] masses [n=13], metastatic renal carcinoma [n=3], metastatic melanoma [n=l], lymphoma [n=l], and malignant fibrous histiocytoma [n=l]. Subjects with ACP were significantly more likely to present with loss of weight [P=0.02] or obstructive jaundice [P<0.001]. Subjects with ACP were more likely to have suspicious/atypical FNA biopsy results as compared with USPM [10% vs 0%]. The sensitivity of EUS-FNA with immunostains was 93% in ACP as compared with 100% in USPM. Diagnostic accuracy was higher in USPM as compared with ACP [100% vs 93%]. EUS-FNA using a 22-gauge needle with immunostains has excellent diagnostic yield in patients with USPMs, which is comparable if not superior to the yield in pancreatic adenocarcinoma. surgery Early recurrence of pancreatic cancer after resection and during adjuvant chemotherapy. Fischer, Richard; Breidert, Matthias; Keck, Tobias; Makowiec, Frank; Lohrmann, Christian; Harder, Jan University Medical Centre Freiburg - Hegau-Bodeusee-Klinikum Siugen, Medicine II Saudi Journal of Gastroenterology [The] 2012; 18 (2): 118-121 (29 ref.) Keywords: Pancreatic Neoplasms-drug therapy; Neoplasm Recurrence, Local; Chemotherapy, Adjuvant; Prognosis; Antimetabolites, Antineoplastic Abstract: Adjuvant chemotherapy for 6 months is the current standard of care after potentially curative resection of pancreatic cancer and yields an overall survival of 15-20 months. Early tumor recurrence before or during adjuvant chemotherapy has not been evaluated so far. These patients may not benefit from adjuvant treatment. Thirty-five patients with resection of ductal pancreatic carcinoma and adjuvant chemotherapy with gemcitabine were analyzed between 2005 and 2007. All patients had a computed tomography [CT] scan before and during adjuvant chemotherapy after 2-3 months, 12/35 patients had a histologically confirmed Rl resection. Recurrence of pancreatic cancer was determined by CT scan and the clinical course. Median survival of 35 patients with resected pancreatic cancer was 19.7 months, and the 2-year survival was 44%. Thirteen [37%] of the 35 patients analyzed with a CT scan showed tumor recurrence during adjuvant chemotherapy. Overall survival of patients with tumor recurrence was 9.3 months with a 2-year survival rate of 13%, whereas median overall survival of patients without early relapse was 26.3 months [P<0.001] . Local recurrence of pancreatic cancer occurred in 38% [5/13]; 46% [6/13] of patients developed distant metastasis, and 38% [5/13] developed lymph node metastasis. Early tumor recurrence during or adjuvant chemotherapy did not correlate with R status [Rl vs R0, P=0.69], whereas histologically confirmed lymph node invasion [pN0 vs pNl] and grading showed a statistically significant correlation with early relapse [P<0.05]. A significant fraction of patients with resected pancreatic cancer have early relapse during adjuvant chemotherapy, especially those with lymph node metastasis. Radiologic examinations prior to and during adjuvant chemotherapy will help to identify patients with tumor recurrence who are unlikely to benefit from adjuvant treatment and will need individualized palliative chemotherapy. Panniculitis diagnosis Traumatic panniculitis of the right thigh: a case report. Shellagi, Nikhil; Rodrigues, Gabriel E-mail:gabyrodricks@gmail.com Manipal University - Kasturba Medical College - Department of General Surgery Oman Medical Journal 2011; 26 (6): 436-437 (3 ref.) Keywords: Wounds and Injuries; Thigh; Inflammation; Subcutaneous Tissue; Biopsy; Tomography, X-Ray Computed Abstract: Panniculitis is a group of diseases whose hallmark is inflammation of the subcutaneous adipose tissue that may be challenging both for the clinician and the dermatopathologist. It can occur in any fatty tissue [cutaneous or visceral] and is often diagnosed on the basis of a deep skin biopsy. Though mesenteric panniculitis is a common entity, and often associated with intra-abdominal inflammatory conditions, cutaneous panniculitis is a rare entity and can be mistaken for other skin and subcuteneous lesions. We present a patient with traumatic panniculitis. IMEMR Current Contents Subject Index 81 Panniculitis, Peritoneal drug therapy Efficacy of colchicine in the treatment of mesenteric panniculitis in a young patient. Fasoulas, Kostas; Beltsis, Athanasios; Katsinelos, Taxiarchis; Dimou, Eleni; Arvaniti, Mary; Charsoula, Anna; Gourvas, Victor; Atmatzidis, Stefanos; Chatzimavroudis, Grigoris; Katsinelos, Panagiotis Aristotle University of Thessaloniki - G. Gennimatas General Hospital - Departments of Endoscopy and Motility Unit Saudi Journal of Gastroenterology [The] 2012; 18 (2): 146-148 (11 ref.) Keywords: Panniculitis, Peritoneal-diagnosis; Colchicine-therapeutic use; Mesentery; Treatment Outcome Abstract: Mesenteric panniculitis [MP] is a rare inflammatory and fibrotic disease of the mesentery of unknown etiology. It has various clinical and radiological manifestations, posing a diagnostic challenge for clinicians. Its diagnosis is indicated via radiologic imaging and is usually confirmed via peritoneal biopsies. We describe a case of a patient with histopathologically proven MP, in which steroid dependence was successfully managed with colchicines. Paranasal Sinus Diseases radiography Correlation of X rays and computed tomography in paranasal sinus diseases. Adil, Ruqqayia; Abdul Qayyum; Qayyum, Adil PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 413-417 (24 ref.) Keywords: Tomography, X-Ray Computed; X-Rays; Paranasal Sinuses-radiography; Sinusitis-radiography; Sinusitis-diagnosis Abstract: Objective of the study was to evaluate the diagnostic yield of X-rays taking CT scan as gold standard in acute and chronic sinusitis. Validation study. The study was conducted in the Radiology Department CMH Rawalpindi, from 1[st] Aug 2007 to 31[st] July 2008. This study involved 95 patients of both genders above 18 years of age who presented with acute and chronic sinusitis in ENT department of CMH Rawalpindi. Patients were referred to Radiology department for their X-ray paranasal sinuses [PNS] and findings were correlated with CT scan. Out of 43 patients clinically suspected of having acute sinusitis, x ray PNS shows imaging findings of acute sinusitis in 26 [60%] patients while 17 patients were having normal x-ray PNS. When CT scan was performed to correlate the findings, it showed 30 [69%] patients were having acute sinusitis while 13 [30%] patients had no imaging findings of sinusitis. Out of 48 patients, x ray PNS showed chronic sinusitis in 26 [54%] patients and 22 patients were having normal x ray PNS. While CT scan showed 33 [68%] patients were having chronic sinusitis and 15 patients were normal. Four patients either didn't reported for their CT scan or they refused to get their CT scan done. Plain radiographs were once the mainstay of diagnosis of sinus disease and now have been replaced by high-resolution CT scan for the evaluation of acute and chronic sinusitis. Plain radiographs do not allow adequate evaluation of the osteomeatal complex or the sphenoid and ethmoid sinuses because of overlapping anatomic structures. CT is the modality of choice for imaging acute and chronic sinusitis and provides the surgeon with important information of the osteomeatal complex and normal variations, preoperatively. Patient Rights Assessing knowledge of the patient bill of rights in central Saudi Arabia: a survey of primary health care providers and recipients. Alghanim, Saad Abdullah E-mail:sagksu@gmail.com King Saud University - College of Business Administration, Saudi Arabia - The Department of Public Administration Annals of Saudi Medicine 2012; 32 (2): 151-155 (21 ref.) Keywords: Knowledge; Primary Health Care; Questionnaires; Health Personnel; Cross-Sectional Studies Abstract: Little is known about the implementation of the patient bill of rights [PBR] in Saudi Arabia. Therefore, this study was conducted to explore to what extent health care recipients and providers know about the bill and its implementation. A cross-sectional survey conducted on health care professionals and patients at Primary Health Care Centers in Riyadh, Saudi Arabia, during July 2010. The study employed a self-administered questionnaire to collect data from 500 patients [aged 18 years or older] and 500 health care providers [physicians and nurses] in primary IMEMR Current Contents Subject Index 82 health care [PHC] centers in Riyadh. Data was collected on the respondents' knowledge of the existence and contents of the bill, the extent to which the bill is implemented, and the obstacles that may hinder bill implementation. The data was analyzed and presented in a descriptive fashion. More than three quarters of patients and one third of PHC providers did not know about the existence of the bill. Among those who knew about its existence, about three quarters of patients and almost half of PHC providers had little [or very little] knowledge about the bill contents. In general, patients scored lower means of perception than PHC staff about the implementation of the bill's aspects. PHC staff reported several obstacles that may hinder the implementation of the PBR in Saudi Arabia. Patients and health care providers lack necessary knowledge about the PBR. More dissemination of information about the bill, taking into account the particularities of the Saudi population is needed. Future research is required to establish measures that are effective in ensuring that patients rights are ensured. Pelvis injuries Management of delayed vertically unstable pelvic fractures. Farouk, Osama; Khalifa, Yaser Emam Assiut University Hospital - Department of Orthopaedics Assiut Medical Journal 2011; 35 (1): 1-16 (42 ref.) Keywords: Fractures, Bone-surgery; Postoperative Complications; Delayed Diagnosis; Clinical Protocols; Treatment Outcome Abstract: Current treatment protocols for surgical intervention in unstable pelvic fractures recommend early fixation. For some reasons, patients are referred late after trauma, and surgery imposes difficulties to the patient and the surgeon. This study represents a case series of 16 patients with vertically unstable pelvic fractures who presented 3 weeks or more after the initial trauma to Assiut University Hospital during a period of five years. Time since injury averaged 7 weeks [range 3-32 weeks]. There were 14 males and 2 females. Age of the patients averaged 28 years. There were twelve unilateral and four bilateral type-C pelvic fractures. The posterior injury was iliac bone fracture in 5 patients, sacroiliac joint disruption in 5 and sacral fracture in 10. The anterior injury was symphyseal disruption in 9 patients, pubic rami fracture in 6, and combined pubic rami fracture and symphyseal disruption in one patient. Seven patients had neurologic injuries. Combined posterior and anterior pelvic ring fracture fixation was done in 9 patients. Posterior pelvic fixation alone was done in 7 patients. Radiographic assessment of reduction was done according to Matta and Tornetta, and functional assessment was done using Majeed score. The mean postoperative follow up was 31 months. All fractures healed. Complications included transient L5 palsy [n=1], ilio-femoral DVT [n=l], early metal failure [n=2]. Postoperative fracture displacement averaged 5 mm [range 1-19 mm]. Fracture reduction was considered excellent in 11 patients [69%], good in four patients [25%], and fair in one patient [6%]. Limb length discrepancy ranged from 0-17 mm [average 4 mm]. Functional result was excellent in 12 patients [75%], good in three patients [18.75%] and fair in one patient [6.25%]. This study supports planned surgical intervention for delayed vertically unstable pelvic fractures. Rules of inter-hospital referral should impose early transfer of patients to avoid the additional difficulties of late fixation. Perinatal Care Comparison of maternity care quality in teaching and non-teaching hospitals in Khorram Abad, Islamic Republic of Iran. Moosavisadat, S.M.; Lamyion, M.; Parsai, S.; Hajizadeh, E. E-mail:Lamyianm@yahoo.com Tarbiat Modares University - Faculty of Medical Sciences - Department of Midwifery EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 638-645 (21 ref.) Keywords: Quality Indicators, Health Care; Hospitals, Teaching; Hospitals; Mothers; Postnatal Care; Pregnancy Outcome; Breast Feeding Abstract: The objective of this study was to compare the quality of maternity care in 2 types of government-run hospital in the town of Khorram Abad, Islamic Republic of Iran in 2009: a university-linked teaching and asocial security organization non-teaching hospital. A sample of 264 women hospitalized in the delivery and postpartum wards was selected. Data collection was done using interviews with mothers and observation checklists based on Iranian government criteria. The quality of maternity care in the non-teaching hospital was higher than the teaching hospital in terms of facilities, processes of maternal and newborn care and outcomes [mother's satisfaction]. In the teaching hospital, the quality of the physical space, the educational level and training of health care personnel and monitoring IMEMR Current Contents Subject Index 83 and evaluation of care quality needed improvement. In both hospitals, meeting women's expectations about the degree of privacy could lead to an increase in the quality of maternity services. Personal Satisfaction Students satisfaction with nursing program. Jaradeen, Najah; Jaradat, Raed; Abo Safi, Ahamad; Al Tarawneh, Falah E-mail:etaiwi-mahmoud@hotmail.com Mu tah University - Faculty of Nursing Bahrain Medical Bulletin 2012; 34 (1): 7-10 (21 ref.) Keywords: Students, Nursing; Nursing Evaluation Research; Questionnaires; Curriculum Abstract: To evaluate students satisfaction with nursing program in the faculty of nursing. Descriptive Survey. Faculty of Nursing, Mutah University, Jordan. Data were collected using a questionnaire. Three hundred fifty-seven questionnaires were distributed, Two hundred sixty-seven were completed, a response rate of 74.8%. The mean of students satisfaction with the nursing program was [x=3.06]. The highest mean of satisfaction with the program dimensions was faculty of nursing climate [x= 3.31] and the lowest satisfactions mean was the faculty of nursing facilities [x= 2.85]. There were no significant relationships between students' satisfaction with the nursing program dimensions and participant's characteristics. Generally, the findings of the study showed that students' satisfaction with nursing program was neutral. Pesticide Residues analysis Investigation of residual pesticides in some vegetable plants in Saudi Arabia. Saati, Abdullah Umm Al-Qura University - Faculty of Medicine - Department of Community Medicine and Pilgrims Healthcare Assiut University Bulletin for Environmental Researches 2011; 14 (2): 13-25 (40 ref.) Keywords: Vegetables; Spinacia oleracea; Lettuce; Petroselinum; Mentha; Barbarea; Gas chromatography-Mass Spectrometry-methods Abstract: Pesticides are used for pest management and vector control in agricultural areas, but many farming communities are not adequately informed about the hazards associated with the chemicals. As a result, farmers use pesticides without full understanding of their impact on human health and the environment. Human contacts with pesticides, whether in the field, during pesticide application, weeding, pruning, harvesting, re-entry to collect fire wood, vegetables or in the houses for killing mosquitoes, cockroaches, fleas and flies. Storing pesticides may lead into acute and/or chronic exposures, with adverse health consequences. Although the inhalation, dermal and oral routes of exposure are the most common, pesticide residues in food and water may add to indirect exposures common in the general population. This study aimed to develop and evaluate a rapid automated screening method for determining pesticides residues in seven green vegetables [rocket, mint, parsley, leek, dill, lettuce and spinach] collected from different sources in Saudi Arabia markets. Thirty nine samples from green vegetables were used in this study. Six types of green vegetables were taken from the open markets [16 samples] and seven types were taken from supermarket [21 samples]. These samples were screened for pesticides residues by using Turbo Matrix Headspace Trap system in conjunction with a Perkin Elmer Clarus soo GC/MS. The classes of pesticides which are detected in this study are herbicides, rodenticides and fungicides. The obtained results revealed that the Dinitrotoluidine [l-hydroxy- 4-[p-toluidine] anthraquinone] was detected in rocket and parsley, which are presents in supermarket but not found in mint, dill, lettuce and spinach. The oxadiazolinon [N, 0-dimethyloxos tephene] herbicide was found only in rocket purchased from open market. It was found that the dill obtained from the open market was the only plant which contains all kinds of rodenticides like cyano-phenolic [3-cyano-6-triflorom ethylphenantherine], sodium flouroacetate [3- methyI-1-phenyl-2- azafluorenone], hydrogen cyanide [l-cyano-6-trifloromethylphenantherine] and arsenical [arsine,l,2- phenylenebis dimethyl]. Hydrogen cyanides were detected in dill only. Identified types of pesticides have shown more occurrences in open market samples than the supermarket samples. The contamination level of pesticide residues considered a possible public health problem. Regular monitoring of a greater number of samples for pesticide residues, especially the imported is needed. IMEMR Current Contents Subject Index 84 Phenylenediamines poisoning Clinical and experimental study of acute intoxication as a result of ingestion of stone hair dye containing paraphenylenediamine. Ahmed, Hatem A.M.; Abdel Maaboud, Ragaa M.; Mubark, Heba A.E.; Abdul Latif, Fathy F.; El Dean, Adel M. Kamal; El Shaieb, Kamal M. Ministry of Justice - Assuit Branch - Assiut Lab. of Medico-legal Department Assiut Medical Journal 2011; 35 (1): 199-208 (17 ref.) Keywords: Coloring Agents; Hair Dyes-toxicity; Administration, Oral; Signs and Symptoms; Mortality; Rats Abstract: Hair dyes containing para-phenylenediamine were used in some communities for criminal purposes and more frequently for attempted suicide and sometimes accidentally ingested. The aim of the present work to analyze the various aspects of poisoning fatalities as a result of stone hair dye [SHD] ingestion through a retrospective study of fatalities investigated by Assiut Chemical Laboratory of Medico-legal Department, Ministry of Justice in four governorates in Upper Egypt and to detect the systemic effects on experimental animals as a result of its ingestion and if there is dose-effect relationship. The records of acute poisoning cases of hair dye ingestion investigated by Assiut Medicolegal Laboratory in the period from January 2002 to December 2009 were examined as regarding type of poison, pattern, incidence, sex, geographical distribution and mode of poisoning. The studying of the systemic effects on ingestion of hair dye was conducted on 30 albino rats divided into five groups each contain 6 animals. The first group was the control and the other groups were subjected to oral administration of either stone hair dye or para- phenylenediamine [PPD] in two doses [10 and 20 mg each]. The animals were sacrificed after 24 hours and haematological, histopathological [liver and kidney] and biochemical examinations were performed. The results obtained from the records revealed that 72.29% of the cases were from Qena, 14.45% from Aswan, 12% from Sohag and 1.2% from Assiut. The highest incidence of poisoning was found in 2006 [19.3%] followed by 2008, 2009 [15.7%] each, then 2004 and 2005 [13.3%], 2007 [12%], 2002 [7.2%] and lastly 2003 [3.6%]. The majority of victim's were females and most of cases were suicides. There were insignificant changes in RBCs count in all groups and insignificant decrease of Hb concentration while WBCs count was very significantly increased. The levels of AST and ALT showed a significant increase in all treated groups while serum level of creatinine was insignificantly decreased. There was significant increase in the plasma enzymes AST, GPT, the liver tissues showed many degenerative changes in the form of vacuolated cytoplasm and irregular deeply stained nuclei of the hepatocytes with vascular congestion and lymphocytic infiltration. The same results were obtained with both SHD and PPD. They were more obvious with high doses of both. The results confirmed that Para-phenylenediamine is the main toxic ingredient in stone hair dye, and the experimental study revealed that the liver is the target organ of para-phenylenediamine and SHD toxicity, also that toxic manifestations were dose related. This compound is highly toxic when taken by mouth and the outcome depends mainly on the dose taken. The study recommends that the sale and use of PPD containing dyes, SHD and henna should be prohibited. Phlebetomus parasitology Vectorial competence of phlebotomus papatasi [diptera: psychodidae] to transmit two old world leishmania species: leishmania major and L. tropica. Darwish, A.B.; Tewfick, M.K.; Doha, S.A.; Abo Ghalia, A.H.; Soliman, B.A. Suez Canal University - Faculty of Science, Suez Branch - Department of Zoology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 565-572 (37 ref.) Keywords: Phlebotomus Fever-transmission; Leishmania tropica-parasitology; Leishmania major-parasitology; Insect Vectors Abstract: The vectorial competence of Phlebotomus papatasi for two old world Leishmania species, L. major and L. tropica was investigated. Phlebotomus papatasi originally collected from Suez Governorate, were membrane fed on homogenized hamster's lesion infected with L. major, MHOM/EG/06/RTC-63, and L. tropica, MGER/EG/06/RTC-74 identified from patients with suspected CL in Northern Sinai, Egypt. Fed flies were dissected at different time intervals and examined microscopically to determine the infection rate and parasite intensity. The feeding rate of P. papatasi on L. major [58.69%] was found higher than on L tropica [45.99%]. Infection rate with L. major [60.19%] was significantly higher than that with L. tropica [39.73%]. Transmission by bites in case of P. papatasi/L. tropica failed. A characteristic IMEMR Current Contents Subject Index 85 L. major lesion was developed on the foot pads region 120 days post infective bites on healthy hamster. It is therefore concluded that P. papatasi is a much more effective vector for L. major than for L. tropica. Plants, Medicinal chemistry Interrelation of antioxidant, anticancer and antilieshmania effects of some selected Egyptian plants and their phenolic constituents. Abdel Hady, Nevein M.; Dawoud, Gouda T.M.; El Hela, Atef A.; Morsy, Tosson A. Al Azhar University - Faculty of Pharmacy [Girls] - Department of Pharmacognosy Journal of the Egyptian Society of Parasitology 2011; 41 (3): 785-800 (63 ref.) Keywords: Plant Extracts-therapeutic use; Antioxidants; Antineoplastic Agents; Leishmaniasis-therapy; Polyphenols- therapeutic use; Flavonoids-therapeutic use Abstract: Medicinal plants are the most potential resource of new therapeutic agents. They are diverse, largely productive, biologically active and chemically unique; among their constituents [polyphenol compounds group] one of the main determinant factors in evaluating the pharmacological potentials i.e. polyphenols display an array of pharmacological properties such as antioxidant, immunostimulant, antitumor and antiparasitic effects. Cancer is a dreadful human disease, increasing with changing life style, nutrition and global warming while current available anticancer drugs cause serious side effects in most instances. Several reports suggested the relationship between antioxidant, anticancer and antiparasitic effects; they suggested that they act indirectly through promoting host resistance, restabilizing body equilibrium and conditioning body tissues in addition to their direct effect on certain parasites involved in cancer etiology. This work was conducted for estimation of total phenolic, flavonoids, phenylethanoid glycoside and iridoid content of twenty-three selected Egyptian plants as well as screening of their anticancer, antioxidant and antileishmanial effects, the overall gained results for suggest that the most suitable medicinal plant used as anticancer and antioxidant is Petrea volubilis L. which contain adequate mixture of total phenolic compounds 88.7 mg% and flavonoids 50.80 mg% and also suggest that flavonoid compounds are the category of phenolic compounds possess significant antioxidant and anticancer effects while the antilieshamnia screening revealed that Thymus decussatus Benth. extract exhibited the highest effect due to the presence of flavonoids and iridoids in adequate combination where iridoid compounds 201 mg% and flavonoid content was 128 mg%. Poliomyelitis prevention and control Coverage and causes of non immunization in national immunization days for polio; a consumer and provider perspective study in Peshawar. Naeem, Mohammad; Khan, Muhammad Zia Ul Islam; Adil, Muhammad; Abbas, Syed Hussain; Khan, Ayasha; Khan, Muhammad Usman; Naz, Syeda Maria E-mail:eaglebook86@gmail.com Khyber Medical College - Department of Community Medicine JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 48-54 (19 ref.) Keywords: Immunization Programs; Poliomyelitis-epidemiology; Refugees; Health Education; Health Knowledge, Attitudes, Practice; Cross-Sectional Studies; Health Services; Mass Vaccination; Urban Health Services; Poliovirus Vaccines Abstract: Polio is a viral disease that may cause paralysis and infant death. Despite ongoing efforts, polio has not been eradicated from Pakistan. The purpose of this survey is to estimate the coverage of polio vaccine during National Immunization Days and to determine the factors associated with lack of immunization. A Cross-sectional survey was conducted in Peshawar, Pakistan, from 1[st] June to 9[th] June 2010. Confidence level of 95% and confidence interval of 4 was used to derive the sample size [for a population more than 20,000]. Parents of 600 children under 5 years were asked about immunization during NIDs of January - May 2010 [5 NIDs]. Questions regarding demographics, income, education, occupation, accessibility to health centers and frequency of visits from health workers was inquired. Knowledge and views on immunization were also asked. 40 health personnel involved in immunization were also interviewed and they were asked about hurdles faced in immunization. 83.7% children were vaccinated in all National Immunization Days, while 94.7% had at least, taken polio vaccine once. 5.3% had not taken polio vaccine during National immunization Days of 2010. Main reasons for not vaccinating were; Vaccinator absent/not visiting IMEMR Current Contents Subject Index 86 home/vaccine not available [63.36%], no awareness [17.4%], Child ill [5.8%], family problem/mother busy [3.3%] and wrong ideas/sterility [3.3%]. Many health personnel [32.5%] considered lack of awareness among people and low accessibility to vaccine as the main hurdles in immunization, besides the poor salaries and incentives. Polio vaccination during National Immunization Days 2010 was a partial success because some pockets of poor children and afghan refugees were poorly vaccinated. In order to eradicate polio, they must be vaccinated. Polyhydramnios Fetal outcome in singleton pregnancies complicated with polyhydramnios from 28 to 36 weeks. Akhter, Shamim; Mustafa, Neelofar; Nazir, Saima Combined Military Hospital - Department of Obs and Gynae PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 443-446 (13 ref.) Keywords: Pregnancy Outcome; Amniotic Fluid; Congenital Abnormalities; Perinatal Mortality; Live Birth; Stillbirth; Cesarean Section; Fetal Death; Delivery, Obstetric Abstract: To describe the fetal outcome in singleton pregnancies complicated with polyhydramnios from 28 to 36 weeks. Descriptive study. Department of Obstetrics and Gynaecology, Combined Military Hospital, Lahore from July 2007 to July 2008. Fifty pregnant women diagnosed with polyhydramnios were included. They were evaluated on ultrasonography, amniotic fluid index greater than 25cm or a maximum vertical pocket of liquor greater than 8cm confirmed the diagnosis of polyhydramnios and associated congenital abnormality. A total of 50 patients were included in the study. Mean gestational age was 34.2 +/- 1.4. Thirty patients [60%] had vaginal delivery while cesarean section was done in 20 patients [40%]. Forty patients [80%] had live birth whereas 4 [8%] and 6 [12%] patients had stillbirth and IUD respectively. Weight of 56% of the babies was less than 2.5kg and 44% of the babies more than or equal to 2.5kg with mean weight of 2.4 +/- 0.3kg. Normal babies were seen in 40 patients [80%] while 10 babies [20%] had congenital abnormalities. Out of 40 live born babies, 18 [45%] did not require resuscitation while 22 [55%] were shifted to NICU. Two babies [9%] expired in nursery and 20 babies [91%] were discharged healthy. Polyhydramnios carries a higher incidence of adverse perinatal outcomes, such as fetal distress during labor, low Apgar scores, NICU transfer, fetal death, congenital anomalies and neonatal death from the study population. Postpartum Hemorrhage therapy Comparison between sublingual misoprostol and intramyometrial prostaglandin F2A in adjunct to routine management of primary postpartum hemmorhage. Qayyum, Mamuna E-mail:shamailatanveer@yahoo.com HIT Hospital Taxilla PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 460-465 (17 ref.) Keywords: Postpartum Hemorrhage-drug therapy; Misoprostol-therapeutic use; Administration, Sublingual; Injections, Intramuscular; Dinoprost-therapeutic use; Random Allocation; Myometrium Abstract: To study the efficacy of sublingual misoprostol as compared with injectable PGF2alpha in management of primary Post Partum hemorrhage [PPH]. Randomized controlled trial. Combined Military Hospital Risalpur, from January 2006 to September 2008. All patients who reported to CMH Risalpur were included except women with previous cesarean section and those with gestational age less than twenty eight weeks at the time of delivery. They were randomized in two equal groups of thirty patients each. One group received 600mcg sublingual misoprostol [Parke-Davis] combined with standard oxytocic treatment and the other group received intramyometrial PGF2alpha [Prostin F2alpha, Dinoprost- Parke-Davis] combined with standard oxytocic for treatment of primary PPH. There was insignificant difference between both groups in terms of blood loss [p>0.05], treatment failure [p=0.640] and side effects [p=0.05]. Sublingual misoprostol was found to be equally effective as compared to intramyometrial PGF2 alpha for the treatment of primary PPH but superior when price, availability and storage are taken into account. Prenatal Diagnosis Antenatal screening for hepatitis B and C virus infection in pregnant women in a tertiary care hospital of Rawalpindi. Azhar, Tahmina; Khan, Iqbal Ahmad; Mohsin, Shumaila; Usman, Javaid E-mail:tina_azhar@hotmail.com IMEMR Current Contents Subject Index 87 National University of Sciences and Technology - Army Medical College - Department of Community Medicine PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 470-473 (14 ref.) Keywords: Prenatal Care; Hepatitis B-epidemiology; Hepatitis B virus; Hepatitis B Surface Antigens; Hepatitis C- epidemiology; Hepacivirus; Hepatitis C Antibodies; Pregnant Women; Cross-Sectional Studies; Questionnaires; Enzyme-Linked Immunosorbent Assay Abstract: To determine the frequency of Hepatitis B and C virus infection in pregnant women and to assess whether it is more common in multigravida as compared to primigravida. A Descriptive Cross Sectional study carried out in the out patient department of Gynaecology and Obstetrics department of Military Hospital, Rawalpindi from August to October 2010. An open and close-ended questionnaire was self designed for this purpose. Data relating to medical, surgical, gynaecological and obstetric history, with particular references to hospital admissions and intravenous interventions was collected through convenience sampling. One hundred and forty pregnant women were questioned. The age of patients varied from 21 to 45 years [mean 28.66 years]. Out of 140 females, 44 [31.4%] females were primigravidas while 96 [68.6%] were multigravidas. Eight [5.7%] females were found positive for HBsAg and 18 [12.8%] were found positive for HCV antibodies by third generation ELISA. It was observed that 0% primigravida and 8.3% cases of multigravida were HBsAg positive cases [p = 0.049]. Frequency of HCV was 4.5% in primigravidas and 16.7% in multigravidas [p = 0.047].Various risk factors like, history of blood transfusion 27.1% ,and IV injection 91.4%, were identified. The hepatitis B vaccination rate was only 24.3%. The frequency of Hepatitis B and C infection was 5.7% and 12.8% respectively in pregnant females as compared to the general population. The multigravidas were at a higher risk of HBV and HCV exposure than primigravida. Presbycusis genetics Mitochondrial DNA [MTDNA] alterations and dysfunctions in presbyacusis. Mohamed, Hossam A.; El Attar, Amal M.; Ahmed, Gamal I.; Berrettini, Stefano Assiut University - Faculty of Medicine - Audiology Unit, ENT Department Assiut Medical Journal 2011; 35 (1): 161-174 (37 ref.) Keywords: DNA, Mitochondrial; Audiometry-methods Abstract: The aim of the study was to investigate the presence of mitochondrial DNA [mtDNA] alterations and mitochondrial metabolic dysfunctions in patients with presbyacusis, and also to discover correlations between presbyacusis and eventually the degree of hearing loss and mitochondrial damage. Seventy patients with presbyacusis were examined, including forty Egyptian patients and thirty Italian patients. Forty eight normal persons were included as control group, including twenty four Egyptian persons and twenty four Italian persons. No common point mutation; A1555G, A3243G, A7445G were detected in all patients and controls. Haplogroup U was significantly common in patients in comparison to controls. Mutation of antioxidant genes [GSTT1,GSTM1] were significantly detected in only Italian patients in comparison to Italian controls. Pressure Ulcer therapy More expensive surfaces are not always better. Valente, Stephanie A.; Greenough III, William B.; DeMarco, Sharon L.; Andersen, Ross E. Ohio University - College of Osteopathic Medicine - Department of Geriatric Medicine/Gerontology KMJ - Kuwait Medical Journal 2012; 44 (1): 40-45 (31 ref.) Keywords: Wound Healing; Treatment Outcome; Retrospective Studies Abstract: To assess efficacy of two support surfaces RIK gel mattress and a power air overlay in preventing and healing pressure ulcers. Retrospective analysis of patient records. An academic affiliated 240-bed long-term care facility in Baltimore, MD, USA. All patients with pressure sores at the start of the study were included. One hundred and twenty-two patient records and weekly wound measurements on 173 pressure ulcers done by a dedicated team of wound nurses and technicians were retrospectively analyzed. The two surfaces studied were assigned by the respective physicians and nurses of each unit. None. The two patient groups were comparable at the start of the study. One third of all patients developed one or more wounds during the study period or 48% of all ulcers studied. Healing rates were similar for both surfaces. New stage II ulcers were most common. There was a trend toward higher risk in patients assigned to the power air overlay mattress. Patients assigned to the gel mattress developed pressure ulcers less frequently than those on the power air overlay; however, the power air overlay tended to heal more ulcers. IMEMR Current Contents Subject Index 88 Controlling for the total amount of time each group spent on the respective mattresses, the efficacy of the gel surface in preventing new ulcers equaled or outweighed the benefit of the power air overlay. Since the gel fluid mattress is less costly we would favor the use of the gel mattress system. Pterygium prevention and control Comparison of preoperative and intraoperative mitomycin C in prevention of pterygium recurrence and postoperative complications. Ishtiaq, Omar; Iqbal, Zamir; Naz, Muhammad Afzal; Ameen, Sameer Shahid E-mail:omar.ishtiaq@gmail.com Armed Forces Institute of Ophthalmology PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 377-381 (25 ref.) Keywords: Mitomycin-therapeutic use; Preoperative Care; Intraoperative Care; Postoperative Complications- prevention and control; Recurrence Abstract: To compare the frequency of recurrence and corneoscleral complications with pre-operative and intraoperative mitomycin C when used with excision of primary pterygium by bare sclera technique. Quasi experimental study. Armed Forces Institute of Ophthalmology Rawalpindi. Ten months [October 2006 to July 2007]. A total of 70 cases with primary pterygium were selected and divided equally into group A and B. in cases of group A, 0.1cc of 0.15 mg/ ml of MMC was injected sub-conjunctivally and pterygium excision with bare sclera technique, a sponge soaked in 0.04% MMC was applied over the bare sclera for three minutes intraoperatively. The patients were followed up to see recurrence and corneoscleral complications for three months. A total of 70 cases, 35 in each group were analyzed statistically. Mean age of group A was 40.83 +/- 12.655 years whereas that of group B was 44.57 +/- 13.718 years. Group A had 28 [80%] males and 7 [20%] females. Group B had 23 [65.7%] males and 12 [34.3%] females. Number of patients who presented with recurrence in group A was 1 [2.9%] and group B were 4 [11.4%]. In group A no patient presented with corneoscleral complications during the study whereas in group B these complications were seen in 7 [20%]. Chi-square test revealed no significant difference in recurrence [P=0.356] whereas it showed significant difference in corneoscleral complications between the groups [P=0.011]. Preoperative MMC is as effective as intraoperative MMC in preventing recurrence but it is much safer than intraoperative MMC causing less corneoscleral complications. Pulmonary Atelactasis drug therapy Safety of recombinant human deoxyribonuclease as a rescue treatment for persistent atelectasis in newborns. Fedakar, Atiye; Aydogdu, Cavit; Fedakar, Ali; Ugurlucan, Murat; Bolu, Semih; Iskender, Marina E-mail:atyfedakar@hotmail.com Atlas Hospital - Pediatrics Clinic Annals of Saudi Medicine 2012; 32 (2): 131-136 (19 ref.) Keywords: Deoxyribonuclease I-administration and dosage; Treatment Outcome; Administration, Inhalation; Prospective Studies Abstract: Pulmonary problems are vitally important in newborns. Increased intense and mucoid secretions may lead to atelectasis, pulmonary infections, respiratory distress, prolonged mechanical ventilation or even death. The aim of this study was to evaluate the safety of recombinant human deoxyribonuclease [rhDNase] in the management of persistent atelectasis in term and preterm newborns, unresponsive to the conventional treatment. Prospective study of patients admitted to a general community setting of a neonatal intensive care unit between December 2007 and December 2009. The study included 22 patients [12 premature and 10 term] who were admitted to the neonatal intensive care unit because of respiratory distress and developed atelectasis, and were unresponsive to conventional treatment. Nebulized rhDNase was administered to all patients at a dose of 1 mg/m[2] twice daily for 3 days. In patients who did not respond to 3 days of treatment, endotracheal rhDNase was administered at a dose of 1 mg/m[2]. We assessed the clinical [respiratory rate and oxygen requirement] and radiologic responses [chest radiographic score], recurrence of atelectasis, the need for a repetitive treatment, and mortality rate. A clinical and radiologic improvement of atelectasis was observed in 18 of 22 patients following 3 days of nebulized rhDNase treatment. Atelectasis relapsed in 4 patients. Following the administration of combined endotracheal and nebulized rhDNase treatment, an IMEMR Current Contents Subject Index 89 improvement of atelectasis was noted in all four recurrent cases. No adverse events were observed in patients because of the rhDNase treatment. rhDNase treatment is a safe option and may be used as an effective method for the management of persistent atelectasis in newborns, which is resistant to other conventional treatment methods. Pulmonary Embolism diagnosis Dual source multislice computed tomography for pulmonary embolism: initial experience at AFIC/NIHD Rawalpindi. Tuyyab, Farhan; Kayani, Azhar Mahmud; Iqbal, Tahir; Main, Atif; Khan, Imtiaz Ahmed; Javed, Asim; Ahmed, Waqar; Malik, Ishtiaq Ahmed; Khan, Muhammad Qaiser Armed Forces Intitute of Cardiology PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 340-344 (19 ref.) Keywords: Pulmonary Embolism-radiography; Multidetector Computed Tomography Abstract: Observation of different computed tomography findings in patients suffering from pulmonary embolism. All patients who underwent computed tomography for pulmonary embolism and had positive findings of pulmonary embolism, were included in the study. Armed Forces Institute of Cardiology/ National Institute of Heart Disease, between April 2009 and October 2010. Patients on mechanical ventilation were excluded from the study. CT pulmonary angiograms were obtained with 64 slice dual source computed tomography [DSCT] machine [Somatom definition] from Siemens. Before scanning breath holding was taught. A craniocaudal acquisition was obtained with a collimation of 64 x 0.6 mm and a pitch of 1.2-1.4. Total number of patients included in the study were 34 with mean age 50 years. The mean of Score by Miller was 10 +/- 5.532 and the mean percentage obstruction by method of Miller was 62.5%. The mean of Score by Qanadli was 19.62 +/- 12.32 and the mean percentage obstruction by method of Qanadli was 49.04%. The mean of Score by Mastora was 54.53 +/- 33.27 and the mean percentage obstruction by method of Mastora was 35.18%. Calculated mean and SD of right ventricular [RV] diameters was 44 +/- 7.75mm, left ventricular [LV] diameter was 32 +/- 8.06mm, RV/LV ratio was 1.508 +/- 0.58 mm, main pulmonary artery [PA] luminal diameter was 29 +/- 4.16mm, ascending aorta size was 32.46 +/- 5.14mm, PA/Aorta ratio was 0.913 +/- 0.188mm, Azygos Vein diameter was 11.14 +/- 1.88mm and superior vena cava [SVC] diameter [at azygos arch] was 18.93 +/- 3.37 mm. Correlation between methods was generally significant. Reflux of contrast injection was noted in 24 out of 34 patients, leftward bowing of inter-ventricular septum was observed in 21 patients, pleural effusion was noted in 10 patients and pericardial effusion was seen in only 3 patients. CT pulmonary angiography has emerged as a reliable non invasive tool for not only confirmation of diagnosis of pulmonary embolism in short time but also gives valuable information about prognosis of these critically ill patients. Further it can provide accurate follow up of thrombolytic therapy and can help plan an interventional strategy. Pyrazoles Orthodontic tooth movement and root resorption after different doses of celecoxib drug treatment in rats. Hashemi, S.M.; Otoofi, A.; Badiee, M.R.; Abdolazimi, Z.; Younesian, F. Journal of Dental School - Shahid Beheshti University of Medical Sciences 2012; 29 (4): 230-241 (24 ref.) Keywords: Sulfonamides; Tooth Movement; Root Resorption; Orthodontics; Rats Abstract: Non- Steroidal Anti Inflammatory [NSAIDs] medications used for treatment of pain related to orthodontic treatment could slow down tooth movements. Selective cyclooxigenase- 2 inhibitors are alternatives to conventional non steroidal drugs. The aim of this study was to compare three different doses of Celecoxib on orthodontic tooth movement and root resorption in Rats. Forty male Rats randomly divided into the following groups; D [the application of orthodontic appliance with taking medications]; E [without any intervention] and experimental groups included A [received 25 mg/kg], B [received 50 mg/kg] and C [received 100 mg/kg] dose of Celecoxib. NiTi coil spring was ligated between the right side maxillary incisor and 1[st] molar. The animals were sacrificed after two weeks and distance between 2 teeth was measured with Caliper. After preparation of histological sections, amount of root resorption, numbers and maximum depth of resorption lacunae in mesial root surfaces of molar was measured. Data were analyzed with ANOVA, LSD and Tukey HSD. The maximum tooth movement was found in group A [0.8537 mm], D, C, B and E respectively. Statistical analysis did not show any significant difference between the different doses of Celecoxib drug in tooth movement. The usage of Celecoxib [particularly in higher doses; 100 mg/kg] decreased the number of resorption lacaunae in mesial root of first maxillary molar [P< 0.05]. 100 mg/kg dose of celecoxib was found to be optimum for the lowest effect on tooth movement and the most protection against root resorption. IMEMR Current Contents Subject Index 90 Rage Road rage behaviour and experiences of rickshaw drivers in Rawalpindi, Pakistan. Shaikh, M.A.; Shaikh, I.A.; Siddiqui, Z. E-mail:masoodali1@yahoo.com EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 719-721 (5 ref.) Keywords: Behavior; Time; Safety; Cross-Sectional Studies; Questionnaires Abstract: A cross-sectional survey with convenience sampling was conducted among rickshaw drivers in Rawalpindi, Pakistan to study their road rage behaviour and experiences. Cumulatively 318 male drivers participated in this study. The most common forms of road rage reported were: having been shouted at; and having experienced rude gestures from other drivers [78.9% each]. Least common forms of road rage reported were: threats of physical hurt or having actually been physically hurt [</= 3% each]. Rickshaw drivers with shorter driving time [</=10 years] had significantly more road rage experiences than those who had been driving for more than 10 years [P < 0.01]. There is a need for nationally representative surveys to study road age in commercial vehicle drivers so as to improve road safety in Pakistan. Renewable Energy Roles of microalgae and bacteria in hydrogen production as one of the renewable energy resources. Abdel Monem, Ahmed M.A.; Shaieb, Farag M.A. E-mail:amedmonem@yahoo.com Omar Al-Mukhtar University - Faculty of science - Botany Department Assiut University Bulletin for Environmental Researches 2011; 14 (2): 153-173 (58 ref.) Keywords: Hydrogen; Microalgae; Bacteria; Energy-Generating Resources; Review Literature as Topic Abstract: Hydrogen gas is considered to be one of the most desired alternate sources of the limited fossil energy resources of today. It shows great promise as a non-polluting fuel, but to reduce carbon dioxide releases hydrogen gas will need to be produced from renewable sources. The limited fossil fuel prompts the prospecting of various unconventional energy sources to take over the traditional fossil fuel energy source. Photosynthetic microbes can produce hydrogen using the nature plentiful resources, sunlight, the included greens, and blue-green algae [Cyanobacteria], either via direct or indirect biophotolysis. In addition, Cyanobacteria produced hydrogen through decomposing the organic compounds [Photodecomposition]. The hydrogen production by green algae could be considered as an economical and sustainable method, water utilization as a renewable resource and recycling CO[2], a greenhouse gas. Rates of hydrogen production by photoheterotrophic bacteria are higher in the case of immobilized cells than that of the suspended cells. Cyanobacteria are highly promising microorganism for hydrogen production. Cyanobacterial hydrogen production is commercially viable, in comparison to the traditional ways of hydrogen production [chemical, photoelectrical]. The present review shows the basic biology of microalgae and bacterial hydrogen production and its future prospects. While integrating the existing knowledge and technology, much future improvement and progress is to be done before hydrogen is accepted as a commercial primary energy source. Respiratory Tract Infections virology Viral pathogens associated with lower respiratory tract infection in adults and children at Assiut university hospitals. Thabit, Amany G.; Brune, Wolfram; Badary, Mohamed S.; Othman, Ahmed H.; Embarek, Mona S.; Schweiger, Brunhilde; Brune, Wolfram Assiut University - Faculty of Medicine - Department of Medical Microbiology and Immunology Assiut Medical Journal 2011; 35 (1): 17-34 (67 ref.) Keywords: Seasons; Child; Adult; Hospitals, Teaching; Polymerase Chain Reaction-methods Abstract: infection of the lower respiratory tract causes significant morbidity at Assiut University Hospitals in Assiut, Egypt among children and adults. Respiratory viruses play an important role in lower respiratory tract infection affecting individuals of all age groups. To determine the contribution of viruses to lower respiratory tract infection in patients presented or admitted at Assiut University Hospitals, with typing, subtyping, and phylogenetic analysis of the detected viruses. A two-year study was conducted from 2007 to 2009 at the National Influenza Centre [Robert Koch Institute, IMEMR Current Contents Subject Index 91 Berlin, Germany]. Respiratory samples obtained from 520 patients suffered from lower respiratory tract infection were collected. Detection and characterization of the causative viruses was performed using both the conventional methods of viral isolation and molecular methods of real-time polymerase chain reaction and phylogenetic analysis. Seventy nine positive cases were detected with real-time polymerase chain reaction [representing a ratio of 15.2% of the total number of cases] for one or more of the main respiratory viruses [influenza viruses, respiratory syncytial viruses, adenoviruses, and human metapneumoviruses]. Twenty two were children [accounting for 46% of the total number of children included in the study] and 47 were adults [accounting for 10.4% of the adult group]. Viruses are the main cause of lower respiratory tract infection in children and can cause lower respiratory infection in adults hospitalized or presented at Assiut University Hospitals, Egypt, Characterization of the detected viruses revealed that, they were similar to those reported from other parts of the world during the same period. This proves worldwide spread of these viruses during winter-spring seasons. Resuscitation education Neonatal resuscitation training programme, its efficiency at rural hospital. Taksande, Amar M.; Vilhekar, K.Y. E-mail:amar.taksande@gmail.com Jawaharlal Nehru Medical College - Department of Pediatrics Medical Journal of Islamic World Academy of Sciences 2012; 20 (1): 6-9 (13 ref.) Keywords: Program Evaluation; Students, Medical; Nurses; Physicians; Infant Mortality; Apgar Score Abstract: Birth asphyxia is one of the commonest causes of neonatal mortality and morbidity. Prompt and proper application of various management strategies as per standard American Academy of Pediatrics [AAP] neonatal resuscitation guidelines will help to prevent birth asphyxia and decrease the consequent/resultant mortality and morbidity. Neonatal resuscitation is an essential skill in maternal and child health, and every health care personnel should know the basic steps of resuscitation. Thus, the neonatal resuscitation training programmed [NRTP] was conducted based on the latest international 2005 AAP neonatal resuscitation guidelines. A set of multiple choice questions for both pre- and post-tests was administered before and after the NRTP to assess the knowledge and skill gained by the participants. The NRTP was conducted by the Department of Pediatrics, MGIMS, KHS Hospital Sevagram. The participants were undergraduate, postgraduate and nurses. Before starting the lectures, participants were given the pre-test consisting of 35 multiple choice questions covering the entire NR protocol based on AAP Neonatal Resuscitation guidelines. The post-test was administered at the end of the training programmed. The participants' pre- and post-test marks were categorized into very good score [>/=80%], good score [60-80%], and unsatisfactory score [<60%]. The t-test for paired samples was calculated using SPSS 10 version. A total of 107 participants who were given pre- and post-tests were included in the study group. Maximum participants were final year undergraduate students [55.14%] followed by B.Sc. nursing students [12.14%] and staff nurses [11.21%]. The mean pre-test score was 17.56 [SD +/- 4.68] that went up to 27.71 [SD +/- 2.36] as a mean post-test score [p value <0.000; 95% CI -10.92 to -9.37]. The highly significant improvement was observed in the post-test scores of MBBS final year students [p < 0.000; 95% CI -11.28 to -9.73], staff nurses [p < 0.000; 95% CI-11.58 to -8.71], community postgraduates [p < 0.000; 95% CI-8.22 to -5.43], and B.Sc. nursing students [p < 0.000; 95% CI -18.59 to -13.07]. Significant improvement was also observed in the post-test scores of anesthesia postgraduates, gynecologist postgraduates, medical officers, and pediatrics postgraduates. Rh-Hr Blood-Group System Rh antigen and phenotype frequency in Kalba region, UAE. Taha, Jenan Y. E-mail:jenan_1965@hotmail.com Kalba Hospital - Hematology Department Bahrain Medical Bulletin 2012; 34 (1): 33-35 (17 ref.) Keywords: Phenotype; Genotype; Prospective Studies; Cohort Studies Abstract: To evaluate the frequency of Rh-phenotypes and the most probable genotype in Kalba region, UAE. Random Prospective cohort study. Setting: Kalba hospital. The study was conducted on 661 blood samples from both sexes and in different age groups who were randomly selected. ABO and Rh phenotype reactivity was determined by using tube method according to the manufacturer's instruction. The Rh antigens studied were D, C, c, E and e. The most frequently occurring antigen was found to be e 643 [97.3%], followed by D 602 [91.1%], C 484 [73.2%], c 470 [71%] and E 139 [21%]. The Rh genotypes present in decreasing order of frequency as follows: R[1]r 204 [30.9%], IMEMR Current Contents Subject Index 92 R[1]R[1] 186 [28%], R[1]R[2]76 [11.5%], R[0]R[0] 72 [10.9%], rr 48 [7.3%], R[2]r 44 [6.7%], R[2]R[2] 12 [1.8%], r[,] r 8 [1.2%], r[,] r[,] 4 [0.6%], R[z]R[2] 4 [0.6%], R[z]R[z] 1 [0.1%], r[,]r[,,] 1[0.1%], r[,,] r[,,] 1 [0.1%]. The study shows that the most frequent Rh antigen in Kalba region is e antigen. Thirteen Rh phenotypic groups of various frequencies were recorded. Knowledge of blood group phenotype distribution is very important for blood banks and transfusion service policies. Rhabdomyosarcoma diagnosis Massive diffuse intraperitoneal multicystic mass in an infant. Singh, Sunita; Kureel, Shiv N.; Chandra, Naveen E-mail:drsunitasingh28@gmail.com CSMMU [Erstwhile King George's Medical University] - Department of Pediatric Surgery Saudi Journal of Gastroenterology [The] 2012; 18 (2): 149-150 (3 ref.) Keywords: Rhabdomyosarcoma-pathology; Immunohistochemistry; Diagnosis, Differential Abstract: An 18-month-old boy was referred for painless progressively increasing abdominal distension, poor oral intake, and lethargy since 1 year. There was no history of fever, hematurea, or intestinal obstruction. The child was pale and had a pulse rate of 150 beats/min. The child had mild respiratory distress due to huge abdominal distension. The abdomen was tense and nontender. There was no evidence of intraperitoneal free fluid or any definitive lump. The hemogram showed anemia, other blood biochemistry test results were normal. Ultrasonography of the abdomen suggested the possibility of encysted ascites. A 64-slice contrast-enhanced computed tomography of abdomen showed diffuse intraperitoneal multicystic mass, composed of variable sizes and wall thickness cysts [Figure 1]. The definitive organ of origin could not be identified. Bowel loops were displaced upward by the mass. Diagnostic laparoscopy showed a pale, soft, extremely friable mass composed of cysts of variable sizes arising from the dome of the bladder. The cysts were noncommunicating and had no fluid. The mass was loosely adhered to the bowel, liver, and peritoneum. The rest of the abdominal organs were normal. Complementary cystoscopy was performed to rule out intraluminal extension of tumor, which was normal. Rhinitis, Vasomotor epidemiology Non allergic rhinitis: prevalence, clinical profile and knowledge gaps in literature. Bhargava, Deepa; Bhargava, Kamlesh; Al Abri, Ahmed; Al Bassam, Wameedh; Al Abri, Rashid E-mail:ralabri@gmail.com Sultan Qaboos University Hospital - Department of Surgery Oman Medical Journal 2011; 26 (6): 416-420 (19 ref.) Keywords: Rhinitis; Prevalence; Cross-Sectional Studies; Nasal Obstruction; Knowledge Abstract: Although Nasal symptoms induced by Non-allergic rhinitis| [NAR] are a cause of wide spread morbidity; the disease is trivialized. There is a lack of Epidemiological studies on the prevalence of non-allergic rhinitis. In spite of being one of the commonest conditions presenting to the General practitioner and otolaryngologists, the clinical profile, diagnosis, and management outcomes are unknown. The objectives of the study were to examine the prevalence and clinical profile of non-allergic rhinitis in Oman. Secondary objective was to identify Knowledge gaps in literature with the aim of directing future research. A cross sectional study of 610 consecutive adult patients presenting to the Ear, Nose and Throat clinic at Sultan Qaboos University Hospital is presented in this paper. The diagnosis of NAR was mainly based on step wise fashion; including a thorough clinical history and exclusion of other causes of rhinitis; all consecutive patients diagnosed with rhinitis [n=113] had a detailed history, nasal endoscopy, nasal smears, CT scans and an antihistamine response trial. The prevalence of NAR with its clinical profile was subsequently determined. Primary research articles and meta-analysis evaluated for the knowledge gap study were identified through MEDLINE search of English language literature published between 2000-2011. A total of 610 consecutive patients were studied. The overall prevalence of rhinitis was 18.5% [n=113]. The prevalence of NAR was 7.5% [n=46]. Cases of allergic rhinitis [5.7%; n=35], Chronic rhinosinusitis [1.8%; n=11], and miscellaneous causes [3.4%; n=21] were excluded. Among the rhinitis population [n=113], the prevalence of NAR was 57% [n=46]. The major presenting symptoms included nasal obstruction [93%; n=43], postnasal drainage [78%; n=36], and rhinorrhea [62%; n=29]. For the knowledge gap study; 115 Medline titles were reviewed, four systematic reviews, and 34 research papers were reviewed. The text of two recent otolaryngology text books was also reviewed, and the main results of the study IMEMR Current Contents Subject Index 93 revealed the prevalence of NAR had not previously been studied in Oman. Although the recent text now clearly defines NAR, there is scant literature on the prevalence, diagnosis and management outcomes of NAR in the literature. The study found that more than half of rhinitis patients suffered from NAR. There are no specific diagnostic tests for NAR; a thorough case history is the best diagnostic tool to date. A substantial knowledge gap exists in literature with relations to pathogenesis, clinical and laboratory diagnosis, as well as in reference to medical and surgical outcomes. Larger studies are required and management outcomes need to be studied. Rhizopus Rhizopus-associated soft tissue infection in an immunocompetent air-conditioning technician after a road traffic accident: a case report and review of the literature. Rabie, Nada B.; Althaqafi, Abdulhakeem O. King Abdulaziz Medical City - National Guard Health Affairs - Department of Medicine Journal of Infection and Public Health 2012; 5 (1): 109-111 (13 ref.) Keywords: Soft Tissue Infections-drug therapy; Mucormycosis-drug therapy; Wound Infection-drug therapy; Amphotericin B-therapeutic use; Antifungal Agents-therapeutic use; Combined Modality Therapy; Debridement Abstract: Rhinocerebral or sinopulmonary mucromycosis is a well-recognized human fungal infection found among immunocompromised and diabetic patients. However, the infection is rare among immunocompetent hosts. We are reporting the case of an adult immunocompetent male patient working as an air-conditioning technician. The patient was a victim of a road traffic accident [RTA] and sustained multiple fractures in the proximal part of the left tibia, distal femur, and scapula. Two weeks postoperatively, Rhizopus microspores were isolated from an infected traumatic wound over the distal femur. Surgical debridement was performed, and the patient was started on amphotericin B. Occupational exposure history and workplace environmental sanitation are crucial for the prevention of this potentially fatal yet preventable infection. 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved. Sandhoff Disease genetics Novel mutations in Sandhoff disease: a molecular analysis among Iranian cohort of infantile patients. Aryan, H.; Aryani, O.; Banihashemi, K.; Zaman, T.; Houshmand, M. Special Medical Center - Department Of Genetic Iranian Journal of Public Health 2012; 41 (3): 111-118 (18 ref.) Keywords: Mutation-genetics; Hexosaminidases A-genetics; Hexosaminidases B-genetics Abstract: Sandhoff disease is an autosomal recessive disorder caused by beta-hexosaminidase deficiency and accumulation of GM2 ganglioside resulting in progressive motor neuron manifestations and death from respiratory failure and infections in infantiles. Pathogenic mutations in HEXB gene were observed which leads to enzyme activity reduction and interruption of normal metabolic cycle of GM2 ganglioside in Sandhoff patients. Six infantile index patients with typical biochemical and clinical picture of the disease were studied at the molecular level. After DNA extraction and amplification, probands and their parents, were evaluated by direct sequencing of amplicons. We identified 7 different mutations among which 4 were novel. The most prevalent finding [50%] among our population was a 16 kb deletion including the promoter and exons 1-5. The other findings included c.1552delG and c.410G>A, c.362 A>G, c.550delT, c.1597c>T, c.1752delTG. We conclude that Cysl37Tyr and R533C mutations may be pathogenic because of changing amino acid and locating at the conserved region and also they have not been observed in hundred controls. Besides, four mutations including: Cysl37Tyr, c.1552delG, c.1597c>T and c.550delT fulfilled almost criteria for pathogenic mutation. Scenedesmus growth and development Effect of vitamins on growth criteria, photosynthetic pigments and some metabolic products of cobalte chloride stressed scenedesmus obliquus cultures. Desouky, S.A.; Usama, M.A.; Ahmed, W.A. IMEMR Current Contents Subject Index 94 Al Azhar University - Faculty of Science - Botany and Microbiology Department Assiut University Bulletin for Environmental Researches 2011; 14 (2): 41-56 (41 ref.) Keywords: Chlorophyta; Phytoplankton; Cobalt-adverse effect; Ascorbic Acid; Thiamine; Water Pollution Abstract: This study show the effect of applied vitamins ascorbic acid [vitamin C] and thiamine [vitamin B[1]] on growth criteria, total photosynthetic pigments total carbohydrate, total protein, free amino acids and proline contents of stressed Scenedesmus obliquus cultured for 7 days. The growth criteria [cell count and dry weight], total photosynthetic pigments, total carbohydrate contents, total protein contents, free amino acids and proline of stressed Scenedesmus obliquus cultures were significantly increased, when the algal cultures subjected to lower doses [1.5 and 3 ppm] of CoCI[2] only. On the other side, under relatively higher concentration [4.5 ppm] of CoGl[2] the cell count, dry weight, total photosynthetic pigments, total carbohydrate contents, total protein contents and free amino acids of CoCl[2] stressed Scenedesmus obliquus cultures were significantly decreased. However, the soluble carbohydrate contents, soluble proteins and praline contents of stressed Scenedesmus obliquus cultures were significantly increased. On the other hand, the parameters tested were significantly increased, when the algal cultures were subject to various doses [1.5, 3 and 4.5 ppm] of CoCI[2] and treated with 200 ppm applied vitamins [ascorbic acid or thiamine]. However, the different carbohydrate fractions [soluble, insoluble and total carbohydrate], soluble proteins of CoC1[2] stressed Scenedesmus obliquus cultures were significantly decreased. Scrub Typhus complications Scrub typhus in children at a tertiary hospital in southern India: Clinical profile and complications. Kumar, Manish; Krishnamurthy, Sriram; Delhikumar, C.G.; Narayanan, Parameswaran; Biswal, Niranjan; Srinivasan, Sadagopan Jawaharlal Institute of Postgraduate Medical Education and Research [JIPMER] - Department of Pediatrics Journal of Infection and Public Health 2012; 5 (1): 82-88 (30 ref.) Keywords: Scrub Typhus-diagnosis; Acute Kidney Injury-etiology; Myocarditis-etiology; Scrub Typhus-drug therapy; Anti-Bacterial Agents-therapeutic use; Doxycycline-therapeutic use; Prospective Studies; Sex Distribution Abstract: To study the clinical profile of and complications in children with scrub typhus. Prospective observational study. Tertiary care hospital. Children up to 12 years of age who had a fever for more than five days without an identifiable infection were included. All children who were suspected of having rickettsial infections were defined as having scrub typhus if they had a positive Weil-Felix test result [OX-K 1:80 or more] and one or more of the following clinical features [after exclusion of other diagnoses]: rash, edema, hepatosplenomegaly, lymphadenopathy, an eschar, and a tick bite or tick exposure. Thirty-five children were diagnosed with scrub typhus between February 2010 and February 2011. The age of the patients ranged from 1.5 to 12 years. Edema, crackles/rhonchi, hepatomegaly and hypotension were encountered in 60%, 23%, 91% and 34% of patients, respectively. An eschar was observed in 11% of the cases. Complications included myocarditis with cardiogenic shock in 34% of the cases and acute kidney injury in 20% of the cases. Anicteric hepatitis and thrombocytopenia were observed in 31% and 61% of cases, respectively. One patient died. High incidences of myocarditis and acute kidney injury were observed, which indicates that the children were treated at a late stage of the disease. Clinicians should be cognizant that myocarditis and acute kidney injury are serious manifestations of pediatric scrub typhus. 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved. Scurvy Scurvy as a predisposing factor in gingival disease - a case report. Akhtar, Shamim E-mail:shamimakhtarkcd@hotmail.com Khyber College of Dentistry - Department of Periodontology JKCD - Journal of Khyber College of Dentistry 2011; 2 (1): 40-43 (20 ref.) Keywords: Gingival Diseases; Malnutrition; Causality; Ascorbic Acid Deficiency; Gingival Hemorrhage; Gingivitis; Gingival Neoplasms; Gingival Overgrowth Abstract: Scurvy is a vitamin C deficiency disease which mainly occurs in teenagers. Vitamin C plays a vital role in the synthesis of collagen, the deficiency of which leads to a widespread pathology of supporting tissues of blood vessels, bone and teeth. There is an increased permeability of the capillaries to red blood cells causing hemorrhage. The bone becomes friable at the growing end. There is interference with timely collagen formation which causes IMEMR Current Contents Subject Index 95 delayed wound healing. In addition to other symptoms, there are bleeding gums, loose teeth plus swollen and stiff joints. A case report of a 13 years old girl is presented with gingival swelling and bleeding since last 4 years. The case was thoroughly investigated, oral prophylaxis along with vitamin C was prescribed and the patient became normal within one week time. Selenium blood The possible role of selenium concentration in hepatitis B and C patients. Khan, Mohammad S.; Dilawar, Shahnaz; Ali, Irshad; Rauf, Naseem E-mail:mshoaibkhan2003@yahoo.com Bannu Medical College - Department of Biochemistry Saudi Journal of Gastroenterology [The] 2012; 18 (2): 106-110 (36 ref.) Keywords: Hepatitis B-blood; Hepatitis C-blood Abstract: The compelling evidence reported that selenium is an essential trace mineral for human beings. Selenium plays a pivotal role in the restoration of immune functions. High rates of hepatitis B and C are present in Pakistan. Epidemiologic surveys demonstrated an inverse association between selenium [Se] level and regional cancer incidence, as well as viral infection. The present study was designed to evaluate the concentration of selenium in the serum of patients suffering from hepatitis B and C. In this cross-sectional descriptive analytical study, serum selenium concentration of 150 patients suffering from hepatitis B and C, along with 26 healthy controls, was determined by atomic absorption spectrophotometer equipped with hydride generation system, model Analytic Jena [Vario III]. The mean and standard deviation of serum selenium concentration observed in male and female patients with hepatitis C were 101.60 +/- 0.55 and 77.43 +/- 0.47 microg/L, respectively, whereas the mean and standard deviation of serum selenium concentration observed in male and female patients with hepatitis B were 107.58 +/- 0.44 and 137.8 +/- 036 microg/L. Analysis of t test showed significant difference between C and B [P<0.001] patients in serum selenium concentration, when compared with the control. The obtained results indicate that serum selenium concentration of hepatitis B and C patients is less than serum selenium concentration of healthy individuals. However, serum selenium decline is relative to severity of disease. Based on findings of this study, it is proposed that selenium should be supplemented in such patients in order to optimize nutritional support and to get better treatment response. Setaria Nematode immunology Cross-reaction of antigen preparations from adult and larval stages of the parasite Setaria equina with sera from infected humans with Wuchereria bancrofti. Bahgat, M.M.; Saad, A.H.; El Shahawi, G.A.; Gad, A.M.; Ramzy, K.M.; Ruppel, A.; Abdel Latif, M. E-mail:mbahgatriad@yahoo.com National Research Centre - Centre of Excellence for Advanced Sciences - Department of Therapeutic Chemistry and Infectious Diseases and Immunology Laboratory EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 679-686 (61 ref.) Keywords: Wuchereria bancrofti; Elephantiasis, Filarial-blood; Enzyme-Linked Immunosorbent Assay; Blotting, Western Abstract: Crude antigenic preparations from Setaria equina were used in ELISA and Western blotting to examine cross-reaction with human sera from areas endemic for bancroftian filariasis. Sera from normal subjects from non- endemic areas were included as negative controls. Cross-reaction was found between 5. equina antigens and antibodies in the sera of Wuchereria bancrofti-infected patients, with the highest levels observed between sera of chronic infected patients and Setaria spp. crude female worm surface antigen [CFSWA]. In the absence of active transmission of Setaria spp. infection, CFWSA is useful to detect chronic W. bancrofti infection before patients become symptomatic, particularly when chronic patients are known to be amicrofilaraemic. In the presence of active 5. equina infection, antigens from the adult and microfilaraemic stages showed the highest degree of cross-reaction with human sera. IMEMR Current Contents Subject Index 96 Silicon Dioxide toxicity Ultrastructral study of rat lung alveoli after silica inhalation. Abdel Aziz, Hekmat O. Sohag University - Faculty of Medicine - Histology Department Assiut Medical Journal 2011; 35 (1): 67-76 (23 ref.) Keywords: Lung-ultrastructure; Microscopy, Electron; Rats; Male Abstract: Silicosis is a fibronodular lung disease caused by inhalation of dust containing crystalline silica [silicon dioxide]. To investigate the changes in the lung alveoli after silica dust inhalation on the ultrastructural level in rats. Thirty adult male albino rats were used and divided into 2 groups [15 animals each]; the l[st] group [Group I] served as a control group, silica dust [SiO[2]] was administrated by inhalation to the 2[nd] group [Group II] [10 times daily for 6 weeks]. Lung specimens were processed for study by electron microscope. After silica treatment, features of thickening of the interalveolar septum by cellular and connective tissue infiltration were manifested. Ultrastructural changes were observed in the form of cellular abnormalities represented by degeneration, vacuolation, dilatation of the rER and clarification of the cytoplasm of type II pneumocytes. Cellular infiltration by neutrophils, eosinophils, lymphocytes, mast cells and macrophages was also observed. Furthermore fibrosis manifested by collagen deposition has been found. Silica is directly cytotoxic to pulmonary target cells. We should always remember that if it is silica, it is not just dust and avoid exposure. Silver Compounds chemical synthesis Synthesis, spectroscopic and potentiometric studies on a silver [I] complex derived from a new BIS [thiosemicarbazone]. Moustafa, Mahmoud Hassan; Abd Elnaeem, Ahmed; Abbas, Osama Ahmed E-mail:mahhassanl959@yahoo.com Al Azhar University - Faculty of Science - Department of Chemistry, Assiut Branch Assiut University Bulletin for Environmental Researches 2011; 14 (2): 27-40 (31 ref.) Keywords: Spectrum Analysis-methods; Potentiometry-methods; Thiosemicarbazones Abstract: A new reagent, [2E, 2Z]2,2-[3[E]-[2-hydroxyphenyl] diazenyl] pentane-2,4-diylidene] bis [hydrazinecarbothioamide] [OPTS] was synthesized and studied. Acid-base, spectrophotometric properties of OPTS were studied in 50% ethanol-water mixture solutions at pH 3-11. Ionization constants of the reagent OPTS have been determined by a spectrophotometric and potentiometric titrations: pK[1]=9.60 +/- 0.02; pK[2]= 10.45 +/- 0.05 in its computational and graphical versions at an ionic strength 0.1 M Na10[4]. The stability constants of the Ag-OPTS are logK[1]=4.55 +/- 0.04 and 10gK[2]=3.92 +/- 0.05. The reaction of Ag [I] with OPTS gives a mononuclear complex in 50% ethanol water mixture solution with lambda[max]=462 nm at pH=8.1. The effects of foreign ions and masking agents on the determination of Ag [I] with the new reagent are studied. The mono complex obeys the Beer's law in the Ag [I] concentration range 1.1-17 mg/25ml. Molar absorption coefficients were determined. In this paper, we report the synthesis of the novel Ag [l] complexes with OPTS. The complexes were characterized by UV-Vis and IR spectroscopy, elemental analysis, molar conductivity and thermal decomposition. Sinus Thrombosis, Intracranial diagnosis Subarachnoid hemorrhage as a rare presentation of cerebral venous sinus thrombosis. Abdul Salam, Suha; Al Fahdli, Mariam; Al Duaij, Sondos E-mail:Suhal305@gmail.com Mubarak Al-Kabeer Hospital - Department of Medicine KMJ - Kuwait Medical Journal 2012; 44 (1): 50-52 (10 ref.) Keywords: Subarachnoid Hemorrhage-etiology; Subarachnoid Hemorrhage-diagnosis; Magnetic Resonance Imaging; Tomography, X-Ray Computed IMEMR Current Contents Subject Index 97 Abstract: Cerebral [Dural] venous thrombosis can present with a variety of symptoms ranging from mild headache to altered level of consciousness and coma. Cerebral venous thrombosis is an uncommon clinical condition. It often affects young to middle aged patients and more commonly women. Subarachnoid hemorrhage is a rare presentation. In this report, we describe a case of cerebral venous thrombosis presenting with Subarachnoid hemorrhage. Skin Diseases epidemiology Frequency of cutaneous diseases in geriatric population of type IV and V skin. Khurshid, Khawar; Irfanullah; Paracha, Mohammad Majid; Amin, Said; Pal, Sabrina Suhail E-mail:drirfanullahafridi@yahoo.com Lady Reading Hospital - Department of Dermatology JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 39-42 (12 ref.) Keywords: Geriatrics; Eczema-epidemiology; Skin Neoplasms-epidemiology; Cross-Sectional Studies; Scabies- epidemiology Abstract: To determine the frequency of common cutaneous diseases in geriatric population of type IV and V skin. This Cross-sectional Survey was conducted at Skin outdoor department in May Hospital, Lahore. Two hundred and seventy patients of either sex aged sixty years and above were included in the study. Frequency of common dermatoses was noted. The data were analyzed according to age, sex and skin type. Two hundred and seventy patients were included in the study. The mean age of the patients in the study was 66.85 [ +/- 8.1: range 60-105] years. Eczemas were found in [40%] of geriatric population, scabies [25.2%], fungal infection [14.8%], pruritus [9.6%], viral [8.1%] and bacterial [2.2%] infections. Regarding miscellaneous diseases, significantly greater number of patients aged 80 years or more were diagnosed to have malignant skin disorders. Eczemas were the most common dermatoses. Scabies was more prevalent in females as compared to males. The chances of skin cancer like BCC increases as the age advances. Snails classification Habitat characteristics for different freshwater snail species as determined biologically through macroin- vertebrate information. El Khayat, Hanaa M.M.; Mahmoud, Kadria M.A.; Mostafa, Bayomy B.; Tantawy, Ahmad A.; El Deeb, Fatma. A.; Ragb, Fawzy M.; Ismail, Nahed M.; El Said, Kalil M.; Abu Taleb, Hoda M. Theodor Bilharz Research Institute - Department of Environmental Research and Medical Malacology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 651-664 (42 ref.) Keywords: Fresh Water-parasitology; Echosystem; Seasons Abstract: Macro-invertebrates including freshwater snails collected from 643 sites over 8 successive seasons among the River Nile, branches, main canals and certain drains in eight Egyptian Governorates. Thirteen snail species and one bivalve species were identified. The most distributed were Lanistus carinatus and Physa acuta while the most abundant were Cleopatra bulimoides and Physa acuta during the whole study. The sites that harbored each snail species in all the examined watercourses were grouped seasonally and their biological assessment was determined by their minimum and maximum total point similarity percentage to that of the corresponded reference site and mean of the total points. Habitats for most snail species attained minimum total point's similarity percentage less than 21% [very poor habitat] during autumn and winter then spring while during summer very poor habitat was harbored by only few snail species. P. acuta was the only survived snails in habitat which attained 0 as a minimum total point's similarity percentage during two seasons and L. carinatus and Succinea cleopatra during one season. With respect to medically important snails very poor sites constituted 23% of Biomphalaria alexandrina sites, 14% of Lymnaea natalensis and 9.4% of Bulinus truncatus sites. The studied macroinvertebrate matrices, total number of organisms, taxa richness, the Ephemeroptera, Plecoptera, and Trichoptera [EPT] index, ratio of EPT index to chironomidae, ratio of scraper to filtering collector, contribution of dominant macroinvertebrate major group, comparison revealed descending tolerances from B. alexanrina followed by L. natalensis then B. truncates, but Hilsenhoff Biotic Index [HBI] showed the same tolerance to organic pollution. IMEMR Current Contents Subject Index 98 Soil analysis Status of some nutrients and heavy metals with relations to their bearing minerals in the soils of nile terraces at Assiut, Egypt. Faragallah, Mohamed El Ameen Abd El Kareem Al Azhar University - Faculty of Agric. - Soil and Water Sci. Department Assiut University Bulletin for Environmental Researches 2011; 14 (2): 69-93 (62 ref.) Keywords: Minerals-analysis; Metals, Heavy-analysis; Potassium-analysis; Iron-analysis; Zinc-analysis Abstract: Nine soil profiles were selected from various Nile terraces located south Assiut barrage at Assiut city, Egypt to a] examine levels and distributions of some available nutrients [P, K, Fe, Mn, Zn and Cu] and some heavy metals [Ni, Pb and Cd, b] clear up their relations with some physical and chemical soil properties, and c] evaluate their relations to their bearing minerals in the soils of the most recent and old Nile terraces. Results showed soil available phosphorus values are higher in the oldest terraces on both Nile sides than in the youngest ones. However, most soil layers of the youngest Nile terraces show greater available potassium levels than the oldest ones. The recent and old Nile terraces soils exhibit very high level of P and medium amounts of K. In most cases, there are no consistent changes in the levels of either available phosphorus or potassium with depth. Highly significant positive correlations were obtained between the available P and K and soil contents of silt, clay, organic matter and CEC. On the other hand, highly significant negative correlations were recorded with sand, pH and CaCO[3] contents. Significant positive correlations were found between the phosphorus levels and both monazite and the sum of apatite + monazite minerals. However, insignificant, positive correlations between available potassium and its bearing minerals were recorded, except the case of feldspars in the clay fraction was a highly significant, positive correlation. The highest levels of DTPA-extractable Fe are obtained in the oldest Nile terrace soils. Whereas, extractable Mn levels are high in the youngest terraces on both Nile sides. Moreover, the soils of the youngest and oldest terraces are Fe and Mn sufficient. However, most soils of the terrace bench in the interference zone and the terrace rear suture in desert fringes are considered Fe and Mn deficient. The levels of soil extractable Cu are quite variable among the youngest and oldest Nile terraces, and all the investigated soils are Cu-nondeficient. On the other hand, most examined soils are considered Zn-deficient. No clear pattern of distributions of these investigated micronutrients was observed with depth. Highly significant positive correlations expressed the relations between fine particles, organic matter and CEC contents and extractable Fe, Mn and Cu. However, highly significant negative correlations were observed with amounts of sand, CaCO[3] and soil pH. The DTPA-extractable Zn did not show any significant correlations with all the considered soil properties. The extractable Fe and Cu showed highly significant positive correlations with epidotes, biotite and feldspars of both sand and clay fractions. Also, the extractable Mn has significant positive correlations with epidotes, hornblende, smectites and chlorite. However, low positive correlations occurred between the extractable Zn with both hornblende and pyroxene. Generally, DTPA-extractable Ni and Pb are slightly higher in the youngest Nile terrace soils than in the oldest ones, without any clear trend of their distributions with depth. Moreover, the youngest and oldest Nile terraces soils contain similar vey low amounts of extractabie Cd. Correlations between extractable Ni and contents of clay, silt, organic matter and CEC are highly significant and positive, whereas, they are highly significant and negative with sand, pH, EC[8] and CaCO[3] contents. The extractable Pb has significant positive correlations with the soil contents of silt, clay, and CEC, but, negative significant correlations with both sand and CaCO[3] contents. Slightly significant positive correlations between the extractable Ni and Pb and hornblende are recorded. Both biotite and chlorite were highly significant positive correlated to Ni. Somatosensory Disorders Pattern of somatic symptoms in anxiety and depression. Shah, Mubashar; Sajid, Wahid Bukhsh; Sabih, Fazaila; Hanif, Muhammad Shoaib Combined Military Hospital - Department of Psychiatry PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 447-452 (22 ref.) Keywords: Depression; Depressive Disorder; Anxiety; Anxiety Disorders; Cross-Sectional Studies Abstract: To determine the pattern of somatic symptoms in anxiety and depressive disorders. Cross Sectional Comparative study. Department of Psychiatry Military Hospital Rawalpindi. From May to November 2002. Patients were divided in Group I of anxiety and group II of depression. Fifty patients considered in each group by convenience sampling. The organic basis of their symptoms was ruled out. The patterns of their somatic symptoms and other information like educational and economic status were recorded on Semi Structured Proforma. The patient's diagnosis was made on schedule based ICD-10 research criteria. The severity of anxiety and depression was assessed by using IMEMR Current Contents Subject Index 99 HARS and HDRS respectively. The pattern of somatic symptoms in both groups was then analyzed by the urdu version of Bradford Somatic Inventory. Patterns of somatic complaints were then analyzed by chi square test. Out of 100 patients we placed 50 each in group I [anxiety] and group II [Depression]. Males were higher in depression whereas females were higher in anxiety disorder group. P-value for headache was 0.017 while in rest of the somatic symptoms it was insignificant ranging from 0.4 to 1. We found that the patterns of somatic symptoms are present in both the groups of anxiety and depression like symptoms related to musculoskeletal and gastrointestinal system were commonly observed in cases of depression whereas symptoms related to autonomic nervous system and cardiovascular system is more significantly somatized in patients of anxiety. A larger sample is required for further studies to get better results . Spermatogenesis drug effects Histomorphometric study of effects of bicalutamide on spermatogenesis in male rats. Khursheed, Atika; Minhas, Liaqat Ali; Niaz, Waqar Azim E-mail:atika.waqar@live.com Army Medical College PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 325-329 (11 ref.) Keywords: Tosyl Compounds-adverse effects; Nitriles-adverse effects; Anilides-adverse effects; Rats, Sprague- Dawley; Random Allocation; Germ Cells-drug effects Abstract: To study the effects of Bicalutamide on spermatogenesis in male rats. Laboratory based randomized controlled trial. Anatomy Department, Armed Forces Postgraduate Medical Institute [AFPGMI], Rawalpindi in collaboration with National Veterinary Laboratories [NVL], Islamabad from April 2008 to May 2008. Forty adult male Sprague Dawley rats weighing 200-300 grams were randomly divided into two groups, Group A and Group B, each consisting of 20 animals each. Group A was taken as control group and was administered 5 cc of distilled water orally daily for 24 days while group B [Experimental group] was given 5 cc of distilled water daily containing bicalutamide 10 mg/ kg/ day for 24 days. All the animals were sacrificed on the next day after the last dose. The testes were removed and fixed in 10% formalin and then processed for paraffin embedding. Five micron thick sections were made. Haematoxylin, Eosin and PAS stains were used. Histomorphometric analysis was done and parameters, including the tubular diameter, height of seminiferous epithelium and germ cell count were noted. Statistically significant differences were found in tubular diameter, height of seminiferous epithelium and germ cell count in testes of experimental group when compared with the control group. The results showed that the mean tubular diameter, the height of the germinal epithelium of the seminiferous tubules and the number of germ cells were significantly reduced in by the experimental group showing that bicalutamide suppresses spermatogenesis in the Sprague - Dawley rats. Spinal Cord Injuries complications Frequency of urinary tract infection [UTI] and commonest causative organisms in spinal cord injury patients with various voiding modes. Mahboob, Farah; Ahmed, Nadeem; Rathore, Farooq; Razzq, Sara Pakistan Naval-ship Shifa PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 438-442 (25 ref.) Keywords: Urinary Tract Infections; Bacteriuria; Pyuria; Escherichia coli; Pseudomonas; Klebsiella pneumoniae; Proteus mirabilis; Citrobacter freundii; Morganella morganii; Candida Abstract: To determine the frequency of urinary tract infection and commonest causative organisms in spinal cord injury patients with various modes of voiding in rehabilitation setup in Pakistan. A descriptive study of 100 spinal cord injury patients. The Armed Forces Institute of Rehabilitation Medicine [AFIRM] Rawalpindi from September 2007 to March 2008 on clinical samples received from admitted patients in CMH Rawalpindi and AFIRM. In 100 patients of spinal cord urine samples were subjected to Urine Routine examination and Urine Culture sensitivity. Urine culture revealing a bacterial colony count of 105 cfu/ml or higher were considered positive for urinary tract infection [UTI] if present with symptoms. Significant bacteriuria was investigated for spectrum and sensitivity pattern as well. Of all 100 spinal cord patients 52 patients [52%] had symptoms suggestive of UTI but only 37 patients [37%] had significant bacteriuria on urine culture supported by high level pyuria were declared to have UTI. E-coli was the most commonly isolated organism with total no of 20 cases [54.1%] followed by Pseudomonas 6 cases [16.2%], Klebsiella pneumoniae IMEMR Current Contents Subject Index 100 3 cases [8.1%], Proteus mirabilis 3 cases [8.1%], Citrobacter freundi 2 cases [5.4%] and the least frequent was Morganella morganii with 1 case [2.7%]. UTI was most frequent in patients with indwelling catheter and was least associated with self voiding. Urinary Tract Infection was commonly observed among spinal cord injury patients. E-coli was the commonest isolated pathogen followed by Pseudomonas, Klebsiella pneumoniae, Proteus mirabilis, Citrobacter freundi, Candida and Morganella morganii in descending order of frequency. UTI was most frequent in patients using indwelling catheter as a mode of voiding. Splenectomy adverse effects Effect of splenectomy on liver regeneration and function following partial hepatectomy: experimental study. Nasr, M.M.; Hassan, A.M. Abdelaziz; Elsebaie, S.B.; Elsebae, M.A.; Nosseir, M.M.F. Theodor Bilharz Medical Research Institute - Department of General Surgery Journal of the Egyptian Society of Parasitology 2011; 41 (3): 604-610 (27 ref.) Keywords: Liver Function Tests-blood; Hepatectomy; Liver Regeneration-physiology; Cricetinae; Animal Experimentation; Antigens, Nuclear-blood Abstract: The presence of enough remaining functioning liver parenchyma to avoid life-threatening postoperative liver failure is a major prerequisite for hepatic resection in patients with hepato biliary carcinoma. There are clinical reports which confirm the beneficial clinical effects of splenectomy on integrity of the residual liver following liver resection for hepatocellular carcinoma in cirrhotic patients with hypersplenism and portal hypertension. This experimental study was designed on hamsters to evaluate the proliferative capacity and function of the remaining liver lobes; in which splenectomy was done simultaneously with partial hepatectomy compared with those in which splenectomy was not done. Forty hamsters were divided into two groups: GI; in which partial hepatectomy was performed without splenectomy and the GIl; in which animals were subjected to partial hepatectomy with prior splenectomy. Animals from each group were subjected to liver biopsy from the remaining lobes 48, 72 hours and one week after surgery. Also, serum alanine aminotransferase [ALT] and total bilirubin were tested before, 48, 72 hours and one week after hepatectomy. Hepatic regeneration in the remaining lobes was assessed through histo- pathological study, DNA ploidy of the hepatic nuclei using computerized image analysis system and determining of the labeling index of the nuclear factor NF Kappa B [P105], a novel monoclonal antibody specific for P105 protein by immunohistochemistry. In GIl: induction of NK kappa B [PI05] labeling index showed maximum expression depending on the regenerative capacity of the remaining liver lobes. In contrast, in GI; liver regeneration was slow. Also, changes in liver function of Gil indicated that splenectomy prior hepatecotomy may minimize dysfunction in the remaining hypertrophied liver lobes. Staphylococcus aureus enzymology Prevalence of beta-lactamase-producing and non-producing staphylococcus aureus associated with patients in intensive care units. Alsaimary, Ihsan E.A. E-mail:ihsanalsaimary@yahoo.com University of Basrah - College of Medicine - Department of Microbiology Medical Journal of Islamic World Academy of Sciences 2012; 20 (1): 17-28 (50 ref.) Keywords: beta-Lactamases; Staphylococcal Infections-epidemiology; Intensive Care Units; Microbial Sensitivity Tests; Drug Resistance, Multiple, Bacterial Abstract: A total of 125 samples were collected from intensive care units [ICUs] of two main hospitals in Basrah: 74 clinical samples including Skin, blood, eye, nose, wounds, and urine and 51 inanimate samples including bed, wall, instruments, and addresses. A total of 334 isolates of bacterial types were isolated from various sources, including the following number of isolates and their percentages: Staphylococcus aureus 45 [13.47%], Staphylococcus epidermidis 31 [9.28%], Staphylococcus saprophyticus 18 [5.38%], Staphylococcus xylosus 11 [3.29%], Staphylococcus capitis 7 [2.09%], Streptococcus pyogenes 28 [8.38%], Viridans streptococci 35 [10.47%], Streptococcuspneumoniae 12 [3.59%], Pseudomonas aeruginosa 41 [12.27%], Escherichia coli 19 [5.68%], Klebsiella spp 20 [5.98%], Proteus spp 10 [2.99%], Enterobacter 9 [2.69%], Propionibacterium acnes 24 [7.18%], Acinetobacter spp 9 [2.69%], and Corynebacterium spp 15 [4.49%]. A total of 31 isolates of S. aureus [68.89%] were beta-lactamase producers, while 14 IMEMR Current Contents Subject Index 101 isolates [31.11%] were beta-lactamase non-producers. The prevalence of multidrug resistance of S. aureus against eight antibiotics was carried out in the present study. The resistance against three antibiotics had the biggest percentage [25.8%] for beta-lactamase-producing S. aureus with resistance of eight antibiotics, while resistance of two antibiotics was the predominant mode off beta-lactamase non-producing S. aureus [35.71%] with no resistance against more than four antibiotics. The study found that vancomycin, cefotaxime, and gentamicin were the most effective antibiotics against beta S-lactamase-producing S. aureus strains isolated from both clinical and inanimate samples of ICUs having percentages of resistance as follows: 42.22%, 44.44%, and 44.44%, respectively, and the antibiotic tetracycline had the biggest percentage of resistance [82.22%] against S. aureus strains under study. Although vancomycin and cefotaxime were the most effective antibiotics for beta-lactamase non-producing S. aureus strains, they had the lowest percentages of resistance in comparison to the first above group that recorded 13.33% and 20.0% of resistance, respectively, and tetracycline still being the weakest antibiotic having great resistance of 53.82% of isolates. The plasmid profiles in beta -lactamase-producing and non-producing MDRSA were also determined in this study. When the band molecular weight ranged between 300 and 600 base pairs [bp], a clear main band appeared in the range 550-570 bp for beta-lactamase-producing S. aureus. When the band molecular weight ranged between 200 and 700 bp, a clear main band appeared each in the band range 450-470 bp and 690-700 bp for beta-lactamase- producing S. aureus. Stomach Ulcer drug therapy Potential antioxidant and antiapoptotic effects of eplerenone versus omeprazole on water immersion restraint stress induced gastric injury in rats. El Kharashi, Omnyah Ali; Nabih, Enas Samir Ain Shams University - Faculty of Medicine - Pharmacology Department EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 327-342 (28 ref.) Keywords: Spironolactone-analogs and derivatives; Omeprazole-therapeutic use; Malondialdehyde; Apoptosis- antioxidants; DNA Fragmentation; Stress, Mechanical; Immersion; Comparative Study; Rats; Male Abstract: Use of proton pump inhibitors as omeprazole in prophylaxis against gastric stress ulcers complicating acute myocardial infarction leads to serious cardiovascular events. Eplerenone is one of the drugs used in treatment of acute myocardial infarction. We have investigated in the current study the possible protective effects of eplerenone versus omeprazole against water immersion restraint stress-induced gastric injury in rats. Twenty four male white albino wistar rats were divided into four groups having six rats in each. These groups were normal control, stress non treated control and two stress groups pretreated with either eplerenone [100 mg/kg i.p] or omeprazole [8 mg/kg i.p]. The injury index of gastric mucosa and structural change of parietal cells was observed under scanned electron microscope. Malondialdehyde and protein carbonyl were quantified in gastric tissues as biomarkers of lipid peroxidation and protein damage respectively. Apoptosis was assessed by measuring DNA fragmentation %. The injury index, Malondialdehyde level, protein carbonyl content and DNA fragmentation % parameters were significantly decreased in water immersion restraint stress groups pretreated with either eplerenone or omeprazole [p<0.05]. The scanned electron microscope of eplerenone pretreated group showed significant reduction in the degree of damage while the omeprazole pretreated group showed nearly complete healing. Our results demonstrated that gastric lesions attenuation by eplerenone are through its antioxidant and antiapoptotic effects and therefore it can be regarded as a useful option for therapy of patients with acute myocardial infarction at risk of developing gastric stress ulcers and threatened gastrointestinal bleeding risk. Streptococcus agalactiae isolation and purification Evaluation of culture and pcr methods for diagnosis of group b streptococcus carriage in Iranian pregnant women. Bakhtiari, R.; Dallal, M.M. Soltan; Mehrabadi, J.F.; Heidarzadeh, S.; Pourmand, M.R. Tehran University of Medical Sciences - Department of Pathobiology, School of Public Health Iranian Journal of Public Health 2012; 41 (3): 65-70 (29 ref.) Keywords: Carrier State-diagnosis; Pregnant Women; Polymerase Chain Reaction; Streptococcus agalactiae- genetics; Culture Media IMEMR Current Contents Subject Index 102 Abstract: Group B streptococcus [GBS] is one of the most important cause of morbidity and mortality among newborns especially in developing countries. It has been shown that the screening approach rather than the identification of maternal clinical risk factors for early-onset neonatal GBS disease is more effective in preventing early- onset GBS neonatal disease. The objective of this study was to detect GBS among clinical samples of women using PCR and standard microbiological culture. Samples were taken from 375 women at 28-38 weeks of gestation during six month from January 15 till June 15, 2011 from a hospital in Tehran, Iran. Samples were tested by standard culture using Todd- Hewitt broth, blood agar and by PCR targeting the cfb gene. Among the 375 women, 35 [9.3%] were identified as carriers of group B streptococci on the basis of the results of the cultures of specimens, compared to 42 [11.2%] on the basis of PCR assay. We found that GBS can be detected rapidly and reliably by a PCR assay in vaginal secretions from women at the time of delivery. This study also showed that the rate of incidence of GBS is high in Iranian women. Streptokinase therapeutic use Effect of post-myocardial infarction streptokinase [SK] therapy, on myocardial viability - evaluation with thallium- 201 single photon emission computed tomography [TL-201 SPECT]. Shaikh, Mohsin Saeed; Raza, Mehdi; Naz, Zehra; Kayani, Azhar Mahmood; Aziz, Sohail; Fazal, Imran Armed Forces Intitute of Cardiology PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 330-335 (27 ref.) Keywords: Thallium Radioisotopes-diagnostic use; Myocardial Infarction-drug therapy; Tomography, Emission- Computed, Single-Photon; Retrospective Studies; Electrocardiography; Myocardium Abstract: To evaluate the effect of post-myocardial infarction Streptokinase therapy on myocardial viability, employing Thallium-201 single photon emission computed tomography [TL-201 SPECT]. Retrospective, experimental study. The Nuclear Cardiology Department, Armed forces Institute of Cardiology / National Institute of Heart Diseases, Rawalpindi, from 1[st] April 2009 to 31[st] October 2009. Male patients, who had suffered from acute myocardial infarction [AMI], in an area supplied by the left anterior descending [LAD] artery, had infarct-related electrocardiogram [ECG] changes and received or did not receive Streptokinase therapy, were included. Those with a normal ECG, or history of revascularization, or non-ST elevation MI, or more than on MIs, were excluded. The patients were divided into groups 1 [who received Streptokinase] and 2 [who did not receive Streptokinase]. Each group contained 42 patients and all underwent scintigraphic viability study through intravenous injection of 3.0 mCi [123 MBq] of TL-201, followed by rest-redistribution SPECT imaging on a dual head, dedicated cardiac gamma camera system [Philips Cardio MD [registered sign]]. Emory's cardiac toolbox [registered sign] and AutoQUANT [registered sign] were used for data processing and quantitative estimation of viable myocardium. Empirical scores from 0 to 2 were assigned to each of the scans, in the order of increasing viability, and these were compared across the two groups. Group 1 contained 42 patients [age range = 38 to 80 years, mean = 53.98 +/- 11.26 years], in whom empirical viability scoring was done. Score 0 was seen in 2 patients, score 1 was seen in 15 patients and score 2 was seen in 25 patients from this group. Group 2 also contained 42 patients [age range = 38 to 80 years, mean = 56.71 +/- 9.05 years], in whom viability score of 0 was seen in 3 patients, score 1 was seen in 11 patients and score 2 was seen in 28 patients from this group. Age difference between the two groups was statistically insignificant [p = 0.223]. The myocardial viability results analysed by 3 x 2 contingency table applying chi- square [X[2]] test also showed no significant difference between groups 1 and 2 [p= 0.611]. This study did not find any significant difference in myocardial viability - post- myocardial infarction - in patients who received or did not receive Streptokinase therapy. Stress Disorders, Post-Traumatic Post-traumatic stress disorder - a psychological aspect of maxillofacial trauma. Rehman, Basheer; Qiam ud Din; Shah, Syeda Nadia E-mail:trygeminal76@yahoo.com Khyber College of Dentistry - Department of Oral and Maxillofacial Surgery JKCD - Journal of Khyber College of Dentistry 2011; 2 (1): 3-8 (27 ref.) Keywords: Wounds and Injuries; Accidents, Traffic; Bombs; Face; Maxilla; Maxillofacial Injuries Abstract: The purpose of this study is to find out the incidence of Post-Traumatic Stress Disorder in patients with maxillofacial trauma and to provide a circumstantial evidence for certain precautionary measures which will play a basic role in the prevention and management of Post-Traumatic Stress Disorder amongst such patients. The study was carried out at the Department of Oral and Maxillofacial Surgery, Khyber College with maxillofacial Pakhtunkhwa, Peshawar from June 2009 to May 2010. Two hundred and Ninety patients with maxillofacial trauma were recruited in IMEMR Current Contents Subject Index 103 this study. For the collection of data, Post-Traumatic Stress Disorder Checklist Civilian version consisting of 17 items was used. The collected data and all relevant information were analysed using SPSS Version 17.0. The results of the present study showed that out of 290 patients, 90 patients [31.03%] had Post-Traumatic Stress Disorder symptoms in which 40 [44.44%] were males and 50 [55.56%] were females. The largest age group suffered from Post-Traumatic Stress Disorder symptoms were 16-25 years and 26-35 years [33.33% each]. Thirty four patients [27.78%] scored 50 or above on Check list indicating severe symptoms, where 27 females [30%] had severe symptoms as compared to 7 males [7.78%]. Young patients between ages 16-35 were the most common group who suffered from severe symptoms. The severe symptoms of Post-Traumatic Stress Disorder were seen in victims of road traffic accidents and bomb injuries [22.22% and 13.33% respectively] with poor and middle socioeconomic status. The importance of psychological morbidity after major trauma is continuing to gain attention in trauma outcomes research. Taking into account the burden of psychological consequences of maxillofacial trauma, further research and preventive strategies are needed to cope with this hidden epidemic in our society. Stroke diagnosis Ischemic stroke secondary to aortic dissection following rifle butt recoil chest injury: a case report. Rao, Mamatha; Panduranga, Prashanth; Al Mukhaini, Mohammed; Al Jufaili, Mahmood; Valiath, John E-mail:mamatha_722002@yahoo.com Royal Hospital - Department of Emergency Medicine Oman Medical Journal 2011; 26 (6): 438-440 (9 ref.) Keywords: Aortic Aneurysm, Thoracic; Thoracic Injuries-complications; Firearms; Hemiplegia; Tomography, Spiral Computed; Echocardiography Abstract: Ischemic stroke secondary to aortic dissection is not uncommon. We present a patient with left hemiplegia secondary to Stanford type A aortic dissection extending to the supra-aortic vessels, which was precipitated by rifle butt recoil chest injury. The diagnosis of aortic dissection was delayed due to various factors. Finally, the patient underwent successful Bentall procedure with complete resolution of symptoms. This case emphasizes the need for caution in the use of firearms for recreation and to take precautions in preventing such incidents. In addition, this case illustrates the need for prompt cardiovascular physical examination in patients presenting with stroke. Struma Ovarii diagnosis Cystic struma ovarii: a rare ovarian teratoma. Malik, Bushra Ayaz; Ali, Zafar Armed Forces Institute of Pathology PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 478-480 (6 ref.) Keywords: Teratoma; Ovarian Neoplasms Surgical Procedures, Elective Reasons for cancellation of elective operations at a major teaching referral hospital in Jordan. Mesmar, M.; Shatnawi, N.J.; Faori, I.; Khader, Y.A. Jordan University of Science and Technology - Faculty of Medicine - Department of Orthopaedic Surgery EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 651-655 (23 ref.) Keywords: Appointments and Schedules; Hospitals, Teaching; Prospective Studies Abstract: Cancellation of elective scheduled operations leads to an inefficient use of operating room time and a waste of resources. This prospective records-based study aimed to determine the rate of and reasons for cancellations of scheduled elective surgical operations in a major teaching referral hospital in Jordan. Over a period of 12 months, cancellation was recorded in 382 [3.6%] of 10485 scheduled elective surgical operations. Day unit cancellations accounted for 27.5% and inpatient cancellations for 72.5%. Patient-related reasons, administrative and medical reasons accounted for 31.4%, 30.4% and 38.2% of all cancelled operations respectively. The most common patient- related reason for cancellation was patient non-attendance. The most common administrative reason for cancellations IMEMR Current Contents Subject Index 104 was unavailability of hospital admission beds. Although the cancellation rate was low in comparison with the reported rates worldwide, reductions might be achieved by adopting some important interventions, especially better bed utilization. Surgical Sponges Textiloma: an Unusual pelvic cyst. Hussain, Zaki Pak Field Hospital level-III PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 488-489 (6 ref.) Keywords: Cysts; Pelvic Neoplasms; Pelvis-abnormalities Tachycardia, Reciprocating diagnosis Persistent junctional reciprocating tachycardia [PJRT]. Khan, Hasan Ali; Mehmood, Khalid; Al Hamdan, Rashed E-mail:drhakj@yahoo.com Al Jahra Hospital - Cardiology Unit - Department of Medicine KMJ - Kuwait Medical Journal 2012; 44 (1): 53-55 (6 ref.) Keywords: Tachycardia, Reciprocating-therapy; Catheter Ablation; Treatment Outcome; Electrocardiography Abstract: Persistent Junctional reciprocating tachycardia [PJRT] is an arrhythmia mostly seen in infants and children, but is reported in the older age group as well. It is an easy diagnosis with [awareness of the mind]. Once confirmed by electro-physiological study, the management is simplified. Radiofrequency ablation of the accessory pathway gives complete cure in almost all cases, especially so, for those with the persistent form. The tachycardia when untreated could induce the so called Tachycardia Induced Cardiomyopathy [TIC] which is reversible. We report the case of a 64- year-old lady with spontaneously relapsing and remitting PJRT which remained undiagnosed. Ultimately, a complete cure was achieved with the help of electro-physiology study and radiofrequency ablation. Temporomandibular Joint Disorders Risk factors for temporomandibular joint ankylosis in different age groups. Khattak, Shahid Khan; Kundi, Jawad Ahmad; Warraich, Riaz Ahmed E-mail:drmskkhattak@gmail.com Gandhara University - Sardar Begum Dental College JKCD - Journal of Khyber College of Dentistry 2011; 2 (1): 9-12 (25 ref.) Keywords: Ankylosis; Temporomandibular Joint-abnormalities; Accidents, Traffic; Otitis Media; Autoimmune Diseases; Risk Factors; Retrospective Studies Abstract: To identify the risk factors responsible for the development of temporomandibular Joint ankylosis. The study was carried out in the Department of Oral and Maxillofacial Surgery at King Edward Medical University, Lahore, Pakistan from April 2005 to April 2009. Two hundred patients with Temporo mandibular Joint Ankylosis were recruited in this study. To identify the risk factors, patients were divided in different groups according to their age so that the most common risk factor was identified amongst these patients. The groups were A. 6 months to 8 years, B. 9-17 years, C. 18-25 years. D>25 years. Risk factors identified were history of fall, road traffic accident, middle ear infection, autoimmune diseases and no obvious history. The highest percentage of the patients belonged to Group B [50%] and history of fall was the main risk factor in the development of Temporomandibular joint ankylosis [72.5%] with p value < 0.05. Trauma is the major factor of Temporomandibular joint ankylosis in all age groups in Pakistan. In this context, we conclude that this complication is a preventable entity if early post traumatic rehabilitation is instituted. Thrombolytic Therapy Effect of thrombolytic therapy on the incidence of early left ventricular infarct expansion in acute anterior myocardial infarction. Al Othman, Abdulkareem A.; Al Tawil, Namir Ghanim E-mail:kareem.abdulkarim@gmail.com IMEMR Current Contents Subject Index 105 Hawler Medical University - College of Medicine - Department of Medicine Oman Medical Journal 2011; 26 (6): 431-435 (22 ref.) Keywords: Fibrinolytic Agents-therapeutic use; Myocardial Infarction; Anterior Wall Myocardial Infarction; Prospective Studies; Tissue Plasminogen Activator-therapeutic use Abstract: To determine the incidence of early left ventricular infarct expansion within five days after first anterior ST- segment elevation myocardial infarction and the effect of early thrombolytic therapy on the incidence of early infarct expansion compared with late thrombolytic therapy. In a prospective study of 101 patients [75males and 26 females], with the first attack of acute anterior myocardial infarction, their ages ranged from 40-80 years [mean age: 61.07 +/- 10.78] who had been admitted to the Coronary Care Unit of Hawler Teaching Hospital for the period from July 2007 through to September 2009. Those who received alteplase </= 3 hours of acute myocardial infarction were labelled as group-I [49 patients] and those who received alteplase >3-12 hours were labelled as group-II [52 patients]. The incidence of early left ventricular infarct expansion was diagnosed by 2D-echocardiography and was found to be 17.8%. Group I patients had a lower incidence of early left ventricular infarct expansion [8.16%] compared with group-II [26.92%; p=0.014]. Patients with early left ventricular infarct expansion had a higher frequency rate of left ventricular systolic dysfunction [94.44%] compared to patients without early left ventricular infarct expansion [8.43%; p<0.001]. There was a significant difference in the incidence of in-hospital mortality between the patients who developed early left ventricular infarct expansion [11.1%] compared with patients without early left ventricular infarct expansion [1.2%; p=0.025]. Early reperfusion therapy in acute anterior myocardial infarction can decrease the incidence of early left ventricular infarct expansion, preserve left ventricular systolic function and decrease in-hospital mortality. Thyroid Neoplasms epidemiology The frequency of malignancy in nodular goiter - a single center study. Anwar, Khurshid; Din, Gulab; Zada, Bakht; Shahabi, Isteraj E-mail:dr.khurshidanwar@yahoo.com Bannu Medical College - Department of ENT JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 96-101 (24 ref.) Keywords: Goiter, Nodular-complications; Carcinoma, Papillary; Goiter, Endemic-surgery Abstract: To find out the frequency of malignancy in nodular goiters. A total of 204 cases were studied in the department of ENT and Head and Neck surgery, Hayatabad Medical Complex, Peshawar. The duration of this descriptive study was from June 1, 2008 to May 31, 2010. After taking informed consent, a detailed history was obtained. Clinical and laboratory investigations were carried out as an aid to diagnosis and determine the patients' fitness for surgery. Patients with nodular goiters were categorized into two categories i.e., Solitary thyroid nodule and multinodular goiter. Surgically resected thyroid specimens were examined histopathologically. The data was analyzed using SPSS 16.0 for windows to determine the frequency of malignancy in nodular goiter. Ages of the patients ranged from 17 to 84 years with a mean age of 37 +/- 12.48 years. The male to female ratio was 1:3:5. 18.14% cases presented as solitary thyroid nodules [STN] and 81.86% as multinodular goiters [MNG]. Out of the total 83.82% cases were benign and 16.18% cases were malignant. The prevalence of malignancy in multinodular goiter was 14.37% and in the solitary thyroid nodules as 24.32%. Papillary carcinoma was the commonest malignancy followed by follicular carcinoma. The prevalence of cancer is significant in nodular goiters and these malignant tumours are usually of the papillary type. Solitary thyroid nodules have more chances of being malignant than multinodular goiter. Tobacco Use Cessation The effects of simulated patient training on senior dental student's confidence and skills in delivering a tobacco cessation counseling program in school of dentistry, Shahid Beheshti university of medical sciences, 2010-2011. Nouri, Z. Tabibzadeh; Atapour, S.; Ebn Ahmady, A. Shahid Beheshti University of Medical Sciences - Dental School - Department of Periodontics Journal of Dental School - Shahid Beheshti University of Medical Sciences 2012; 29 (4): 290-298 (22 ref.) Keywords: Students, Dental; Patient Simulation; Confidentiality; Counseling; School Dentistry; Questionnaires Abstract: Simulated patients are highly effective in the medical education and are potentially useful to present tobacco cessation counseling. Although, some studies have reported the advantages of this method in TCC, different aspects of it did not clarified yet. The present study assessed the effects of training by the standardized patients on the confidence and skills of dental students in Shahid Beheshti Medical Sciences University to provide TCC on 2010-2011. IMEMR Current Contents Subject Index 106 In this controlled non randomized trial, 28 students of semester 11 [controls] and 39 students of semester 12 [cases] were selected and their confidence and skills in providing TCC were determined using a questionnaire. Case students received training by means of standardized patients and TCC was presented according to WHO guidelines of 5A's and 5R's. Finally, confidence and TCC skills of the students were assessed using the same measures. The changes occurred in the confidence and TCC skills of both groups were statistically analyzed using student t and ANCOVA tests. The mean skills scores of the case participants were 5.10 and 13.05 before and after training while the values were 5.14 and 5.25 for the controls. Furthermore, the mean confidence scores were 43.19and 47.13 for the cases with the means of 43.75 and 43.32 for the control participants before and after the training. Significant differences were noted between two groups regarding the increased confidence [p<0.001] and skills scores [p<0.001] while ANCOVA test showed training via standardized patients significantly affected the final confidence and skills of the participants after adjustment for age, gender, marriage status and the primary confidence and skills [both: p<0.001]. According to the results, TCC training via standardized patients improved the dental students' confidence and skills as compared to the control participants. Tooth Injuries Aetiology and pattern of dentoalveolar injuries in patients at armed forces institute of dentistry, Rawalpindi. Janjua, Omer Sefvan; Ahmed, Waseem; Ibrahim, Muhammad Waseem; Luqman, Uzair; Qayyum, Muhammad Umar E-mail:osj1982@hotmail.com Armed Forces Institute of Dentistry PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 405-408 (21 ref.) Keywords: Tooth Avulsion; Tooth Fractures; Cross-Sectional Studies; Surgery, Oral Abstract: To determine the aetiology and pattern of dentoalveolar injuries in patients presenting to oral surgery department of Armed Forces Institute of Dentistry, Rawalpindi. Cross sectional study. Oral Surgery department, Armed Forces Institute of Dentistry, Rawalpindi. September 2008 to August 2009. One hundred and thirty eight consecutive patients presenting to oral surgery department with dentoalveolar injuries irrespective of the age and gender were included in the study. Edentulous patients, patients with only soft tissue injury and patients with other maxillofacial injuries but no dentoalveolar injury were excluded. The included patients were asked about the cause of injury and the pattern of injury was noted clinically. This information was collected on specially designed proformas. All injuries were classified according to Andersean's classification. Out of these 138 patients, 111 [80.4%] were males with a male to female ratio of 4.1:1. The age ranged from 2-65 years with a mean age of 21.22 years. RTA was the most common cause of injury and was seen in 58 [42%] patients. Followed by fall noted in 52 [37.7%] patients. Other causes observed were contact sports in 7 [5.1%], violence in 4 [2.9%] and work place accident in 7 [5.1%] patients. Regarding pattern, the most common type of injury was avulsion and subluxation followed by crown fractures, luxation, root fractures and tooth displacements in various directions. Males especially the young lot was more affected by dentoalveolar trauma. RTA and fall remain the main causes of these injuries in our population. Avulsion, subluxation and luxation were the most common patterns of trauma observed. Maxillary incisors were the most commonly affected teeth in these traumatic episodes. Torque teno virus isolation and purification Prevalence of sen virus infection in hemodialysis and blood diseased patients in Assiut university hospitals. Mohamed, Ismail S.; Thabit, Amany G.; Abd El Rahman, Sherine A.; Abdelmohsen, Essam Eldin; Seif Eldin, Salwa S.; Ghandour, Aliaa M.A. Assiut University - Faculty of Medicine - Department of Medical Microbiology and Immunology Assiut Medical Journal 2011; 35 (1): 175-188 (44 ref.) Keywords: Renal Dialysis-blood; Blood Transfusion; Hematologic Diseases-blood; Hospitals, Teaching; Prevalence; Polymerase Chain Reaction Abstract: SENV is a blood- borne, circular ss DNA virus and possessing nine genotypes [A to I]. Among nine genotypes, SENV-D and SENV-H genotypes have the strong link with patients with non [A-E] hepatitis infections .Recently, the identification of SEN virus [SENV] as a possible etiologic agent of parenteral transmission hepatitis let to the study of the prevalence of such agent. This study compared SENV prevalence and its two important genotypes [D and H] which might be pathogenic in high risk subjects including blood diseased patients and hemodialysis patients and low risk subjects as healthy blood donors. This study included 75 multitransfused patients, 60 of them were IMEMR Current Contents Subject Index 107 hemodialysis and the remaining were blood diseased including hemophilics, anemics and leukemics. The study included also 25 healthy blood donors as a control They were received consecutively at Department of Internal Medicine, Assiut University Hospital. The sera were separated and SENV DNA was detected by polymerase chain reaction. The results showed a higher prevalence of SENV infection in patients group than blood donors [46.7% versus 20%].No significant relation was found between SENV infection and age, duration of hemodialysis or liver enzymes. However, there was significant difference between SENV positive and negative patients as regards gender and number of blood transfusions. SENV is commonly present in blood diseased and hemodialysis patients attended to Assiut University Hospitals as well as in blood donors at variable rates. SENV infection has been found in only 20% of blood donors but in 46.7% of patients. The results also indicated that other possible routes of SENV infection other than blood transfusion may be included. Its pathogenic role in causing hepatitis is not documented, so far it can be considered as simple guest till further studies have been done. Toxocariasis classification Acute cases of toxocariasis classified by IGG antibodies avidity in Venezuela. Delgado, Olinda M.; Bustamante, Jesmary Rosas; Ortegoza, Jaire; Duarte, Elder; Coraspe, Virginia; Rivas, Maria; Silva, Sylvia; Morales, Alfonso J. Rodriguez Faculty of Medicine - Tropical Medicine Institute, Section of Immunoparasitology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 611-614 (14 ref.) Keywords: Acute Disease; Immunoglobulin G-blood; Toxocariasis-diagnosis; Toxocariasis-epidemiology Toxoplasmosis epidemiology RE: Antenatal screening for Toxoplasma gondii infection at a tertiary care hospital in Riyadh, Saudi Arabia. Al Mendalawi, Mahmood D. E-mail:mdalmendalawi@yahoo.com Baghdad University - Al Kindy College of Medicine - Department of Pediatrics and Child Health Annals of Saudi Medicine 2012; 32 (2): 214-215 (2 ref.) Keywords: Prenatal Diagnosis; Mass Screening; Antibodies, Protozoan-blood; Prevalence; Hospitals Reply. Almogren, Adel E-mail:almogren@ksu.edu.sa King Saud University - College of Medicine - Department of Pathology Annals of Saudi Medicine 2012; 32 (2): 215 Keywords: Prevalence; Mass Screening Tracheal Stenosis etiology Tracheal resection and end-to-end anastomosis for tracheal stenosis: etiology and outcome. Ali, Mujahid Zulfiqar; Muzafar, Sultan; Umair, Bilal; Asghar, Asif; Khan, Muhammad Imtiaz; Subhani, Samar; Husnain, Rashid; Hanif, Muhamamd Shoaib E-mail:surgeon.mujahid@gmail.com PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 418-422 (22 ref.) Keywords: Tracheal Stenosis-surgery; Trachea-abnormalities; Trachea-surgery; Anastomosis, Surgical; Prospective Studies; Peak Expiratory Flow Rate; Bronchoscopy; Postoperative Complications; Treatment Outcome Abstract: To know the etiology of tracheal stenosis and asses outcome of tracheal resection and end-to-end anastomosis for tracheal stenosis. Descriptive prospective case series. Department of Thoracic Surgery, Combined IMEMR Current Contents Subject Index 108 Military Hospital, Rawalpindi and Quetta from May 2005 to March 2010. Twenty two patients were included in the study who underwent tracheal resection followed by primary tracheal reconstruction by same surgical team. Etiology was ascertained on the basis of available history and per-operative findings. End-to-end tracheal anastomosis was done using vicryl 3/0. Outcome of surgical technique was assessed using peak expiratory flow rate [PEFR] and flexible bronchoscopy. Twenty two patients were managed over a period of five years, of which 17 [77.3%] were male and 5[22.7%] female. Mean patient age was 27.31 +/- 9.61 years. Seven [31.8%] patients had New York Heart Association grade [NYHA]-III and 15 [68.2%] had NYHA grade-IV dyspnoea. Seventeen [77.3%] had stridor. All patients were already being managed by pulmonologists, ENT specialists or intensivists. Twelve [54.5%] had grade-V stenosis [91- 100% luminal obstruction] and 9 [40.9%] had cervical tracheal stenosis and 3[13.6%] had mediastinal tracheal stenosis. Six [27.3%] patients had partial cricoid resection followed by thyrotracheal anastomosis, 13[59.1%] patients underwent cervical tracheal anastomosis and 3 [13.6%] patients required mediastinal tracheal anastomosis. Patients were followed up post-operatively for the development of immediate and delayed complications. The follow up was carried out for a minimum period of 6 months to a maximum period of 2 years. Postoperative complications included neck pain, lung collapse, and superficial skin infection. Tracheal resection with end-to-end anastomosis is a safe, reliable and permanent procedure for the treatment of tracheal stenosis. Tracheoesophageal Fistula diagnosis Megaesophagus in the pediatric age group: a diagnostic dilemma. Singh, Sunita; Wakhlu, Ashish E-mail:drsunitasingh28@gmail CSMMU [Erstwhile King George's Medical University] - Department of Pediatric Surgery Saudi Journal of Gastroenterology [The] 2012; 18 (2): 151-152 (6 ref.) Keywords: Esophageal Achalasia-diagnosis; Diagnosis, Differential; Bronchoscopy Abstract: A 5-year-old boy weighing 8 kg presented with recurrent pulmonary infections, occasional nonbilious vomiting, intermittent cough, and failure to thrive since birth. On physical examination, vital signs were normal, but on auscultation left-sided fine crackles were found. The child was anemic, other blood biochemistry levels were within the normal range. A chest X-ray and computed tomography [CT] revealed bronchiectasis localized to the left hemithorax and a radiolucent air column within a distended esophagus. Other causes of chronic pulmonary diseases, such as cystic fibrosis, congenital immune deficiencies and primary ciliary dyskinesia were excluded. A barium swallow demonstrated a dilated esophagus with an air-fluid level and sudden narrowing at the distal end [Figure 1]. Esophageal manometry showed uncoordinated, low-amplitude peristalsis of the esophageal body and the lower sphincter pressure was normal. Travel Medicine Emporiatrics: the travellers medicine. Sushma, R.; Nagabhushana, D. E-mail:hisushhere@yahoo.co.in J.S.S University - J.S.S Dental College and Hospital - Department of Public Health Dentistry Iranian Journal of Public Health 2012; 41 (3): 133 (5 ref.) Keywords: Travel Tuberculosis prevention and control Tuberculosis infection control in a high drug-resistance setting in rural South Africa: Information, motivation, and behavioral skills. Kanjee, Z.; Amico, K.R.; Li, F.; Mbolekwa, K.; Moll, A.P.; Friedland, G.H. E-mail:zkanjee@partners.org Yale University - School of Medicine - Office of Student Affairs Journal of Infection and Public Health 2012; 5 (1): 67-81 (37 ref.) IMEMR Current Contents Subject Index 109 Keywords: Tuberculosis, Multidrug-Resistant-prevention and control; Cross Infection-prevention and control; Clinical Competence; Health Knowledge, Attitudes, Practice; Infection Control-statistics and numerical data; Motivation; Questionnaires; Health Personnel; Rural Population Abstract: Tuberculosis [TB] is transmitted in resource-limited facilities where TB infection control [1C] is poorly implemented. Theory-based behavioral models can potentially improve 1C practices. The present study used an anonymous questionnaire to assess healthCare worker [HCW] TB IC information, motivation, and behavioral skills [1MB] implementation in two resource-limited rural South African hospitals with prevalent behavioral skills drug- resistant TB. Between June and August 2010, 198 surveys were completed. Although the respondents demonstrated information proficiency and positive motivation, 22.8% did not consider TB IC to be worthwhile. Most tasks were rated as easy by survey participants, but responding HCWs highlighted challenges in discrete behavioral skills. The majority of responding HCWs reported that they always wore respirators [54.3%], instructed patients on cough hygiene [63.0%], and ensured natural ventilation [67.4%] in high-risk areas. Most respondents [74.0%] knew their HIV status. Social support items correlated with the implementation of the first three aforementioned practices but not with the respondents' knowledge of their HIV status. In most cases, motivation and behavioral skills, but not information, were associated with implementation. therapy Treatment of tuberculosis from past to future. Khan, Muhammad Babar; Iftikhar, Raheel; Iqbal, Zuhaib Military Hospital PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 474-477 (32 ref.) Keywords: Tuberculosis, Multidrug-Resistant-therapy; Extensively Drug-Resistant Tuberculosis-therapy; Mycobacterium tuberculosis; Streptomycin-therapeutic use; Aminosalicylic Acid-therapeutic use; Isoniazid-therapeutic use; Rifampin-therapeutic use; Pyrazinamide-therapeutic use; Oxazolidinones-therapeutic use; Ethambutol-therapeutic use; Fluoroquinolones-therapeutic use; Ofloxacin-therapeutic use; Acquired Immunodeficiency Syndrome Tuberculosis, Multidrug-Resistant Detection of multidrug-resistant tuberculosis using PCR compared to the conventional proportional method. Elhassan, Mogahid M.; Saeed, Samar M.; Elmekki, Miskelyemen A.; Al Jarie, Ahmed A.; Hamid, Mohamed E. E-mail:mogahidelhassan@yahoo.com King Khalid University - Department of Microbiology, Tuberculosis Research Group Bahrain Medical Bulletin 2012; 34 (1): 11-14 (23 ref.) Keywords: Polymerase Chain Reaction; Cross-Sectional Studies; Mycobacterium tuberculosis-genetics; Mycobacterium tuberculosis-drug effects; Microbial Sensitivity Tests; Mutation-genetics Abstract: To evaluate the PCR technique for the rapid defection of Multidrug-Resistant [MDR] Mycobacterium tuberculosis compared to the conventional proportional drug sensitivity testing. Cross sectional laboratory based study. Alshaab Teaching Hospital, Abu-Angah Hospital and the National Health Laboratory, Sudan. One hundred thirty tuberculosis suspected individuals of both sexes and of different ages were included in the study. Sputum samples were cultured on Lowenstein-Jensen [LJ] medium. Resistant strains were tested for the presence of mutations conferring resistance using molecular techniques to amplify 315 base pair [bp] rifampicin [RIF] and 146 bp isoniazid [INH], as markers for MDR among Mycobacterium tuberculosis. One hundred nineteen [91.5%] showed Mycobacterium tuberculosis-like colonies, 65 of which were randomly subjected to PCR and examined for the presence of IS6110 insertion sequences. Fifty-six [86.2%] were confirmed members of the Mycobacterium tuberculosis. The result of antibiotics susceptibility testing revealed that 32/56 [57.1%] of the strains were resistant to RIF, 36/56 [64.3%] to INH and 30/56 [53.6%] were resistant to both drugs [MDR]. The conventional method showed 21/56 [37.5%] were resistant to RIF, 32/56 [57.1%] to INH and 16/56 [28.6%] were resistant to both drugs [MDR]. Not all resistant strains detected by conventional were detected by PCR method; 14 [25%] were missed for RIF, 9 [16.1%] for INH and 4 [7.1%] for both. This represents a significant lack of sensitivity of the PCR technique, which could be due to the presence of other types of mutations that needs other primers and PCR protocol. diagnosis New approaches in the diagnosis and treatment of susceptible, multidrug-resistant and extensively drug resistant tuberculosis. Ahmad, Suhail; Mokaddas, Eiman IMEMR Current Contents Subject Index 110 E-mail:suhail_ah@hsc.edu.kw Kuwait University - Faculty of Medicine - Department of Microbiology KMJ - Kuwait Medical Journal 2012; 44 (1): 3-19 (186 ref.) Keywords: Tuberculosis, Multidrug-Resistant-drug therapy; Extensively Drug Resistant Tuberculosis-diagnosis; Extensively Drug Resistant Tuberculosis-drug therapy; Mycobacterium tuberculosis-drug effects; Extensively Drug Resistant Tuberculosis-epidemiology; Tuberculosis, Multidrug-Resistant-epidemiology Abstract: Tuberculosis [TB] is killing nearly two million people worldwide every year. The current global burden of TB is mainly due to the expanding human immunodeficiency virus infection and its association with active TB disease and increasing resistance of Mycobacterium tuberculosis strains to most-effective [first-line] anti-TB drugs. Incomplete/ improper treatment of TB patients leads to evolution of drug-resistant M. tuberculosis strains as a result of chromosomal mutations in genes encoding drug targets. Sequential accumulation of mutations in target genes generate multidrug-resistant [resistant atleast to rifampin and isoniazid] M. tuberculosis [MDR-TB] and extensively drug-resistant [additionally resistant to fluoroquinolones and an injectable anti-TB agent] M. tuberculosis [XDR-TB] strains. While proper treatment of susceptible TB has > 95% cure rate, effective treatment of MDR-TB is difficult in developing countries as it is heavily dependent on rapid diagnosis, supervised aggressive therapy with several [5 - 6] expensive, toxic and less efficacious drugs for 18 - 24 months and regular monitoring for bacteriological and clinical improvement. Treatment of XDR-TB is far more difficult even in developed countries. Several anti-TB drugs with novel mechanism of action are under clinical development, which may shorten treatment duration of susceptible TB to around three months and also help in effective treatment of MDR-TB / XDR-TB. Turbinates surgery Comparison of submucosal diathermy with partial inferior turbinectomy: a fifty case study. Imad; Javed; Sanaullah E-mail:imad.hameed@yahoo.com Bacha Khan Medical College - Department of ENT JPMI - Journal of Postgraduate Medical Institute 2012; 26 (1): 91-95 (15 ref.) Keywords: Hypertrophy-pathology; Nasal Obstruction-etiology; Otorhinolaryngologic Surgical Procedures-methods Abstract: To compare the results in respect of safety and efficacy of Submucousal diathermy with partial inferior turbinectomy in terms of bleeding, pain, crusting and healing. A prospective comparative study was done at the department of ENT, HMC and Mardan Medical Complex from 01 July 2008 to 31 June 2010. Fifty patients with inferior turbinate hypertrophy were selected by simple convience method and divided into two groups. Group A was subjected to submucosal diathermy and group B to partial inferior turbinectomy. Patients were assessed with regard to nasal patency, pain, bleeding and crusting. Follow up was done at day 01, day 07 and one Month. Out of fifty patients, 28 were females and 22 males. They were in the age range of 20-60 years. At day one assessment 22 patients with SMD had no bleeding while 10 patients with PIT had moderate bleeding [P=0.00]. None of the SMD patients had severe pain while 8 patients with PIT had severe pain [P=0.002]. At day seven 12 patients of SMD had moderate crusting as compared to 21 patients of PIT [P=0.008]. At the end of one month 23 of SMD patients had good healing while only 13 PIT patients were satisfied with healing [P=0.002]. We found Submucousal diathermy a safe and better procedure in respect of bleeding, pain, crusting and healing than partial inferior turbinectomy. Ureter abnormalities Medical quiz. Alhindi, Saeed E-mail:sjalhindi@yahoo.com Arabian Gulf University - Salmaniya Medical Complex Bahrain Medical Bulletin 2012; 34 (1): 36 Keywords: Ureter-ultrasonography; Ureter-anatomy and histology; Hydronephrosis-etiology; Ureter-surgery; Hydronephrosis-surgery IMEMR Current Contents Subject Index 111 Urinary Bladder Neoplasms diagnosis Diagnostic value of urinary CK-20 RNA and VEGF in bladder cancer. Abdel Motaleb, Fayda; Eissa, Sanaa; Tash, Fathy; Al Habori, Molham; Al Eryani, Ekram Fadl E-mail:dr.fayda@hotmail.com Ain Shams University - Faculty of Medicine - Oncology Diagnostic Unit, Medical Biochemistry Department EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 2011; 29 (2): 311-326 (31 ref.) Keywords: Vascular Endothelial Growth Factor A-urine; Keratin-20-urine; Polymerase Chain Reaction-methods; Sensitivity and Specificity; Urine-cytology Abstract: The present study was carried out to evaluate the diagnostic value of urinary cytokeratin 20 [CK-20] RNA and vascular endothelial growth factor [VEGF] in comparison with urine cytology in the detection of bladder cancer. This study included 80 patients with bladder cancer, 20 patients with bilharzial bladder lesions and 20 normal volunteers as control group. CK-20 RNA in urine sediment was detected by reverse transcription polymerase chain reaction [RT-PCR]. VEGF in urine supernatant was detected by ELISA and confirmed by western blotting [WB]. The median value of VEGF and positivity rates of both VEGF and CK-20 in bladder cancer group was significantly higher as compared to benign bladder lesions group and normal control group. There was no significant association between the postivity rates of CK-20 and VEGF with any of the clinicopathological factors except a significant positive association between VEGF positivity and clinical stage. The overall sensitivity, specificity, positive predictive value, negative predictive value were; 66.25%, 92.5%, 94.46%, 57.81% for VEGF, 65.2%, 70%, 80.65%. This article was taken from Ph.D thesis submitted by Ekram Fadl Al-Eryani To: Faculty of Medicine-Ain Shams University. 2005 48.28% for voided urine cytology, and 83.7%, 100%, 100%, 75.47% for CK-20 respectively. Combined sensitivity of cytology, VEGF andCK-20 RNA reached [96.25%] and was higher than the combined sensitivity of cytology and VEGF [90%], or cytology and CK-20 RNA [92.5%], or VEGF and CK-20 [91.25%]. These results indicate that VEGF can be quantitively measured in urine of bladder cancer patients, and its combined use with cytology increases its sensitivity. Uterine Hemorrhage diagnosis Sonographic, hysteroscopic, and pathologic findings in patients with abnormal uterine bleeding. Sayed, Ezzat H.; Darwish, Atef M.M.; Mohammad, Safwat A.; Hasan, Howayda I.; Mohammad, Ibraheem I. Assiut University - Faculty of Medicine - Obstetrics and Gynecology Departement Assiut Medical Journal 2011; 35 (1): 141-152 (37 ref.) Keywords: Ultrasonography-methods; Hysteroscopy-methods; Endometrium-pathology; Prospective Studies Abstract: Abnormal uterine bleeding AUB is the cause of gynecological referral in about 50% of perimenopausal women. The main aim in investigating this condition is to exclude focal, premalignant, or malignant endometrial disease. This is achieved via sonographic, hysteroscopic, and pathologic examinations. To evaluate the sonographic, hysteroscopic, and pathologic findings in women with AUB in a new one stop clinic. Prospective, observational study of 240 premenopausal and 55 postmenopausal consecutive patients with abnormal uterine bleeding. All patients 35 years or more with AUB not related to pregnancy were included. Exclusion criteria included active pelvic infection, severe cardiopulmonary co morbidity, cervical cancer, and initiation of contraception within the last 3 months. All the patients had vaginal sonographic examination, office hysteroscopy, and endometrial biopsy on one stop bases. Diagnostic indices of the different methods. Endometrial biopsy was the gold standard for diagnosing hyperplasia or cancer and combined hysteroscopy and biopsy 'was the gold standard for focal lesion and global endometrial disease. For focal lesion vaginal ultrasound had 42% sensitivity, 87% specificity, 3.2 positive predictive value, and 0.67% negative predictive value. Office hysteroscopy had corresponding figures of 91%, 100%, 91, and 0.09 respectively. Endometrial biopsy had corresponding figures of 17%, 100%, 17, and 0.83 respectively. Office hysteroscopy is the gold standard for diagnosing endometrial focal lesions and combined VUS and EB failed to detect more than 50% of them. This makes that 14% of patients wrongly diagnosed of being free of endometrial focal lesion. So, OH should be included in the initial evaluation of patients with AUB. IMEMR Current Contents Subject Index 112 Vaginal Birth after Cesarean Outcome of vaginal birth after caesarean section in women with one previous section and spontaneous onset of labour. Frass, K.A.; Al Harazi, A.H. E-mail:kaimafrass@hotmail.com University of Sana'a - Faculty of Medicine - Department of Obstetrics and Gynaecology EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 646-650 (12 ref.) Keywords: Pregnancy Outcome; Cesarean Section; Delivery, Obstetric; Prospective Studies; Uterine Rupture; Stillbirth; Apgar Score; Oxytocin Abstract: The data about the safety of vaginal birth after caesarean section are conflicting. This study in a referral hospital in Sana'a, Yemen investigated the outcome of vaginal birth after caesarean section in 357 women who had one prior caesarean section and were admitted to hospital at term with spontaneous onset of labour. A control group [n = 155] was matched from women without previous caesarean section. The success rate of vaginal birth after caesarean section was 311/357 [87.1%]. The mean duration of the first and second stages of labour were not significantly different in the study group [146.2 and 30.7 min respectively] compared with the control group [146.7 and 29.8 min]. There were infrequent complications; only 1 woman [0.3%] had ruptured uterus and 3 women [1.0%] suffered uterine dehiscence. There was 1 stillbirth after the uterine rupture but no maternal deaths. Vaginal Discharge microbiology The microbiology of vaginal discharge and the prevalence of bacterial vaginosis in a cohort of non-pregnant women in Kuwait. Saleh, Amal A.M.; Altooky, Mohammad H.; Elkady, Adel A.; Azab, Hamdy S.; Elaaser, Elsayed M. South Ardyia Clinic KMJ - Kuwait Medical Journal 2012; 44 (1): 20-25 (35 ref.) Keywords: Vaginosis, Bacterial-epidemiology; Prevalence; Retrospective Studies; Sexually Transmitted Diseases; Gardnerella vaginalis Abstract: To examine the microbiology of vaginal discharge and to estimate the prevalence of bacterial vaginosis and its association with sexually transmitted infections in a cohort of non-pregnant women in Kuwait. Retrospective study conducted during a six-month period [November 2009 - April 2010]. The gynecology outpatient clinic at the South Ardyia Health Unit, Farwania, Kuwait. Retrospective evaluation of medical records of 668 women, who attended the gynecology outpatient clinic at the South Ardyia Clinic, Farwania, Kuwait complaining of vaginal discharge during the study period. Retrospective review of the files for complaints, history, clinical examination and investigations of the vaginal discharge. A retrospective microbiological study of the infective etiology of vaginal discharge, the prevalence of bacterial vaginosis and its association with sexually transmitted infections. Microbiological causes of vaginal discharge accounted for 43.4% of cases. The commonest causes were bacterial vaginosis [prevalence = 18.9%] and candida infections [prevalence = 11.8%]. There was no significant association of bacterial vaginosis and sexually transmitted infections. Bacterial vaginosis is the commonest microbiological cause of vaginal discharge. Bacterial vaginosis is not a sexually transmitted disease. Vibrio cholerae pathogenicity Two cases of vibrio cholera non-O1/non-O139 septicaemia with favourable outcome in Lebanon. Feghali, R.; Adib, S.M. E-mail:refeghali@ul.edu.tb Rafik Hariri University Hospital - Department of Laboratory Medicine EMHJ - Eastern Mediterranean Health Journal 2011; 17 (8): 722-724 (19 ref.) Keywords: Vibrio cholerae non-O1-pathogenicity; Cholera-diagnosis; Sepsis-microbiology; Cholera-microbiology; Prognosis IMEMR Current Contents Subject Index 113 Waste Management methods The status of solid waste management in Gaza city and the dustmen' views: an environmental study. Hemdan, Sabry Mohamed Assiut University Bulletin for Environmental Researches 2011; 14 (2): 15-30 (28 ref.) Keywords: Waste Management-standards; Refuse Disposal-methods; Questionnaires Abstract: This study investigates the dustmen's opinion about collecting and moving of solid waste into the dump, the problems of waste management, and how to improve work in Gaza city and Al-Shati' Refugee Camp. So, a questionnaire of 87 open ended and non open ended items was designed and distributed among 230 dustmen in the summer of 2007. Results revealed that most of the residents put their waste in simple plastic bags which are always found torn out due to kids, rodents, dogs, and rubbish diggers. Therefore, dustmen prefer special plastic bags. In addition, results revealed that the municipality collects the waste found in front of houses for nearly 70% of Gaza population twice a day to once every two days, and that there are two methods of collecting and moving waste into the dump: collecting from house to house, and collecting from garbage containers. Sometimes the two methods go together; however, the first is preferable. Furthermore, the study pointed out some problems that hinder the work of management because of workers, municipality, residents and waste containers. Moreover, results showed that workers refused privatizing the system of collecting the waste. Finally, the study recommends collecting waste from house to house as well as changing the existing methods into a new proposed one. Wegener Granulomatosis Rhinological manifestations of Wegener's granulomatosis in Pakistani patients. Abdul Raheem; Ahmad, Shakeel E-mail:rahimsalak@hotmail.com Combined Military Hospital Okara Cantt PAFMJ - Pakistan Armed Forces Medical Journal 2011; 61 (3): 401-404 (14 ref.) Keywords: Antibodies, Antineutrophil Cytoplasmic; Epistaxis; Nasal Obstruction; Olfaction Disorders; Nasal Septal Perforation; Otitis Media, Suppurative; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Abstract: To assess the rhinological manifestations in Pakistani patients and early diagnosis of Wegener's Granulomatosis. Case Series. This study was conducted at ENT Department of CMH Rawalpindi in collaboration with Rheumatology Department of Military Hospital Rawalpindi, Pakistan Institute of Medical Sciences Islamabad and Fauji Foundation Hospital from March 2005 to January 2009. In this study 20 adult patients reporting to these hospitals were included according to inclusion criteria. All were c-ANCA positive. Both males and female were included. The condition was more common in males than females 3:2]. All the patients were followed regularly and c-ANCA titres were used to monitor disease activity in these patients. The age range at presentation was between 20 to 65 years. Rhinological features were present in 16 [80%] of our patients. These patients presented with the symptoms of epistaxis, nasal discharge, nasal obstruction, postnasal drip, anosmia and septal perforation. There [15%] patients had chronic supporative otitis media. They were initially treated by ENT specialists and an alternative diagnosis was suspected only when they failed to respond to conventional treatment or developed other complaints like haemoptysis, and renal impairment. Nasal biopsy was done in 7 patients. It showed necrotizing vasculitis with evidence of granuloma formation in 4 cases while the rest of cases showed chronic non specific inflammation. Evaluation of rhinological features have significant role in the early diagnosis of Wegener's Granulomatosis. Wind Mineralogical composition of khamasin wind dust at Assiut, Eygpt. Farragallah, Mohamed El Ameen A.; Essa, Mahmoud A. Al Azhar University - Faculty of Agric. - Soil and water Sic. Department Assiut University Bulletin for Environmental Researches 2011; 14 (2): 95-108 (33 ref.) Keywords: Dust-analysis; Minerals-chemistry; Electron Microscopy, Scanning Abstract: The present study investigated the mineralogical composition of the deposited dust from Khamasin wind on the agricultural soils at Assiut city through April 2008 and 2009. Five sites were chosen between the fringes of eastern and western deserts throughout the Nile valley. Wood boxes [dimensions of 1xlm] were put in the selected IMEMR Current Contents Subject Index 114 sites and precipitated dust was collected from each box after the finish of Khamasin storms in the two years. The quantity, pH and EC were determined for the collected Khamasin dust. The mineral particles of these dusts were examined by the scanning electron microscope [SEM] and the X-ray analysis. The obtained results revealed some variation in the dust quantity of Khamasin wind in the year of 2008 and 2009. The quantity of the collected bulk samples of the Khamasin dust varied from site to another in both 2008 and 2009 years. The highest amounts in both years are recorded in the sites of the eastern side of the Nile valley that faraway from the western desert where the Khamasin wind come. The mean values of dust EC and pH were low and similar in both years of 2008 and 2009. The Scanning electron microscope photomicrographs showed that the grain sizes of Khamasin dust in the sites located in the interference zone of Nile valley with the eastern desert were finer than those in site located in the western side of the Nile river. Generally, relatively large angular to subangular grains, larger amount of very Fine grains with more oblate particle and spherical particles with differences in size as well as particles with irregular shapes in Khamasin dust of 2008 and 2009 years. Semi-quantitative measurements of the identified minerals in the Khamasin dust of 2008 year have shown the order of quartz >k-feldspar>calcite> magnetite >epidote> anhydrite > garnet > augite> tourmaline > zircon > ilmenite > plagioclase > goethite > actinolite > hematite. However, the minerals in the Khamasin dust of 2009 year could be ordered as quartz >k-feldspar>calcite> epidote> magnetite > tourmaline > anhydrite > augite > plagioclase >Imenite>rutile> hematite > garnet >actinolite. There was no general trend for distribution of these minerals throughout the studied sites. From a qualitative point of view, most of the sites have the same mineralogical composition. Comparison of the mineralogical compositions of mineral dusts at the five sites, revealed certain quantitative differences. Wounds and Injuries epidemiology Non-intentional injuries in adolescents and youth: facts and figures. Sarhan, Nayara Ali E-mail:Nayara.sarhan@gmail.com Ministry of Health Bahrain Medical Bulletin 2012; 34 (1): 37-40 (28 ref.) Keywords: Wounds and Injuries-mortality; Risk-Taking; Accidents, Traffic; Sex Distribution; Drowning; Violence Zoonosis transmission Corvus R. ruficollis [desert or brown necked raven]: a reservoir host for zoonotic parasites in Egypt. Khalil, Mona F.; Shoukry, Nahla M.; Morsy, Tosson A. Helwan University - Faculty of Science - Department of Zoology and Entomology Journal of the Egyptian Society of Parasitology 2011; 41 (3): 753-764 (39 ref.) Keywords: Disease Reservoirs-parasitology; Crow5-parasitology; Intestinal Diseases, parasitic; Feces-parasitology Abstract: Egypt includes many desert and rural areas. The small uptown fertile areas are placed under illegal enormous pressure of existing resources, where intensive agricultural practices are performed, in combination with high population densities. The brown necked ravens [Corvus ruficollis] are attracted in huge numbers to such areas. The birds are omnivorous, very aggressive pest and seriously affect human welfare. The study focused on zoonotic role of ravens. Appendix I Author Index

IMEMR Current Contents Author Index 117 Aamir, Azizul Hasan DIABETIC RETINOPATHY (epidemiology) Abassi, Roya GRANULOCYTE COLONY-STIMULATING FACTOR (therapeutic use) Abbas, Osama Ahmed SILVER COMPOUNDS (chemical synthesis) Abbas, Syed Hussain POLIOMYELITIS (prevention and control) Abbasi, S.H. CORONARY ARTERY DISEASE (etiology) Abd El Rahman, Sherine A. TORQUE TENO VIRUS (isolation and purification) Abd Elnaeem, Ahmed SILVER COMPOUNDS (chemical synthesis) Abdalla, Ahlam M. DIABETES MELLITUS, EXPERIMENTAL (drug therapy) Abdallah, Esam Eldin M. CORONARY ARTERY BYPASS (utilization) Abdallah, Khalid CARCINOMA, HEPATOCELLULAR (diagnosis) Abdallah, Tajeldin M. AIDS SERODIAGNOSIS (statistics and numerical data) Abdel Latif, Nahla A. Bahgat INFANT, NEWBORN (growth and development) DIABETES MELLITUS, TYPE 1 (Blood) Abdel Maaboud, Ragaa M. PHENYLENEDIAMINES (poisoning) Abdel Monem, Ahmed M.A. RENEWABLE ENERGY Abdel Motaleb, Fayda URINARY BLADDER NEOPLASMS (diagnosis) Abdel Rahem, Mohamed G. CRANIOCEREBRAL TRAUMA Abdel Rahman, Khaled A. MYOCARDIAL REPERFUSION INJURY (drug therapy) Abdelmohsen, Essam Eldin TORQUE TENO VIRUS (isolation and purification) Abdelwahab, Magy S. HEPATITIS C (epidemiology) Abdo, Ayman A. CARCINOMA, HEPATOCELLULAR (diagnosis) Abdolazimi, Z. PYRAZOLES Abdollahi, A.A. ABO BLOOD-GROUP SYSTEM Abo Elfetoh, Noha M. DIABETES MELLITUS, TYPE 2 (complications) DIABETES MELLITUS, TYPE 2 (drug therapy) Abo Ghalia, A.H. PHLEBETOMUS (parasitology) Abo Safi, Ahamad PERSONAL SATISFACTION Abou Elew, Heba H. HEPATITIS C (epidemiology) Abraham, Rtika R. ENTEROCOLITIS, PSEUDOMEMBRANOUS (complications) Abroun, S. LEUKEMIA, PROMYELOCYTIC, ACUTE (genetics) Abu Elwafa, Zeinab M. CRANIOCEREBRAL TRAUMA Abu Noor, Tarek ARTHROPLASTY, REPLACEMENT, HIP Abu Taleb, Hoda M. SNAILS (classification) Abuldahb, Faten Farid JUVENILE HORMONES (adverse effects) Adam, Ishag AIDS SERODIAGNOSIS (statistics and Ahmad, Nadeem GUILLAIN-BARRE SYNDROME Ahmad, Naseer FOREIGN BODIES (radiography) Ahmad, Shakeel WEGENER GRANULOMATOSIS Ahmad, Suhail TUBERCULOSIS, MULTIDRUG-RESISTANT (diagnosis) Ahmad, Tanzeel HEALTH PROMOTION (history) Ahmadvand, M. MESENCHYMAL STEM CELLS Ahmed, Gamal I. PRESBYCUSIS (genetics) Ahmed, Hatem A.M. PHENYLENEDIAMINES (poisoning) Ahmed, Mahgoub M. CYCLOPHOSPHAMIDE (toxicity) Ahmed, Masood FETOMATERNAL TRANSFUSION IMEMR Current Contents Author Index 118 Ahmed, Mohamed A. AMYOTROPHIC LATERAL SCLEROSIS Ahmed, Moustafa Mohamed CHICKENS JAW NEOPLASMS (etiology) Ahuizi, Eke Reginald LEPROSY (rehabilitation) Akelma, Zalfikar FAMILIAL MEDITERRANEAN FEVER (diagnosis) Akhtar, Shamim SCURVY Akhter, Shamim POLYHYDRAMNIOS Akrayi, Hero F.S. LEPIDIUM SATIVUM Al Abri, Ahmed RHINITIS, VASOMOTOR (epidemiology) Al Abri, Rashid RHINITIS, VASOMOTOR (epidemiology) Al Alsuhaibani, Hamad CARCINOMA, HEPATOCELLULAR (diagnosis) Al Ansari, Ahmed ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY (therapy) Al Arrayed, Shaikha BETA-THALASSEMIA Al Awa, Bahjat ACCREDITATION Al Hadad, Zainab GANGLIONEUROMA (diagnosis) Al Hajeri, Amani BETA-THALASSEMIA Al Hamdan, Rashed TACHYCARDIA, RECIPROCATING (diagnosis) Al Hammadi, Adhoob Abdul Aziz GANGLIONEUROMA (diagnosis) Al Harazi, A.H. VAGINAL BIRTH AFTER CESAREAN Al Harthi, Saeed A. DRUG RESISTANCE (physiology) Al Herbish, Abdullah S. OVERWEIGHT (epidemiology) Al Hubail, M. ACINETOBACTER INFECTIONS (drug therapy) Al Hujaily, Ahmed S. MYOEPITHELIOMA (pathology) Al Hussaini, Abdulrahman OCTREOTIDE (therapeutic use) Al Jarie, Ahmed A. TUBERCULOSIS, MULTIDRUG-RESISTANT Al Judaibi, Bandar ADRENAL CORTEX NEOPLASMS (pathology) Al Merri, Khaled BEHCET SYNDROME (diagnosis) Al Muaikeel, Mohammad CARCINOMA, HEPATOCELLULAR (diagnosis) Al Mukhaini, Mohammed STROKE (diagnosis) Al Mulhim, A. Abdul Mohsen INTESTINAL OBSTRUCTION (therapy) Al Mulla, Ahmed DIABETIC FOOT (microbiology) Al Mutairi, Mohammad BEHCET SYNDROME (diagnosis) Al Nassar, Muath BOTULISM Al Noury, Khaled ACCREDITATION Al Olayan, Ashwaq CARCINOMA, HEPATOCELLULAR (diagnosis) Al Omar, Ahmad A. OVERWEIGHT (epidemiology) Al Omari, Wameedh R.S. OSTEOARTHRITIS, KNEE Al Othman, Abdulkareem A. THROMBOLYTIC THERAPY Al Sweih, N.A. ACINETOBACTER INFECTIONS (drug therapy) Al Tarawneh, Falah PERSONAL SATISFACTION Al Tawfiq, Jaffar A. CATHETERIZATION, PERIPHERAL (adverse effects) Al Tawil, Namir Ghanim THROMBOLYTIC THERAPY Al Wadani, Hamid INTESTINAL OBSTRUCTION (therapy) Al Zahrani, Hind A.A. BACILLUS THURINGIENSIS (isolation and purification) Ala, F. FACTOR XIIIA (genetics) Alamgir, Waseem DYSLIPIDEMIAS (epidemiology) Alaqeel, Faten O. INTESTINAL OBSTRUCTION (therapy) IMEMR Current Contents Author Index 119 Alavian, S.M. HEPATITIS B SURFACE ANTIGENS (genetics) Aldekhail, Wajeeh COLLAGEN DISEASES (pathology) Ale Taha N. DENTAL CASTING TECHNIQUE Ali, Marwa HEAD AND NECK NEOPLASMS (virology) Ali, Mujahid Zulfiqar TRACHEAL STENOSIS (etiology) Ali, Qazi Ehsan ANESTHESIA, SPINAL (methods) Ali, Syed Khawar DYSLIPIDEMIAS (epidemiology) Ali, Zafar STRUMA OVARII (diagnosis) ALJumah, AbdulRahman CARCINOMA, HEPATOCELLULAR (diagnosis) Alkindi, Salam CATHETERIZATION, CENTRAL VENOUS (adverse effects) Almas, Khalid OSTEOPOROSIS Almaz, Mohamed G. CRANIOCEREBRAL TRAUMA Almogren, Adel TOXOPLASMOSIS (epidemiology) Almoollim, H. COMPETENCY-BASED EDUCATION Alreheili, Khalid COLLAGEN DISEASES (pathology) Amin, Meyzgan MALOCCLUSION, ANGLE CLASS III Amin, Said SKIN DISEASES (epidemiology) Amir, A.A. CONSTIPATION (etiology) Amiri, B. CHRONIC DISEASE (epidemiology) Amirizadeh, N. MESENCHYMAL STEM CELLS (genetics) CELL DIFFERENTIATION (genetics) Amr, A.A. INFLUENZA, HUMAN (complications) Andersen, Ross E. PRESSURE ULCER (therapy) Ang, W. GEOLOGIC SEDIMENTS (analysis) Anjum, Raheel ANTIBIOTIC PROPHYLAXIS Anwar, Jaleel BLOOD COAGULATION DISORDERS (epidemiology) Anwar, Khurshid THYROID NEOPLASMS (epidemiology) Ashki, M. CELL DIFFERENTIATION (genetics) Ashoor, Abdul Aziz NASAL OBSTRUCTION (surgery) Asif, Mohammad CARCINOMA, BASAL CELL (diagnosis) Asiri, Mohammed Medawi ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY (therapy) Asokan, G.V. OSTEOARTHRITIS Ataei, B. HEPATITIS B SURFACE ANTIGENS (genetics) Atapour, S. TOBACCO USE CESSATION Athar, U. HIV INFECTIONS (epidemiology) Atia, Alaa M.A. CRANIOCEREBRAL TRAUMA Atif, Muhammad IMMUNOGLOBULINS, INTRAVENOUS (therapeutic use) Atique, Mohammad CARCINOMA, BASAL CELL (diagnosis) Atmatzidis, Stefanos PANNICULITIS, PERITONEAL (drug therapy) Azeem, Zahra EDUCATION, MEDICAL, GRADUATE Azhar, Tahmina PRENATAL DIAGNOSIS Aziz, Sohail STREPTOKINASE (therapeutic use) Babar, Nabeela Fazal ALUMINUM COMPOUNDS (poisoning) Babatin, Mohammad CARCINOMA, HEPATOCELLULAR (diagnosis) Badary, Mohamed S. RESPIRATORY TRACT INFECTIONS (virology) Badawi, K. MOTOR ACTIVITY IMEMR Current Contents Author Index 120 Badiee, M.R. PYRAZOLES Bahgat, M.M. SETARIA NEMATODE (immunology) Bakhshi, M. BLOOD COAGULATION TESTS Bakhtiari, R. STREPTOCOCCUS AGALACTIAE (isolation and purification) Bakir, Amal S.M. COLORECTAL NEOPLASMS (complications) Bazarbashi, Shouki CARCINOMA, HEPATOCELLULAR (diagnosis) Beissner, Robert S. LYMPHOMA (diagnosis) Beltsis, Athanasios PANNICULITIS, PERITONEAL (drug therapy) Bernard, D. Minbay HEALTH EXPENDITURES Berrettini, Stefano PRESBYCUSIS (genetics) Bhandari, Shyam ANESTHESIA, SPINAL (methods) Bhargava, Deepa RHINITIS, VASOMOTOR (epidemiology) Bhargava, Kamlesh RHINITIS, VASOMOTOR (epidemiology) Bhatti, Muhammad Riaz EDUCATION, MEDICAL, GRADUATE Bilal, Mohammad CLEFT PALATE Binawara, Bijendra Kumar EXERCISE Biswal, Niranjan SCRUB TYPHUS (complications) Cakir, Evrim IODINE (urine) Calisici, Erhan MEDIASTINAL EMPHYSEMA (diagnosis) Canpolat Fuat E. MEDIASTINAL EMPHYSEMA (diagnosis) Chande, Nilesh GASTROSTOMY (methods) Chandra, Naveen RHABDOMYOSARCOMA (diagnosis) Chao, Wen Chii OBESITY (genetics) Charsoula, Anna PANNICULITIS, PERITONEAL (drug therapy) Chatzimavroudis, Grigoris PANNICULITIS, PERITONEAL (drug therapy) Chen, Ke Chang OBESITY (genetics) Cheng, Q. GEOLOGIC SEDIMENTS (analysis) Chi, Su Sheng OBESITY (genetics) Choudhary, Sunita EXERCISE Darwish, A.B. PHLEBETOMUS (parasitology) Darwish, Atef M.M. UTERINE HEMORRHAGE (diagnosis) Davarpanah, M.A. ANTIBIOTIC PROPHYLAXIS Dawoud, Gouda T.M. PLANTS, MEDICINAL (chemistry) De Lean, A Ponce CORONARY ARTERY DISEASE (etiology) Delgado, Olinda M. TOXOCARIASIS (classification) Delhikumar, C.G. SCRUB TYPHUS (complications) DeMarco, Sharon L. PRESSURE ULCER (therapy) Deshpande, Smita N. DISABILITY EVALUATION Desouky, S.A. SCENEDESMUS (growth and development) Devaangam, Sheshadri Shekar AMANTADINE (therapeutic use) Devreux, Isabelle ACCREDITATION Ebadifar, A. ORTHODONTIC WIRES Ebn Ahmady, A. TOBACCO USE CESSATION Eftekhar, F. BETA-LACTAMASES (isolation and purification) Eissa, Sanaa URINARY BLADDER NEOPLASMS (diagnosis) El Asmer, M. Farid COBRA CARDIOTOXIN PROTEINS (isolation and purification) IMEMR Current Contents Author Index 121 El Attar, Amal M. PRESBYCUSIS (genetics) El Badawy, Reda M. HEPATITIS C, CHRONIC (complications) El Bahnasawy, Mamdouh M. ECHINOCOCCOSIS (diagnosis) ANOPHELES (parasitology) DENSOVIRINAE (pathsogenicity) El Barbary, Taher Mostafa OVARIAN NEOPLASMS (surgery) El Batch, Manal BREAST NEOPLASMS (immunology) El Baz, Mona A. DIABETES MELLITUS, TYPE 2 (complications ) DIABETES MELLITUS, TYPE 2 (drug therapy) El Halaby, Alaa F. INFANT, NEWBORN (growth and development) El Hati, Taghreed ACCREDITATION El Hayek, Muhammad LIVER NEOPLASMS (therapy) El Hela, Atef A. PLANTS, MEDICINAL (chemistry) El Henawy, Ahmed HEPATITIS C, CHRONIC (complications) El Kady, Nabeel ECHINOCOCCOSIS (diagnosis) El Kharashi, Omnyah Ali STOMACH ULCER (drug therapy) El Khawaga, G. MOTOR ACTIVITY El Khayat, Hanaa M.M. SNAILS (classification) FRESH WATER (chemistry) El Mouzan, Mohammad I. OVERWEIGHT (epidemiology) El Raziky, Nona S. HEPATITIS C (epidemiology) El Said Kalil M Elhaish, Mahmoud Khairy CORONARY ARTERY BYPASS (utilization) Elhassan, Mogahid M. TUBERCULOSIS, MULTIDRUG-RESISTANT Elkady, Adel A. VAGINAL DISCHARGE (microbiology) Ellithy, Mahmoud A. COLORECTAL NEOPLASMS (complications) Elmekki, Miskelyemen A. TUBERCULOSIS, MULTIDRUG-RESISTANT Elnour, Abdelsalam IODINE (urine) Eloubeidi, Mohamad A. PANCREATIC NEOPLASMS (diagnosis) Elsebae, M.A. SPLENECTOMY (adverse effects) Elsebae, Magdey Mohamed CHOLECYSTECTOMY, LAPAROSCOPIC Elsebaie, S.B. SPLENECTOMY (adverse effects) Emam, Manal A. ASPARAGINASE (isolation and purification) Embarek, Mona S. RESPIRATORY TRACT INFECTIONS (virology ) Faheem, Fouzia LEVONORGESTREL (therapeutic use) Faori, I. SURGICAL PROCEDURES, ELECTIVE Faragallah, Mohamed El Ameen Abd El Kareem SOIL (analysis) Fard, A. Dehghani MESENCHYMAL STEM CELLS Farnaz CA-125 ANTIGEN (blood) Farooq, Saeed ANXIETY (epidemiology) Farooq, Yasir MITRAL VALVE PROLAPSE Farouk, Gihan BREAST NEOPLASMS (immunology) Farouk, Osama PELVIS (injuries) Farragallah, Mohamed El Ameen A. WIND Fasoulas, Kostas PANNICULITIS, PERITONEAL (drug therapy) Fawzy, Manal S. DIABETES MELLITUS, TYPE 1 (genetics) Gabr, Hanan Sobhy Mohamed ARGASIDAE (classification) Gad, A.M. SETARIA NEMATODE (immunology) Gao, Shang feng CANCER VACCINES (immunology) IMEMR Current Contents Author Index 122 Gauba, Deepak DISABILITY EVALUATION Gaygisiz, Esma HEALTH BEHAVIOR (psychology) Gaygisiz, Ummugulsum HEALTH BEHAVIOR (psychology) George, Sara Mathew GANGLIONEUROMA (diagnosis) Ghamari, S. HEPATITIS B SURFACE ANTIGENS (genetics) Ghandour, Aliaa M.A. TORQUE TENO VIRUS (isolation and purification) Ghani, Fazal MAXILLARY NEOPLASMS (epidemiology) Gharehbaghian, A. MESENCHYMAL STEM CELLS (genetics) Ghavamzadeh, A. LEUKEMIA PROMYELOCYTIC ACUTE Greenough III, William B. PRESSURE ULCER (therapy) Greenough, William B. FLUID THERAPY Gregor, Jamie GASTROSTOMY (methods) Gu, Tianxiang CORONARY ARTERY BYPASS (methods) Gul, Adnan Mahmood ANGINA PECTORIS (therapy) Gul, Riaz MALNUTRITION (epidemiology) Gupta, Pankaj ARTERIOVENOUS MALFORMATIONS Gwarzo, M.Y. NEUROBLASTOMA (enzymology) Habib, hamed ACCREDITATION Habibzadeh, S. DENTAL IMPLANT-ABUTMENT DESIGN Hafizullah, Mohammad ANGINA PECTORIS (therapy) Haider, Imran Ijaz EDUCATION, MEDICAL, GRADUATE Hanif, Muhamamd Shoaib TRACHEAL STENOSIS (etiology) Hanif, Muhammad Shoaib SOMATOSENSORY DISORDERS Harder, Jan PANCREATIC NEOPLASMS (surgery) Harrison, John ATTITUDE OF HEALTH PERSONNEL Hasan, Howayda I. UTERINE HEMORRHAGE (diagnosis) Hasan, Rumina DENGUE (epidemiology) Hashemi, S.M. PYRAZOLES Hashim, Rizwan IMMUNOGLOBULINS, INTRAVENOUS (therapeutic use) Hasnain, Muhammad Ali Zul JAW NEOPLASMS (etiology) Hassan, A.M. Abdelaziz SPLENECTOMY (adverse effects) Hassan, Ahmed Mohamed Abdel Aziz CHOLECYSTECTOMY, LAPAROSCOPIC Hassan, Khairi Ahmed INTESTINAL OBSTRUCTION (therapy) Helmy, Hussein HEAD AND NECK NEOPLASMS (virology) Hemdan, Sabry Mohamed WASTE MANAGEMENT (methods) Hildebrand, Phillip JEJUNAL DISEASES (complications) Hoffmann, Martin JEJUNAL DISEASES (complications) Hosseinpour, L. ARTHRODERMATACEAE (isolation and purification) Houshmand, M. SANDHOFF DISEASE (genetics) Hubail, Amal R. OBESITY (epidemiology) Husnain, Rashid TRACHEAL STENOSIS (etiology) Hussain, Capt Sameed ENDOMETRIOSIS (diagnosis) Hussain, Chiragh ANGINA PECTORIS (therapy) Hussain, Muna S. Hussain Abdullah OSTEOARTHRITIS Hussain, Raja Mushtaq IMMUNOGLOBULINS, INTRAVENOUS (THERAPEUTIC USE ) IMEMR Current Contents Author Index 123 Iheanocho, Okereke Chukwunenye LEPROSY (rehabilitation) Imad TURBINATES (surgery) Imam, Amjad EDUCATION, MEDICAL, UNDERGRADUATE (history) Imam, Hashmat HEALTH PROMOTION (history) Imran, M. HIV INFECTIONS (epidemiology) Imran, Nazish EDUCATION, MEDICAL, GRADUATE Iqbal, Azhar IMMUNOGLOBULINS, INTRAVENOUS (therapeutic use) Iqbal, Tahir CORONARY ANGIOGRAPHY (methods) PULMONARY EMBOLISM (diagnosis) Iqbal, Zamir PTERYGIUM (prevention and control) Iqbal, Zuhaib TUBERCULOSIS (therapy) EPSTEIN-BARR VIRUS INFECTIONS Jacques, Didier CATHETER-RALATED INFECTIONS (prevention and control) Jafery, Nusrat MALARIA (prevention and control) Jalalian, E. DENTAL CASTING TECHNIQUE Jalalian, S.H. DENTAL CASTING TECHNIQUE Jalalizand, N. ARTHRODERMATACEAE (isolation and purification) Jalili, M.A. CELL DIFFERENTIATION (genetics) Jameel, Abid LEUKEMIA, MYELOGENOUS, CHRONIC, BCR-ABL POSITIVE (genetics) Jamil, Altaf LIVER NEOPLASMS (therapy) Jan, Sanaullah DIABETIC RETINOPATHY (epidemiology) Janjua, Omer Sefvan TOOTH INJURIES Janjua, Sarfraz Khan IMMUNOGLOBULINS, INTRAVENOUS (therapeutic use) Judaki, M.A. HEPATITIS B SURFACE ANTIGENS (genetics) Kabbani, Monther CARCINOMA, HEPATOCELLULAR (diagnosis) Kaddah, Normine A. HEPATITIS C (epidemiology) Kamal, Heba CARBON TETRACHLORIDE (toxicity) Kamal, Ibrahim AZATHIOPRINE (toxicity) CARBON TETRACHLORIDE (toxicity) Kamran, Shawana BLOOD COAGULATION DISORDERS (epidemiology) Kanjee, Z. TUBERCULOSIS (prevention and control) Kaoud, Sayed CORONARY ARTERY BYPASS (utilization) Karimi, A.A. CORONARY ARTERY DISEASE (etiology) Karimi, Ali ESCHERICHIA COLI INFECTIONS (diagnosis) Karimi, Mohammad HEPATITIS B VACCINES Keck, Tobias PANCREATIC NEOPLASMS (surgery) Keshta, Amr E. DALBERGIA (anatomy and histology) Khadem, Zahra K.A. OSTEOARTHRITIS Khader, Y.A. SURGICAL PROCEDURES, ELECTIVE Khajeh Noori, B. LEPTIN (blood) Khalifa, Yaser Emam PELVIS (injuries) Khalil, Hazem H.M. DENSOVIRINAE (pathsogenicity) Khalil, Mona F. ANOPHELES (parasitology) ZOONOSIS (transmission) Khan, Ali Akhtar JAW NEOPLASMS (etiology) Khan, Amanat FRACTURES, UNUNITED (etiology) Khan, Ayasha POLIOMYELITIS (prevention and control) IMEMR Current Contents Author Index 124 Khan, Dilshad Ahmed CORONARY ARTERY DISEASE Khan, Muhammad Babar ALUMINUM COMPOUNDS (poisoning) GUILLAIN-BARRE SYNDROME ASTHMA TUBERCULOSIS (therapy) EPSTEIN-BARR VIRUS INFECTIONS Khan, Muhammad Imtiaz TRACHEAL STENOSIS (etiology) Khan, Muhammad Ismail HEPATITIS B (epidemiology) Khan, Muhammad Khalid Azam DEXAMETHASONE (therapeutic use) Khan, Muhammad Qaiser PULMONARY EMBOLISM (diagnosis) Khan, Muhammad Usman POLIOMYELITIS (prevention and control) Khan, Muhammad Zia Ul Islam POLIOMYELITIS (prevention and control) Khan, Muslim HEMANGIOMA Khan, Muzaffar JAW NEOPLASMS (etiology) Khan, Qaisar FOREIGN BODIES (radiography) Khodaei, Hossain ABORTION, HABITUAL Khoddami, Esmaeil HEPATITIS B VACCINES Khursheed, Atika SPERMATOGENESIS (drug effects) Khurshid, Khawar SKIN DISEASES (epidemiology) Kiani, A.A. MESENCHYMAL STEM CELLS (genetics) Kiramat, Aamir MALNUTRITION (epidemiology) Kiyani, Khalid Amjad DIABETIC FOOT Kleemann, Markus JEJUNAL DISEASES (complications) Krishnamurthy, Sriram SCRUB TYPHUS (complications) Kumar, Ashok AMANTADINE (therapeutic use) Kumar, K.Eswar AMANTADINE (therapeutic use) Kumar, Manish SCRUB TYPHUS (complications) Li, H. CRANIOFACIAL ABNORMALITIES (epidemiology) Li, Qi ling CANCER VACCINES (immunology) Li, Xd CRANIOFACIAL ABNORMALITIES (epidemiology) Lin, Jj CRANIOFACIAL ABNORMALITIES (epidemiology) Lin, Yi Chen OBESITY (genetics) Liu, Wen Sheng OBESITY (genetics) Lohrmann, Christian PANCREATIC NEOPLASMS (surgery) Lone, Azad H. HEALTH PROMOTION (history) Luqman, Uzair TOOTH INJURIES Ma, Jun CANCER VACCINES (immunology) Macassa, G. CORONARY ARTERY DISEASE (etiology) Mahmoud, Kadria M.A. SNAILS (classification) FRESH WATER (chemistry) Mahmoud, Motamed Elsayed CHICKENS Mahmoud, Moushira A. DIABETES MELLITUS, TYPE 1 (genetics) Mahmoudi, Mahmoud HEPATITIS B VACCINES Main, Atif PULMONARY EMBOLISM (diagnosis) Majeed, Imran MITRAL VALVE PROLAPSE Majzoobi, M.M. CHRONIC DISEASE (epidemiology) Makimura, K. ARTHRODERMATACEAE (isolation and purification) Makowiec, Frank PANCREATIC NEOPLASMS (surgery) Malekzadeh, R. HEPATITIS B SURFACE ANTIGENS (genetics) IMEMR Current Contents Author Index 125 Malik, Bushra Ayaz STRUMA OVARII (diagnosis) Matehkolaei, A. Rezaei ARTHRODERMATACEAE (isolation and purification) Mathew, Jayant T. CYSTADENOMA, MUCINOUS (pathology) Matter, M.K. BONE DENSITY Matwani, Samaa CATHETERIZATION, CENTRAL VENOUS (adverse effects) Mawardi, Mohammed ADRENAL CORTEX NEOPLASMS (pathology) Maymand, M. Mahmoodinia MESENCHYMAL STEM CELLS Mbolekwa, K. TUBERCULOSIS (prevention and control) Mehboob, Bushra MALOCCLUSION, ANGLE CLASS III Mehmood, Faisal DYSLIPIDEMIAS (epidemiology) Mehmood, Khalid TACHYCARDIA, RECIPROCATING (diagnosis) IMMUNOGLOBULINS, INTRAVENOUS (therapeutic use) Minhas, Liaqat Ali SPERMATOGENESIS (drug effects) Mirhashemi, F.S. DENTAL IMPLANT-ABUTMENT DESIGN Mirhendi, H. ARTHRODERMATACEAE (isolation and purification) Mishwani, Ahmad Hussain IMMUNOGLOBULINS, INTRAVENOUS (therapeutic use) DIABETIC FOOT Moeini, R.S. Mir CHRONIC DISEASE (epidemiology) Moezzyzadeh, M. CASEINS Moghaddam, K. Ali LEUKEMIA, PROMYELOCYTIC, ACUTE (genetics) Mogharehabed, A. ENAMEL MICROABRASION Mohamed, Amel Abdel Azim HOMELESS YOUTH (psychology) Mohamed, Asmaa Ghareeb HOMELESS YOUTH (psychology) Mohamed, Ehab K. INSULIN RESISTANCE Mohammed, Kawther CARBON TETRACHLORIDE (toxicity) Mohammed, Sayed Shubbar GANGLIONEUROMA (diagnosis) Mohareb, Ahmed M. MYOCARDIAL REPERFUSION INJURY (drug therapy) Mohsin, Shumaila PRENATAL DIAGNOSIS Mohsin, Syed Tariq IMMUNOGLOBULINS, INTRAVENOUS (therapeutic use) Mokaddas, Eiman TUBERCULOSIS, MULTIDRUG-RESISTANT (diagnosis) Mokhtar, Medhat BOTULISM Molaei, Hamid Reza HEPATITIS B VACCINES Moll, A.P. TUBERCULOSIS (prevention and control) Mollahosseini, M. Haji LEPTIN (blood) Mollaverdi, F. DENTAL PINS Mosbah, Amira A. Abdel Rahman INFANT, NEWBORN (growth and development) DIABETES MELLITUS, TYPE 1 (Blood) Mostafa, Bayomy B. SNAILS (classification) FRESH WATER (chemistry) Motamedi, S.H. CASEINS Mothafar, Fatmah J. ADENOCARCINOMA, MUCINOUS (complications) Mousazadeh, H. ENAMEL MICROABRASION Moustafa, Mahmoud Hassan SILVER COMPOUNDS (chemical synthesis) Mozeh, M.B. LEPTIN (blood) Mubark, Heba A.E. PHENYLENEDIAMINES (poisoning) Mubedi, I. LETTUCE (microbiology) IMEMR Current Contents Author Index 126 Muhammad, Mumtaz HEPATITIS B (epidemiology) Muhammad, Wasem Wali GUILLAIN-BARRE SYNDROME Nag, Hirdaya H. COMMON BILE DUCT NEOPLASMS (pathology) Nagabhushana, D. TRAVEL MEDICINE Naghavi, Seyed Hamid Reza ATTITUDE OF HEALTH PERSONNEL Najmi, Muzammil Hassan MALARIA (prevention and control) Namazi, A. HEPATITIS B SURFACE ANTIGENS (genetics) Namazi, S. ANTIBIOTIC PROPHYLAXIS Naqvi, Shahid Hussain FRACTURES, UNUNITED (etiology) Narayanan, Parameswaran SCRUB TYPHUS (complications) Nasr, M.M. SPLENECTOMY (adverse effects) Nasr, Magid Mahmoud CHOLECYSTECTOMY, LAPAROSCOPIC Nawaz, Khuram Haq GUILLAIN-BARRE SYNDROME Naz, Muhammad Afzal PTERYGIUM (prevention and control) Nosseir, M.M.F. SPLENECTOMY (adverse effects) Nouman, Ghassan S. MORBIDITY Nouri, Z. Tabibzadeh TOBACCO USE CESSATION Nouroozi, M. ABO BLOOD-GROUP SYSTEM Nousheen, Javaria FETAL MEMBRANES, PREMATURE RUPTURE Oguz, Serife Suna MEDIASTINAL EMPHYSEMA (diagnosis) Oncel, Mehmet Y. MEDIASTINAL EMPHYSEMA (diagnosis) Ortegoza, Jaire TOXOCARIASIS (classification) Othman, Ahmed H. RESPIRATORY TRACT INFECTIONS (virology) Otoofi, A. PYRAZOLES Ozkan, Turker HEALTH BEHAVIOR (psychology) Pal, Sabrina Suhail SKIN DISEASES (epidemiology) Pourmand, M.R. STREPTOCOCCUS AGALACTIAE (isolation and purification) LETTUCE (microbiology) Prakash, Chetan ARTHROPLASTY, REPLACEMENT, HIP Prasad, Krishna CYSTADENOMA, MUCINOUS (pathology) Qamar ul Islam HEMIANOPSIA (diagnosis) Qayyum, Adil PARANASAL SINUS DISEASES (radiography) Qayyum, Asad DEXAMETHASONE (therapeutic use) Qayyum, Mamuna POSTPARTUM HEMORRHAGE (therapy) Qayyum, Muhammad Umar TOOTH INJURIES Qiam ud Din STRESS DISORDERS, POST-TRAUMATIC HEMANGIOMA Qiam, Fahad HEMANGIOMA Qorbani, M. Rafique, Isma MAGNESIUM SULFATE (therapeutic use) Ragab, Fawzy M. FRESH WATER (chemistry) Ragb, Fawzy M. SNAILS (classification) Rahimnia, R. HEPATITIS B SURFACE ANTIGENS (genetics) Rajalingam, Rajesh COMMON BILE DUCT NEOPLASMS (pathology) Rajnee EXERCISE Ramadan, Ibrahim Ghoneam HEPATITIS C, CHRONIC (complications) Ramadan, O.S. INFLUENZA, HUMAN (complications) Ramzan, Faiqah HYPOTHYROIDISM (epidemiology) IMEMR Current Contents Author Index 127 Ramzan, Faiza HYPOTHYROIDISM (epidemiology) Ramzan, Muhammad HYPOTHYROIDISM (epidemiology) Ramzan, Muhammad Haris HYPOTHYROIDISM (epidemiology) Ravari, Ali INTERLEUKIN-4 (genetics) Rayes, Osama ACCREDITATION Raza, Mehdi STREPTOKINASE (therapeutic use) Raza, Syed Nusrat DEXAMETHASONE (therapeutic use) Razek, Yasser A. MULLERIAN DUCTS (abnormalities) Razjou, F. CULTURE MEDIA Razzq, Sara SPINAL CORD INJURIES (complications) Rehman, Basheer STRESS DISORDERS, POST-TRAUMATIC Reza, T. HIV INFECTIONS (epidemiology) Rezvani, M.B. DENTAL PINS Rivas, Maria TOXOCARIASIS (classification) Rodrigues, Gabriel PANNICULITIS (diagnosis) Saati, Abdullah PESTICIDE RESIDUES (analysis) Sabih, Fazaila SOMATOSENSORY DISORDERS Sabry, Gilane M. ASPARAGINASE (isolation and purification) Sabt, Sajeda GANGLIONEUROMA (diagnosis) Sadegh, M. DENTAL CASTING TECHNIQUE Sadrnejad, S.K.H. ORTHODONTIC WIRES Saeed, Farrukh ALUMINUM COMPOUNDS (poisoning) Saeed, Mariam CORONARY ARTERY DISEASE Saeed, Samar M. TUBERCULOSIS, MULTIDRUG-RESISTANT Sahabi, M. DENTAL IMPLANT-ABUTMENT DESIGN Said, Soha BREAST NEOPLASMS (immunology) Sajid Wahid Bukhsh SOMATOSENSORY DISORDERS Sarhan, Nayara Ali WOUNDS AND INJURIES (epidemiology) Sattari, M. LEPTIN (blood) Satyanarayana, S. AMANTADINE (therapeutic use) Sayed, Ezzat H. UTERINE HEMORRHAGE (diagnosis) Schloericke, Erik JEJUNAL DISEASES (complications) Schweiger, Brunhilde RESPIRATORY TRACT INFECTIONS (virology) Seif Eldin, Salwa S. TORQUE TENO VIRUS (isolation and purification) Seif, Amal I. MITOSPORIC FUNGI (immunology) Shabestari, Omid ATTITUDE OF HEALTH PERSONNEL Shabestari, S. Basir BLOOD COAGULATION TESTS Shafi Ullah JAW NEOPLASMS (etiology) Shah, Irfan JAW NEOPLASMS (etiology) Sharma, Dheeraj ANESTHESIA, SPINAL (methods) Sharma, Raju ARTERIOVENOUS MALFORMATIONS Sharma, Surendra K. ARTERIOVENOUS MALFORMATIONS Shatnawi, N.J. SURGICAL PROCEDURES, ELECTIVE Shattaf, Aysha LIVER NEOPLASMS (therapy) Shawky, Ola A. AMYOTROPHIC LATERAL SCLEROSIS Shehata, Magdi G. MITOSPORIC FUNGI (immunology) IMEMR Current Contents Author Index 128 Shellagi, Nikhil PANNICULITIS (diagnosis) Shi, Enyi CORONARY ARTERY BYPASS (methods) Shidfar, M.R. ARTHRODERMATACEAE (isolation and purification) Shirinbak, I. BLOOD COAGULATION TESTS Shirzad, Hedayatollah ESCHERICHIA COLI INFECTIONS (diagnosis) Soleimani, M. MESENCHYMAL STEM CELLS Soliman, B.A. PHLEBETOMUS (parasitology) Soliman, Maha F.M. CICHLIDS (parasitology) Sorour, Ehab Ibrahim INFANT, NEWBORN (growth and development) DIABETES MELLITUS, TYPE 1 (Blood) Srinivasan, Sadagopan SCRUB TYPHUS (complications) Subhani, Samar TRACHEAL STENOSIS (etiology) Sulku, S. Nur HEALTH EXPENDITURES Sundin, O. CORONARY ARTERY DISEASE (etiology) Sushma, R. TRAVEL MEDICINE Susuman, A. Sathiya CHILD MORTALITY Tag, Lubna M. DIABETES MELLITUS, TYPE 2 (complications) DIABETES MELLITUS TYPE 2 (drug therapy) Tariq, Khalid Mehmood ALUMINUM COMPOUNDS (poisoning) Tariq, Naseer Alam ASTHMA Tariq, Seema FETAL MEMBRANES, PREMATURE RUPTURE Tariq, Shahrukh FRACTURES, UNUNITED (etiology) Tash, Fathy URINARY BLADDER NEOPLASMS (diagnosis) Tawfeeq, Jwan D. LEPIDIUM SATIVUM Tayebi, Naeimeh ABORTION, HABITUAL Teimori, Hossein INTERLEUKIN-4 (genetics) Telmesani, A. EDUCATION, MEDICAL Teriaky, Anouar GASTROSTOMY (methods) Tewfick, M.K. PHLEBETOMUS (parasitology) Thabit, Amany G. RESPIRATORY TRACT INFECTIONS (virology) Umer, Afsheen DENTAL CARIES (epidemiology) Umer, Andaleeb DENTAL CARIES (epidemiology) Upadhyay, R. Prakash CARDIOVASCULAR DISEASES (economics) Usama, M.A. SCENEDESMUS (growth and development) Usman, Javaid PRENATAL DIAGNOSIS Utman, Naeema LEVONORGESTREL (therapeutic use) Vaeli, S.H. BLOOD PLATELETS Valente, Stephanie A. PRESSURE ULCER (therapy) Valiath, John STROKE (diagnosis) Varshney, Rohit ANESTHESIA, SPINAL (methods) Velmurugan, C. AMANTADINE (therapeutic use) Vessal, G. ANTIBIOTIC PROPHYLAXIS Warraich, Riaz Ahmed TEMPOROMANDIBULAR JOINT DISORDERS Wu, Wen Tung OBESITY (genetics) Xiong, CI CRANIOFACIAL ABNORMALITIES (epidemiology) Yaghini, J. ENAMEL MICROABRASION Yahyapour, Yousef HEPATITIS B VACCINES IMEMR Current Contents Author Index 129 Yarahmadi, M. LETTUCE (microbiology) Yari, F. BLOOD PLATELETS Yeganeh, F. LEPTIN (blood) Younesian, F. PYRAZOLES Yousaf, Muhammad Ali GUILLAIN-BARRE SYNDROME Yousef, A. INFLUENZA, HUMAN (complications) Youssef, Hamdy A. MYOCARDIAL REPERFUSION INJURY (drug therapy) Zakirullah MAXILLARY NEOPLASMS (epidemiology) Zaman, T. SANDHOFF DISEASE (genetics) Zamani, R. CHRONIC DISEASE (epidemiology) Zamanzad, Behnam ESCHERICHIA COLI INFECTIONS (diagnosis) Zhang, Hp. CRANIOFACIAL ABNORMALITIES (epidemiology) Zhao, Z. GEOLOGIC SEDIMENTS (analysis) Zimmermann, Markus S. JEJUNAL DISEASES (complications)

Appendix II List of EMR Journals Indexed in IMEMR (by country)

IMEMR Current Contents EMR Journals List 133 Journal ISSN Status Afghanistan (1) AFJPH - Afghanistan Journal of Public Health N/A Active Bahrain (3) Arab Journal for Food and Nutrition 1608-8352 Interrupted Bahrain Medical Bulletin 1012-8298 Active JBMS - Journal of the Bahrain Medical Society 1015-6321 Active Egypt (134) AAMJ - Al-Azhar Assiut Medical Journal 1687-1693 Interrupted African Journal of Urology 1110-5704 Active Afro-Arab Liver Journal 1687-224X Active Ain-Shams Journal of Forensic Medicine and Clinical Toxicology 1687-1030 Active Ain-Shams Medical Journal 0002-2144 Interrupted AJAIC - Alexandria Journal of Anaesthesia and Intensive Care N/A Interrupted Al-Azhar Journal of Dental Science 1110-6751 Interrupted Al-Azhar Medical Journal 1110-0400 Active Alexandria Dental Journal 1110-015X Interrupted Alexandria Journal of Food Science and Technology 1687-3920 Interrupted Alexandria Journal of Hepatogastroenterology 2090-1879 Interrupted Alexandria Journal of Pediatrics 1687-9945 Active Alexandria Journal of Pharmaceutical Sciences 1110-1792 Interrupted Alexandria Journal of Veterinary Science 1110-2047 Active Alexandria Medical Journal [The] 0516-5849 Interrupted Annals of Pediatric Surgery 1687-4137 Interrupted Applied Endocrinology in Egypt 1110-1776 Interrupted Arab Family Health and Population N/A Active Arab Journal of Biotechnology 1110-6875 Active Arab Journal of Gastroenterology 1687-1979 Active Arab Journal of Laboratory Medicine [The] 1110-1822 Active ASJOG - Ain-Shams Journal of Obstetrics and Gynecology 1697-2193 Interrupted ASNJ - Alexandria Scientific Nursing Journal 1687-3858 Active Assiut Medical Journal 1110-0494 Active Assiut University Bulletin for Environmental Researches 1110-6107 Active Assiut Veterinary Medical Journal N/A Interrupted Benha Medical Journal 1110-208X Active New IMEMR Current Contents EMR Journals List 134 Journal ISSN Status Bulletin of Alexandria Faculty of Medicine 1110-0834 Active Bulletin of Alexandria Thoracic Association N/A Interrupted Bulletin of Faculty of Pharmacy - Cairo University 1110-0931 Interrupted Bulletin of Faculty of Physical Therapy - Cairo University 1110-6611 Interrupted Bulletin of High Institute of Public Health [The] 1110-0036 Active Bulletin of Pharmaceutical Sciences - Assiut University 1110-0052 Active Bulletin of the Faculty of Science - University of Alexandria 0568-9619 Interrupted Bulletin of the National Nutrition Institute of the Arab Republic of Egypt N/A Active Bulletin of the National Research Centre 1110-0591 Active Bulletin of the Ophthalmological Society of Egypt 0078-5342 Interrupted Childhood and Development Quarterly 1110-8681 Interrupted Clinical Diabetes 0891-8929 Active EDJ - Egyptian Dental Journal 0070-9484 Interrupted Egyptian Heart Journal [The] 1110-2608 Interrupted Egyptian Journal of Anatomy [The] 1110-2144 Interrupted Egyptian Journal of Biomedical Engineering 1012-5558 Active Egyptian Journal of Biophysics and Biomedical Engineering 1110-8525 Active Egyptian Journal of Bronchology [The] 1687-8426 Active Egyptian Journal of Cataract and Refractive Surgery [The] N/A Active Egyptian Journal of Chemistry 0449-2285 Active Egyptian Journal of Community Medicine [The] 1110-1865 Active Egyptian Journal of Dermatology and Andrology 1110-7650 Interrupted Egyptian Journal of Diabetes [The] N/A Interrupted Egyptian Journal of Food Science 1110-0192 Active Egyptian Journal of Genetics and Cytology 0046-161X Interrupted Egyptian Journal of Histology [The] 1110-0559 Active Egyptian Journal of Hospital Medicine [The] 1687-2002 Interrupted Egyptian Journal of Immunology [The] 1110-4902 Active Egyptian Journal of Medical Human Genetics [The] 1110-8630 Active Egyptian Journal of Medical Laboratory Sciences 1110-5593 Active Egyptian Journal of Medical Microbiology 1110-2179 Interrupted Egyptian Journal of Microbiology 0022-2704 Interrupted Egyptian Journal of Neonatology [The] 1110-8991 Interrupted Egyptian Journal of Neurology, Psychiatry and Neurosurgery [The] 1110-1083 Active IMEMR Current Contents EMR Journals List 135 Journal ISSN Status Egyptian Journal of Nutrition 1687-1235 Active Egyptian Journal of Nutrition and Health 1687-7950 Active Egyptian Journal of Occupational Medicine 1110-1881 Interrupted Egyptian Journal of Otolaryngology [The] 1012-5574 Interrupted Egyptian Journal of Paediatrics [The] 1687-1677 Interrupted Egyptian Journal of Pediatric Allergy and Immunology 1687-1642 Active Egyptian Journal of Pharmaceutical Sciences 0301-5068 Active Egyptian Journal of Physiological Sciences 0301-8660 Interrupted Egyptian Journal of Psychiatry [The] 1110-1105 Interrupted Egyptian Journal of Schistosomiasis and Infectious and Endemic Diseases 1110-7278 Interrupted Egyptian Journal of Surgery [The] 1110-1121 Active Egyptian Journal of Urology 1110-5712 Interrupted Egyptian Journal of Veterinary Science 1110-0222 Active Egyptian Liver Journal 2090-6218 Active Egyptian Medical Journal of the National Research Center 1687-1278 Interrupted Egyptian Orthodontic Journal N/A Interrupted Egyptian Orthopaedic Journal [The] 1110-1148 Interrupted Egyptian Pharmaceutical Journal [National Research Center] 1687-4315 Active Egyptian Population and Family Planning Review [The] N/A Interrupted Egyptian Rheumatology and Rehabilitation 1110-161X Active Egyptian Science Magazine [The] 1687-3815 Active EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 1687-1502 Active EJENTAS - Egyptian Journal of ENT and Allied Sciences 2090-0740 Interrupted EMHJ - Eastern Mediterranean Health Journal 1020-3397 Active Gazette of the Egyptian Paediatric Association [The] 1110-6638 Interrupted Health Services Journal of the Eastern Mediterrenean Region 1014-9899 Interrupted JESN - Journal of Egyptian Society of Nephrology [The] N/A Interrupted Journal of Childhood Studies 2090-0619 Active Journal of Drug Research of Egypt 0085-2406 Active Journal of Hepatology, Gastroenterology and Infectious Diseases 1110-0796 Interrupted Journal of Legal Medicine and Forensic Sciences [The] 1110-6468 Interrupted Journal of the Arab Society for Medical Research 1687-4293 Active Journal of the Egyptian Medical Association [The] 0013-2411 Interrupted IMEMR Current Contents EMR Journals List 136 Journal ISSN Status Journal of the Egyptian National Cancer Institute 1110-0362 Interrupted Journal of the Egyptian Public Health Association [The] 0013-2446 Active Journal of the Egyptian Society of Endocrinology, Metabolism and Diabetes [The] 1110-1245 Active Journal of the Egyptian Society of Obstetrics and Gynecology [The] 0258-3216 Interrupted Journal of the Egyptian Society of Parasitology 1110-0583 Active Journal of the Egyptian Society of Pharmacology and Experimental Therapeutics [The] N/A Interrupted Journal of the Egyptian Society of Toxicology 1110-127X Active Journal of the Medical Research Institute - Alexandria University 1110-0133 Interrupted JPC - Journal of Pediatric Club [The] N/A Active Kasr El Aini Journal of Surgery 0022-9237 Interrupted Kasr El-Aini Medical Journal N/A Active Kidney Forum 1369-3050 Interrupted Mansoura Journal of Pharmaceutical Sciences 1110-1318 Interrupted Mansoura Medical Bulletin N/A Active Mansoura Medical Journal 1110-211X Active Medical Journal of Ahmed Maher Teaching Hospital [The] N/A Interrupted Medical Journal of Cairo University [The] 0045-3803 Active Medical Journal of Teaching Hospitals and Institutes [The] 1110-2039 Interrupted Minoufia Medical Journal 1110-2098 Active MJFCT - Mansoura Journal of Forensic Medicine and Clinical Toxicology 1110-5437 Interrupted Neonatology 1687-0492 Interrupted New Egyptian Journal of Medicine [The] 1110-1946 Active Pan Arab Journal of Orthopaedic and Trauma [The] 1607-4912 Active Population Researches and Studies N/A Active Population Sciences N/A Interrupted Population Studies 1110-1342 Interrupted PUJ - Parasitologists United Journal 1687-7942 Active Scientific Journal of Al-Azhar Medical Faculty [Girls] [The] 1110-2381 Interrupted Scientific Journal of El-Minia Faculty of Medicine [The] 1110-2446 Interrupted Scientific Medical Journal 1110-5607 Active Sohag Medical Journal 1110-7529 Active South Valley Medical Journal 1110-7529 Interrupted Suez Canal University Medical Journal 1110-6999 Active IMEMR Current Contents EMR Journals List 137 Journal ISSN Status Tanta Medical Journal 1110-1415 Interrupted Tanta Medical Sciences Journal 1687-5788 Interrupted Veterinary Medical Journal 1110-1423 Active Zagazig Journal of Forensic Medicine and Toxicology 1687-160X Interrupted Zagazig Journal of Pharmaceutical Sciences 1110-5089 Interrupted Zagazig Medical Association Journal 1110-2322 Interrupted Zagazig University Medical Journal 1110-1431 Interrupted Iraq (30) Al-Kindy College Medical Journal 1810-9543 Active Almustansiriya Journal of Pharmaceutical Sciences 1815-0993 Interrupted Annals of the College of Medicine - Mosul 0028-1446 Interrupted Basrah Journal of Surgery N/A Interrupted Bulletin of Endemic Disease - Baghdad 0007-4845 Interrupted DMJ - Dohuk Medical Journal 2071-7326 Active IMJ - Iraqi Medical Journal 0304-4564 Interrupted IOJ - Iraqi Orthodontic Journal 1816-0581 Interrupted IPMJ - Iraqi Postgraduate Medical Journal 1608-8360 Active Iraqi Army Medical Journal N/A Interrupted Iraqi Journal of Agriculture 1818-6645 Active Iraqi Journal of Biotechnology N/A Interrupted Iraqi Journal of Community Medicine 1684-5382 Interrupted Iraqi Journal of Medical Sciences 1681-6579 Interrupted Iraqi Journal of Microbiology N/A Interrupted Iraqi Journal of Pharmaceutical Sciences N/A Interrupted Iraqi Journal of Tropical Disease Researches 1814-0823 Interrupted Journal of Basic Medical Sciences N/A Interrupted Journal of Community Medicine N/A Interrupted Journal of Dohuk University 1812-7568 Interrupted Journal of Karbala University 1813-0410 Interrupted Journal of the College of Dentistry - Baghdad N/A Interrupted Journal of the Faculty of Medicine - Baghdad 0041-9419 Interrupted Kufa Medical Journal N/A Interrupted Medical Journal of Basrah University [The] 0253-0759 Active Medical Journal of Tikrit University [The] N/A Interrupted IMEMR Current Contents EMR Journals List 138 Journal ISSN Status New Iraqi Journal of Medicine [The] 1817-5562 Active Risafa Medical Journal N/A Interrupted Scientific Nursing Journal 1812-2388 Interrupted Zanco Journal of Medical Sciences 1995-5588 Active Islamic Republic of Iran (176) Acta Medica Iranica 0044-6025 Active Advances in Cognitive Science 1561-4174 Interrupted AJMB - Avicenna Journal of Medical Biotechnology 2008-2835 Active Archives of Iranian Medicine 1029-2977 Active Armaghane-danesh 1728-6506 Active ARYA Atherosclerosis Journal 1735-3955 Interrupted Asian Journal of Sports Medicine 2008-000X Active Audiology 1735-1936 Active Basic and Clinical Neurosciences N/A Active BCCR - Basic and Clinical Cancer Research 2228-6527 Active Bina Journal of Ophthalmology 1026-6399 Interrupted Cell Journal (Yakhteh) 2228-5806 Active DARU - Journal of Pharmaceutical Sciences 1560-8115 Active DENA - Quarterly Journal of Yasuj Faculty of Nursing and Midwifery 1735-8450 Interrupted Dermatology and Cosmetic Quarterly 2008-7470 Active DRJ - Dental Research Journal 1735-3327 Active Endovascular Journal 2008-1812 Active Feyz - Journal of Kashan University of Medical Sciences 1029-7855 Active Gastroenterology and Hepatology from Bed to Bench 2010-2258 Active Genetics in the 3rd Millennium 1728-6182 Active Govaresh 1560-7186 Active HAKIM Research Journal 1561-252X Active HAYAT - Journal of Faculty of Nursing and Midwifery [The] 1735-2215 Active Health Information Management 1735-7853 Active Hepatitis Monthly 1735-143X Active Homa-ye-Salamat 2008-2002 Active Hormozgan Medical Journal 1735-2223 Active Hospital - Journal of Iranian Scientific Hospital Association 2008-1982 Active IBJ - Iranian Biomedical Journal 1028-852X Active IMEMR Current Contents EMR Journals List 139 Journal ISSN Status IEJ - Iranian Endodontic Journal 1735-7497 Active IHJ - Iranian Heart Journal 1735-7306 Active IJB - Iranian Journal of Biotechnology 1728-3043 Active IJBC - Iranian Journal of Blood and Cancer 2008-4595 Active IJCN - Iranian Journal of Child Neurology 1735-4668 Active IJEM - Iranian Journal of Endocrinology and Metabolism 1683-4844 Active IJFS - International Journal of Fertility and Sterility 2008-076X Active IJHOSCR - International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 Active IJI - Iranian Journal of Immunology 1735-1383 Active IJKD - Iranian Journal of Kidney Diseases 1735-8582 Active IJM - Iranian Journal of Microbiology 2008-3289 Active IJME - Iranian Journal of Medical Education 1608-9359 Active IJMS - Iranian Journal of Medical Sciences 0253-0716 Active IJO - Iranian Journal of Orthodontics 1735-5087 Interrupted IJOH - International Journal of Occupational Hygiene 2008-5109 Active IJPM - International Journal of Preventive Medicine 2008-7802 Active IJPR - Iranian Journal of Pharmaceutical Research 1735-0328 Active IJRM - Iranian Journal of Reproductive Medicine 1680-6433 Active IJVM - Iranian Journal of Veterinary Medicine 2251-8894 Active International Journal of Endocrinology and Metabolism 1726-913X Active International Journal of Environmental Research 1735-6865 Active International Journal of Environmental Science and Technology 1735-1472 Active International Journal of Occupational and Environmental Medicine 2008-6520 Active International Journal of Organ Transplantation Medicine 2008-6490 Active Iran Journal of Nursing 2008-5923 Active Iran Occupational Health 1735-5133 Active Iranian Cardiovascular Research Journal 1735-885X Active Iranian Journal of Allergy, Asthma and Immunology 1735-1502 Active Iranian Journal of Arthropod-Borne Diseases 1735-7179 Active Iranian Journal of Basic Medical Sciences 2008-3866 Active Iranian Journal of Cancer Prevention 2008-2398 Active Iranian Journal of Clinical Infectious Diseases 1735-5109 Active Iranian Journal of Dermatology 0021-082X Active IMEMR Current Contents EMR Journals List 140 Journal ISSN Status Iranian Journal of Diabetes and Lipid Disorders 1726-7544 Interrupted Iranian Journal of Diabetes and Obesity 2008-6792 Active Iranian Journal of Environmental Health Science and Engineering 1735-1979 Active Iranian Journal of Epidemiology 1735-7489 Active Iranian Journal of Health and Environment 2008-2029 Active Iranian Journal of Medical Microbiology 1735-8612 Active Iranian Journal of Medical Physics 1735-160X Active Iranian Journal of Nuclear Medicine 1681-2824 Active Iranian Journal of Nursing and Midwifery Research [IJNMR] 1735-9066 Interrupted Iranian Journal of Nutrition Sciences and Food Technology 1735-7756 Active Iranian Journal of Obstetric, Gynecology and Infertility [The] 1680-2993 Active Iranian Journal of Ophthalmology 1735-4153 Active Iranian Journal of Otorhinolaryngology 1560-1293 Active Iranian Journal of Parasitology 1735-7020 Active Iranian Journal of Pediatrics 2008-2142 Active Iranian Journal of Psychiatry 1735-4587 Interrupted Iranian Journal of Psychiatry and Behavioral Sciences 1735-8639 Active Iranian Journal of Psychiatry and Clinical Psychology [IJPCP] 1735-4315 Active Iranian Journal of Public Health 0304-4556 Active Iranian Journal of Radiation Research 1728-4554 Active Iranian Journal of Radiology 1735-1065 Active Iranian Journal of Veterinary Research 1728-1997 Active Iranian Rehabilitation Journal 1735-3602 Active JBUMS - Journal of Babol University of Medical Sciences 1561-4107 Interrupted JDT - Journal of Dentistry Tehran University of Medical Sciences 1735-2150 Interrupted JMR - Journal of Medical Research 1728-1962 Interrupted JNP - Journal of Nephropathology 2251-8363 Active Journal of Anesthesiology and Pain 2228-6659 Active Journal of Arak University of Medical Sciences - Rahavard Danesh 1735-5338 Active Journal of Dental Medicine - Tehran University of Medical Sciences 1024-641X Active Journal of Dental Research, Dental Clinics, Dental Prospects 2008-210X Active Journal of Dental School - Shahid Beheshti University of Medical Sciences 1735-7683 Active Journal of Dentistry - Shiraz University of Medical Sciences 1728-3426 Active New IMEMR Current Contents EMR Journals List 141 Journal ISSN Status Journal of Environmental Studies 1025-8620 Active Journal of Family and Reproductive Health 1735-8949 Active Journal of Fundamentals of Mental Health [The] 1028-6918 Active Journal of Gorgan University of Medical Sciences 1562-4765 Active Journal of Guilan University of Medical Sciences 2008-4048 Active Journal of Health Administration 2008-1200 Active Journal of Hygiene and Health 1735-2363 Interrupted Journal of Injury and Violence Research 2008-2053 Active Journal of Iranian Anatomical Sciences 1728-6158 Active Journal of Isfahan Dental School 1735-255X Interrupted Journal of Isfahan Medical School 1027-7595 Interrupted Journal of Islamic Dental Association of Iran [The] - JIDA 1024-6428 Active Journal of Jahrom University of Medical Sciences 1735-5168 Active Journal of Kerman University of Medical Sciences 1023-9510 Active Journal of Kermanshah University of Medical Sciences (JKUMS) 2251-9068 Active Journal of Lasers in Medical Sciences 2008-9783 Active Journal of Mashhad Dental School 1560-9286 Active Journal of Mazandaran University of Medical Sciences 1735-9260 Active Journal of Medical Council of Islamic Republic of Iran 1562-1073 Active Journal of Medical Education 1735-3998 Interrupted Journal of Medical Science - Islamic Azad University of Mashhad 1735-7594 Active Journal of Medicinal Plants 1684-0240 Active Journal of Modern Rehabilitation 2008-2576 Active Journal of Nursing and Midwifery Quarterly - Shaheed Beheshti University of Medical Sciences and Health Services 1605-8941 Active Journal of Ophthalmic and Vision Research 2008-2010 Active Journal of Periodontology and Implant Dentistry N/A Active Journal of Qazvin University of Medical Sciences [The] 1561-3666 Active Journal of Rafsanjan University of Medical Sciences 1735-3165 Active Journal of Rehabilitation 1607-2960 Active Journal of Reproduction and Infertility 2228-5482 Active Journal of Research in Behavioural Sciences 1735-2029 Active Journal of Research in Dental Sciences 2008-4676 Active Journal of Research in Health Sciences [JRHS] 1682-2765 Active IMEMR Current Contents EMR Journals List 142 Journal ISSN Status Journal of Research in Medical Sciences 1735-5311 Active Journal of Sabzevar School of Medical Sciences 1606-7487 Interrupted Journal of School of Public Health and Institute of Public Health Research 1735-7586 Active Journal of Shaheed Sadoughi University of Medical Sciences and Health Services 1562-272X Active Journal of Shahrekord University of Medical Sciences 1735-1448 Active Journal of Tehran University Heart Center [The] 1735-8620 Active Journal of Veterinary Research 2008-2525 Active Journal of Zahedan University of Medical Sciences and Health Services 1735-076X Active Journal of Zanjan University of Medical Sciences and Health Services 1606-9366 Active JRH - Journal of Research and Health 2251-6395 Active JRMS - Journal of Research in Medical Sciences 1735-1995 Active JRRS - Journal of Research in Rehabilitation Sciences 1735-7519 Active Jundishapur Journal of Microbiology [JJM] 2008-3645 Active Jundishapur Journal of Natural Pharmaceutical Products 1735-7780 Active Jundishapur Scientific Medical Journal 2252-052x Active KOOMESH - Journal of the Semnan University of Medical Sciences 1608-7046 Active Medical Journal of Mashad University of Medical Sciences 1735-4013 Active Medical Journal of Tabriz University of Medical Sciences and Health Services 1608-5671 Interrupted Medical Journal of the Islamic Republic of Iran 1016-1430 Active Medical Sciences Journal of Islamic Azad University 1023-5922 Active MEJC - Middle East Journal of Cancer 2008-6709 Active Middle East Journal of Digestive Diseases 2008-5230 Active Modares Journal of Medical Sciences, Pathobiology 1562-9554 Active Nephro-Urology Monthly 2251-7006 Active Nursing and Midwifery Research 1753-5001 Interrupted Ofogh-E-Danesh 1735-1855 Active Payavard - Salamat 1735-8132 Active Payesh - Health Monitor 1680-7626 Active Pejouhandeh: Bimonthly Research Journal 1735-1022 Active Qom University of Medical Sciences Journal 1735-7799 Active Quarterly Journal of Medical Ethics 2008-4374 Active Quarterly Journal of Medical Law N/A Active Quarterly Journal of Relief and Rescue 4544-2008 Active New New New IMEMR Current Contents EMR Journals List 143 Journal ISSN Status Razi Journal of Medical Sciences 2228-7043 Active Salmand - Iranian Journal of Aging 1735-806X Active Scientific and Research Journal of Army University of Medical Sciences - J.A.U.M.S. 1727-1789 Active Scientific Journal of Forensic Medicine 1027-1457 Interrupted Scientific Journal of Iranian Blood Transfusion Organization [The] 1027-9520 Active Scientific Journal of Kurdistan University of Medical Sciences 1560-652X Active Social Welfare Quarterly 1735-8191 Interrupted Strides in Development of Medical Education 1735-4242 Active Tanaffos 1735-0344 Active Teb Va Tazkie 1608-2397 Active Tehran University Medical Journal [TUMJ] 1683-1764 Active Toloo-e-Behdasht 1728-5127 Interrupted Trauma Monthly 2251-7464 Active Urology Journal 1735-1308 Active Yafteh Journal 1563-0773 Active Jordan (9) Arab Journal of Psychiatry [The] 1016-8923 Active Dirasat 1026-3772 Interrupted Jordan Journal of Pharmaceutical Sciences 1995-7157 Active Jordan Medical Journal 0446-9283 Active Journal of the Royal Medical Services 2078-8703 Active Medical Journal of Islamic World Academy of Sciences 1016-3360 Active Pan Arab Medical Journal N/A Interrupted Population Bulletin of ESCWA 0258-1914 Interrupted Smile Dental Journal 2072-473X Active Kuwait (6) Bulletin of the Kuwait Institute for Medical Specialization N/A Active Food and Nutrition Bulletin N/A Active GJO - Gulf Journal of Oncology [The] 2078-2101 Active KMJ - Kuwait Medical Journal 0023-5776 Active Medical Arabization N/A Active Medical Principles and Practice 1011-7571 Active Lebanon (9) ACES - Actualites Cliniques et Scientifiques 1683-8068 Active AJU - Arab Journal of Urology N/A Active New IMEMR Current Contents EMR Journals List 144 Journal ISSN Status Arab Dental Journal N/A Interrupted JLDA - Journal of the Lebanese Dental Association 1810-9632 Active Journal of the Arab Neonatology Forum 1812-1756 Iterrupted Lebanese Science Journal 1561-3410 Active LMJ - Lebanese Medical Journal 0023-9852 Active Middle East Journal of Anesthesiology 0544-0440 Active Middle East Journal of Family Medicine N/A Interrupted Libyan Arab Jamahiriya (6) DMJ - Derna Medical Journal N/A Active Garyounis Medical Journal 0254-7198 Interrupted JMJ - Jamahiriya Medical Journal N/A Active Libyan Journal of Infectious Diseases [The] N/A Active LJM - Libyan Journal of Medicine 1993-2820 Interrupted Tabib Attifil Alarabi N/A Interrupted Morocco (6) Bulletin Epidemiologique 0851-8238 Interrupted Journal du Practicien 1113-5667 Interrupted Maroc Medical 0025-4053 Active Revue Marocaine de Chirurgie Orthopedique et Traumatologique N/A Interrupted Revue Marocaine de Medecine et Sante 0251-0758 Interrupted Revue Marocaine des Maladies de L'Enfant N/A Interrupted Oman (3) Oman Journal of Ophthalmology 0974-620X Active Oman Medical Journal 1999-768X Active SQUMJ - Sultan Qaboos University Medical Journal 2075-051X Active Pakistan (74) Anaesthesia, Pain and Intensive Care 1607-8322 Active Annals Abbassi Shaheed Hospital and Karachi Medical and Dental College 1563-3241 Active Annals of Jinnah Postgraduate Medical Centre - Karachi N/A Interrupted Annals of King Edward Medical College 1684-6680 Interrupted APMC - Annals of Punjab Medical College 1024-8919 Active Bahria Journal of Professional Psychology 1816-0840 Active Biomedica 1992-4852 Active Challenge - Quarterly [The] 0528-7944 Interrupted Community Medicine 0301-7265 Interrupted IMEMR Current Contents EMR Journals List 145 Journal ISSN Status Diabetes Digest 1369-7501 Active GJMS – Gomal Journal of Medical Sciences 1819-7973 Active Hamdard Medicus 0250-7188 Active Infectious Diseases Journal of Pakistan 1027-0299 Interrupted International Journal of Pathology 1810-0155 Active Isra Medical Journal 2073-8285 Active JAMC - Journal of Ayub Medical College - Abbotabad - Pakistan 1025-9589 Active JCPSP - Journal of the College of Physicians and Surgeons Pakistan 1022-386X Active JDUHS - Journal of the Dow University of Health Sciences 1995-2198 Active JKCD - Journal of Khyber College of Dentistry 2220-2633 Active JLUMHS - Journal of the Liaquat University of Medical Health Sciences 1729-0341 Interrupted JOPDAK - Journal of the Pakistan Dental Association Karachi N/A Interrupted Journal of Basic and Applied Sciences 1814-8085 Active Journal of Medical Sciences 1682-4474 Interrupted Journal of Medical Sciences 1997-3438 Active Journal of Nephrology Urology and Transplantation N/A Interrupted Journal of Surgery [The] 1681-4517 Interrupted JPAD - Journal of Pakistan Association of Dermatologists 1560-9014 Active JPDA - Journal of the Pakistan Dental Association 1680-2292 Active JPIMS - Journal of Pakistan Institute of Medical Sciences 1683-6928 Interrupted JPMA - Journal of Pakistan Medical Association 0030-9982 Active JPMI - Journal of Postgraduate Medical Institute 1013-5472 Active JPPS - Journal of Pakistan Psychiatric Society 1726-8710 Active JSP - Journal of Surgery Pakistan International 1817-0242 Active KMUJ - Khyber Medical University Journal 2072-7763 Active Lahore Journal of Public Health N/A Interrupted Medical Channel 1681-5491 Interrupted Medical Forum Monthly 1029-385X Active Medical Spectrum [The] 0254-8534 Interrupted Medicine Today 1813-9876 Active Mother and Child 0379-2617 Interrupted PAFMJ - Pakistan Armed Forces Medical Journal 0030-9648 Active Pakistan Heart Journal 0048-2706 Active IMEMR Current Contents EMR Journals List 146 Journal ISSN Status Pakistan Journal of Biochemistry 0300-8185 Interrupted Pakistan Journal of Chest Medicine N/A Interrupted Pakistan Journal of Clinical Psychology 1019-438X Active Pakistan Journal of Community Medicine [The] N/A Interrupted Pakistan Journal of Health N/A Interrupted Pakistan Journal of Medical and Health Sciences 1996-7195 Active Pakistan Journal of Medical Ethics N/A Active Pakistan Journal of Medical Sciences 1682-024X Active Pakistan Journal of Neurology N/A Interrupted Pakistan Journal of Obstetrics and Gynaecology N/A Interrupted Pakistan Journal of Orthodontics, Pediatric and Community Dentistry 1608-134X Interrupted Pakistan Journal of Otolaryngology - Head and Neck Surgery 0257-4985 Active Pakistan Journal of Pathology 1024-6193 Active Pakistan Journal of Pharmaceutical Sciences 1011-601X Active Pakistan Journal of Pharmacology 0255-7088 Interrupted Pakistan Journal of Physiology 1819-270X Active Pakistan Journal of Psychology 0030-9869 Active Pakistan Journal of Scientific and Industrial Research 0030-9885 Stopped Pakistan Journal of Scientific and Industrial Research Series A: Physical Sciences 2221-6413 Active Pakistan Journal of Scientific and Industrial Research Series B: Biological Sciences 2221-6421 Active Pakistan Medical Journal 0031-000X Interrupted Pakistan Ophthalmology 0259-3661 Interrupted Pakistan Oral and Dental Journal 1012-8700 Active Pakistan Paediatric Journal 0304-4904 Interrupted PJC - Pakistan Journal of Cardiology 1016-1244 Interrupted PJMR - Pakistan Journal of Medical Research 0030-9842 Active PJO - Pakistan Journal of Ophthalmology 0886-3067 Interrupted PJPH - Pakistan Journal of Public Health 2225-0891 Active PJS - Pakistan Journal of Surgery 0258-8552 Active Proceedings N/A Interrupted Professional Medical Journal - Quarterly [The] 1024-8919 Active RMJ - Rawal Medical Journal 0303-5212 Interrupted IMEMR Current Contents EMR Journals List 147 Journal ISSN Status Palestine (3) Al-Quds Medical Journal N/A Interrupted Annals of Alquds Medicine 1815-2635 Interrupted PMJ - Palestinian Medical Journal N/A Interrupted Qatar (4) Gulf Journal of Dermatology and Venereology [The] N/A Active Heart Views 1995-705X Active JEMTAC - Journal of Emergency Medicine, Trauma and Acute Care 1999-7086 Active Qatar Medical Journal 0253-8253 Active Saudi Arabia (29) Annals of Saudi Medicine 0256-4947 Active Annals of Thoracic Medicine 1817-1737 Active Hematology, Oncology and Stem Cell Therapy 1658-3876 Active International Journal of Diabetes Mellitus 1877-5934 Active International Journal of Health Sciences 1658-3639 Active Joint Centre for Research in Prosthetics and Orthotics [The] N/A Interrupted Journal of Family and Community Medicine 1319-1683 Active Journal of Infection and Public Health 1876-0341 Active Journal of King Abdulaziz University - Medical Sciences 1319-1004 Interrupted Journal of Taibah University Medical Sciences 1658-3612 Active Journal of the Saudi Heart Association 1016-7315 Active MEAJO - Middle East African Journal of Ophthalmology 0974-9233 Active Neurosciences 1319-6138 Active Pan Arab Journal of Neurosurgery 1319-6995 Active Rehabilitation International N/A Interrupted Research Centre Bulletin 1019-5335 Interrupted Saudi Epidemiology Bulletin 1319-3965 Interrupted Saudi Heart Journal 1018-077X Interrupted Saudi Journal of Disability and Rehabilitation 1319-6499 Interrupted Saudi Journal of Gastroenterology [The] 1319-3767 Active Saudi Journal of Oto-Rhino-Laryngology Head and Neck Surgery [The] 1319-8491 Interrupted Saudi Journal of Sports Medicine [The] 1319-6308 Interrupted Saudi Medical Journal 0379-5284 Active SDJ - Saudi Dental Journal [The] 1013-9052 Active IMEMR Current Contents EMR Journals List 148 Journal ISSN Status SGH Medical Journal 1658-2489 Interrupted SJA - Saudi Journal of Anaesthesia 1658-354X Active SJO - Saudi Journal of Ophthalmology 1319-4534 Active SPJ - Saudi Pharmaceutical Journal 1319-0164 Active Urology Annals 0974-7796 Active Sudan (9) Gezira Journal of Health Sciences 1810-5386 Active JMJ - Juba Medical Journal N/A Interrupted Khartoum Pharmacy Journal N/A Interrupted Omdurman Journal of Pharmaceutical Sciences N/A Interrupted SJPH - Sudanese Journal of Public Health 1990-7567 Active Sudan Journal of Medical Sciences 1858-5051 Active Sudan Medical Journal 0491-4481 Active Sudan Medical Monitor 1858-5000 Active Sudanese Journal of Dermatology 1815-3941 Interrupted Syrian Arab Republic (10) Arab Journal of Pharmaceutical Sciences 1683-0369 Active Arabic Journal of Forensic Medicine and Criminal Science N/A Interrupted Arabic Medical Journal N/A Active Damascus University Journal for Health Sciences N/A Active JABHS - Journal of the Arab Board of Health Specializations 1561-0217 Active JISHIM - Journal of the International Society for the History of Islamic Medicine 1303-667X Interrupted Journal of Clinical Laboratory [The] 1814-411X Active Journal of the Arab Board of Medical Specializations 1561-0217 Active Journal of the Arab Dentist N/A Interrupted Research Journal of Aleppo University - Medical Sciences Series N/A Interrupted Tunisia (9) Archives de l'Institut Pasteur de Tunis 0020-2509 Active Cahiers Medicaux de Tunisie 0300-5291 Interrupted IDEES - Revue de Perfectionnement Medical et Paramedical N/A Interrupted Maghreb Medical 0330-258X Active Revue Maghrebine de Pediatrie [La] 0330-7611 Active Revue Maghrebine d'Endocrinologie - Diabete et de Reproduction [La] N/A Active New IMEMR Current Contents EMR Journals List 149 Journal ISSN Status Revue Tunisienne d'Infectiologie 1737-8958 Active SST - Sante et Securite au Travail N/A Active Tunisie Medicale [La] 0041-4131 Active United Arab Emirates (4) EMJ - Emirates Medical Journal 0250-6882 Active International Journal of Diabetes and Metabolism 1606-7754 Active IRCMJ - Iranian Red Crescent Medical Journal 1561-4395 Active JMS - Journal of Medical Sciences 1996-3262 Active Yemen (7) Journal of Tropical Nephro-Urology N/A Active Sana'a University Journal of Medical Sciences N/A Interrupted University of Aden Journal of Natural and Applied Sciences 1606-8947 Active Yemeni Journal for Medical Sciences [The] N/A Interrupted YHMRJ - Yemeni Health and Medical Research Journal N/A Interrupted YJMHR-Yemeni Journal of Medical and Health Research N/A Interrupted YMJ - Yemen Medical Journal N/A Interrupted Last update September 2012

Appendix III List of EMR Journals Indexed in IMEMR (by title)

IMEMR Current Contents EMR Journals List 153 S/N Journal ISSN Status 1 AAMJ - Al-Azhar Assiut Medical Journal 1687-1693 Interrupted 2 ACES - Actualites Cliniques et Scientifiques 1683-8068 Active 3 Acta Medica Iranica 0044-6025 Active 4 Advances in Cognitive Science 1561-4174 Interrupted 5 AFJPH - Afghanistan Journal of Public Health N/A Active 6 African Journal of Urology 1110-5704 Active 7 Afro-Arab Liver Journal 1687-224X Active 8 Ain-Shams Journal of Forensic Medicine and Clinical Toxicology 1687-1030 Active 9 Ain-Shams Medical Journal 0002-2144 Interrupted 10 AJAIC - Alexandria Journal of Anaesthesia and Intensive Care N/A Interrupted 11 AJMB - Avicenna Journal of Medical Biotechnology 2008-2835 Active 12 AJU - Arab Journal of Urology N/A Active 13 Al-Azhar Journal of Dental Science 1110-6751 Interrupted 14 Al-Azhar Medical Journal 1110-0400 Active 15 Alexandria Dental Journal 1110-015X Interrupted 16 Alexandria Journal of Food Science and Technology 1687-3920 Interrupted 17 Alexandria Journal of Hepatogastroenterology 2090-1879 Interrupted 18 Alexandria Journal of Pediatrics 1687-9945 Active 19 Alexandria Journal of Pharmaceutical Sciences 1110-1792 Interrupted 20 Alexandria Journal of Veterinary Science 1110-2047 Active 21 Alexandria Medical Journal [The] 0516-5849 Interrupted 22 Al-Kindy College Medical Journal 1810-9543 Active 23 Almustansiriya Journal of Pharmaceutical Sciences 1815-0993 Interrupted 24 Al-Quds Medical Journal N/A Interrupted 25 Anaesthesia, Pain and Intensive Care 1607-8322 Active 26 Annals Abbassi Shaheed Hospital and Karachi Medical and Dental College 1563-3241 Active 27 Annals of Alquds Medicine 1815-2635 Interrupted 28 Annals of Jinnah Postgraduate Medical Centre - Karachi N/A Interrupted 29 Annals of King Edward Medical College 1684-6680 Interrupted 30 Annals of Pediatric Surgery 1687-4137 Interrupted 31 Annals of Saudi Medicine 0256-4947 Active 32 Annals of the College of Medicine - Mosul 0028-1446 Interrupted IMEMR Current Contents EMR Journals List 154 S/N Journal ISSN Status 33 Annals of Thoracic Medicine 1817-1737 Active 34 APMC -Annals of Punjab Medical College 1024-8919 Active 35 Applied Endocrinology in Egypt 1110-1776 Interrupted 36 Arab Dental Journal N/A Interrupted 37 Arab Family Health and Population N/A Active 38 Arab Journal for Food and Nutrition 1608-8352 Interrupted 39 Arab Journal of Biotechnology 1110-6875 Active 40 Arab Journal of Gastroenterology 1687-1979 Active 41 Arab Journal of Laboratory Medicine [The] 1110-1822 Active 42 Arab Journal of Pharmaceutical Sciences 1683-0369 Active 43 Arab Journal of Psychiatry [The] 1016-8923 Active 44 Arabic Journal of Forensic Medicine and Criminal Science N/A Interrupted 45 Arabic Medical Journal N/A Active 46 Archives de l'Institut Pasteur de Tunis 0020-2509 Active 47 Archives of Iranian Medicine 1029-2977 Active 48 Armaghane-danesh 1728-6506 Active 49 ARYA Atherosclerosis Journal 1735-3955 Interrupted 50 Asian Journal of Sports Medicine 2008-000X Active 51 ASJOG - Ain-Shams Journal of Obstetrics and Gynecology 1697-2193 Interrupted 52 ASNJ - Alexandria Scientific Nursing Journal 1687-3858 Active 53 Assiut Medical Journal 1110-0494 Active 54 Assiut University Bulletin for Environmental Researches 1110-6107 Active 55 Assiut Veterinary Medical Journal N/A Interrupted 56 Audiology 1735-1936 Active 57 Bahrain Medical Bulletin 1012-8298 Active 58 Bahria Journal of Professional Psychology 1816-0840 Active 59 Basic and Clinical Neurosciences N/A Active 60 Basrah Journal of Surgery N/A Interrupted 61 BCCR - Basic and Clinical Cancer Research 2228-6527 Active 62 Benha Medical Journal 1110-208X Active 63 Bina Journal of Ophthalmology 1026-6399 Interrupted 64 Biomedica 1992-4852 Active New New IMEMR Current Contents EMR Journals List 155 S/N Journal ISSN Status 65 Bulletin Epidemiologique 0851-8238 Interrupted 66 Bulletin of Alexandria Faculty of Medicine 1110-0834 Active 67 Bulletin of Alexandria Thoracic Association N/A Interrupted 68 Bulletin of Endemic Disease - Baghdad 0007-4845 Interrupted 69 Bulletin of Faculty of Pharmacy - Cairo University 1110-0931 Interrupted 70 Bulletin of Faculty of Physical Therapy - Cairo University 1110-6611 Interrupted 71 Bulletin of High Institute of Public Health [The] 1110-0036 Active 72 Bulletin of Pharmaceutical Sciences - Assiut University 1110-0052 Active 73 Bulletin of the Faculty of Science - University of Alexandria 0568-9619 Interrupted 74 Bulletin of the Kuwait Institute for Medical Specialization N/A Active 75 Bulletin of the National Nutrition Institute of the Arab Republic of Egypt N/A Active 76 Bulletin of the National Research Centre 1110-0591 Active 77 Bulletin of the Ophthalmological Society of Egypt 0078-5342 Interrupted 78 Cahiers Medicaux de Tunisie 0300-5291 Interrupted 79 Cell Journal (Yakhteh) 2228-5806 Active 80 Challenge - Quarterly [The] 0528-7944 Interrupted 81 Childhood and Development Quarterly 1110-8681 Interrupted 82 Clinical Diabetes 0891-8929 Active 83 Community Medicine 0301-7265 Interrupted 84 Damascus University Journal for Health Sciences N/A Active 85 DARU - Journal of Pharmaceutical Sciences 1560-8115 Active 86 DENA - Quarterly Journal of Yasuj Faculty of Nursing and Midwifery 1735-8450 Interrupted 87 Dermatology and Cosmetic Quarterly 2008-7470 Active 88 Diabetes Digest 1369-7501 Active 89 Dirasat 1026-3772 Interrupted 90 DMJ - Derna Medical Journal N/A Active 91 DMJ - Dohuk Medical Journal 2071-7326 Active 92 DRJ - Dental Research Journal 1735-3327 Active 93 EDJ - Egyptian Dental Journal 0070-9484 Interrupted 94 Egyptian Heart Journal [The] 1110-2608 Interrupted 95 Egyptian Journal of Anatomy [The] 1110-2144 Interrupted 96 Egyptian Journal of Biomedical Engineering 1012-5558 Active IMEMR Current Contents EMR Journals List 156 S/N Journal ISSN Status 97 Egyptian Journal of Biophysics and Biomedical Engineering 1110-8525 Active 98 Egyptian Journal of Bronchology [The] 1687-8426 Active 99 Egyptian Journal of Cataract and Refractive Surgery [The] N/A Active 100 Egyptian Journal of Chemistry 0449-2285 Active 101 Egyptian Journal of Community Medicine [The] 1110-1865 Active 102 Egyptian Journal of Dermatology and Andrology 1110-7650 Interrupted 103 Egyptian Journal of Diabetes [The] N/A Interrupted 104 Egyptian Journal of Food Science 1110-0192 Active 105 Egyptian Journal of Genetics and Cytology 0046-161X Interrupted 106 Egyptian Journal of Histology [The] 1110-0559 Active 107 Egyptian Journal of Hospital Medicine [The] 1687-2002 Interrupted 108 Egyptian Journal of Immunology [The] 1110-4902 Active 109 Egyptian Journal of Medical Human Genetics [The] 1110-8630 Active 110 Egyptian Journal of Medical Laboratory Sciences 1110-5593 Active 111 Egyptian Journal of Medical Microbiology 1110-2179 Interrupted 112 Egyptian Journal of Microbiology 0022-2704 Interrupted 113 Egyptian Journal of Neonatology [The] 1110-8991 Interrupted 114 Egyptian Journal of Neurology, Psychiatry and Neurosurgery [The] 1110-1083 Active 115 Egyptian Journal of Nutrition 1687-1235 Active 116 Egyptian Journal of Nutrition and Health 1687-7950 Active 117 Egyptian Journal of Occupational Medicine 1110-1881 Interrupted 118 Egyptian Journal of Otolaryngology [The] 1012-5574 Interrupted 119 Egyptian Journal of Paediatrics [The] 1687-1677 Interrupted 120 Egyptian Journal of Pediatric Allergy and Immunology 1687-1642 Active 121 Egyptian Journal of Pharmaceutical Sciences 0301-5068 Active 122 Egyptian Journal of Physiological Sciences 0301-8660 Interrupted 123 Egyptian Journal of Psychiatry [The] 1110-1105 Interrupted 124 Egyptian Journal of Schistosomiasis and Infectious and Endemic Diseases 1110-7278 Interrupted 125 Egyptian Journal of Surgery [The] 1110-1121 Active 126 Egyptian Journal of Urology 1110-5712 Interrupted 127 Egyptian Journal of Veterinary Science 1110-0222 Active 128 Egyptian Liver Journal 2090-6218 Active IMEMR Current Contents EMR Journals List 157 S/N Journal ISSN Status 129 Egyptian Medical Journal of the National Research Center 1687-1278 Interrupted 130 Egyptian Orthodontic Journal N/A Interrupted 131 Egyptian Orthopaedic Journal [The] 1110-1148 Interrupted 132 Egyptian Pharmaceutical Journal [National Research Center] 1687-4315 Active 133 Egyptian Population and Family Planning Review [The] N/A Interrupted 134 Egyptian Rheumatology and Rehabilitation 1110-161X Active 135 Egyptian Science Magazine [The] 1687-3815 Active 136 EJB - Egyptian Journal of Biochemistry and Molecular Biology [The] 1687-1502 Active 137 EJENTAS - Egyptian Journal of ENT and Allied Sciences 2090-0740 Interrupted 138 EMHJ - Eastern Mediterranean Health Journal 1020-3397 Active 139 EMJ - Emirates Medical Journal 0250-6882 Active 140 Endovascular Journal 2008-1812 Active 141 Feyz - Journal of Kashan University of Medical Sciences 1029-7855 Active 142 Food and Nutrition Bulletin N/A Active 143 Garyounis Medical Journal 0254-7198 Interrupted 144 Gastroenterology and Hepatology from Bed to Bench 2010-2258 Active 145 Gazette of the Egyptian Paediatric Association [The] 1110-6638 Interrupted 146 Genetics in the 3rd Millennium 1728-6182 Active 147 Gezira Journal of Health Sciences 1810-5386 Active 148 GJMS – Gomal Journal of Medical Sciences 1819-7973 Active 149 GJO - Gulf Journal of Oncology [The] 2078-2101 Active 150 Govaresh 1560-7186 Active 151 Gulf Journal of Dermatology and Venereology [The] N/A Active 152 HAKIM Research Journal 1561-252X Active 153 Hamdard Medicus 0250-7188 Active 154 HAYAT - Journal of Faculty of Nursing and Midwifery [The] 1735-2215 Active 155 Health Information Management 1735-7853 Active 156 Health Services Journal of the Eastern Mediterrenean Region 1014-9899 Interrupted 157 Heart Views 1995-705X Active 158 Hematology, Oncology and Stem Cell Therapy 1658-3876 Active 159 Hepatitis Monthly 1735-143X Active 160 Homa-ye-Salamat 2008-2002 Active IMEMR Current Contents EMR Journals List 158 S/N Journal ISSN Status 161 Hormozgan Medical Journal 1735-2223 Active 162 Hospital - Journal of Iranian Scientific Hospital Association 2008-1982 Active 163 IBJ - Iranian Biomedical Journal 1028-852X Active 164 IDEES - Revue de Perfectionnement Medical et Paramedical N/A Interrupted 165 IEJ - Iranian Endodontic Journal 1735-7497 Active 166 IHJ - Iranian Heart Journal 1735-7306 Active 167 IJB - Iranian Journal of Biotechnology 1728-3043 Active 168 IJBC - Iranian Journal of Blood and Cancer 2008-4595 Active 169 IJCN - Iranian Journal of Child Neurology 1735-4668 Active 170 IJEM - Iranian Journal of Endocrinology and Metabolism 1683-4844 Active 171 IJFS - International Journal of Fertility and Sterility 2008-076X Active 172 IJHOSCR - International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 Active 173 IJI - Iranian Journal of Immunology 1735-1383 Active 174 IJKD - Iranian Journal of Kidney Diseases 1735-8582 Active 175 IJM - Iranian Journal of Microbiology 2008-3289 Active 176 IJME - Iranian Journal of Medical Education 1608-9359 Active 177 IJMS - Iranian Journal of Medical Sciences 0253-0716 Active 178 IJO - Iranian Journal of Orthodontics 1735-5087 Interrupted 179 IJOH - International Journal of Occupational Hygiene 2008-5109 Active 180 IJPM - International Journal of Preventive Medicine 2008-7802 Active 181 IJPR - Iranian Journal of Pharmaceutical Research 1735-0328 Active 182 IJRM - Iranian Journal of Reproductive Medicine 1680-6433 Active 183 IJVM - Iranian Journal of Veterinary Medicine 2251-8894 Active 184 IMJ - Iraqi Medical Journal 0304-4564 Interrupted 185 Infectious Diseases Journal of Pakistan 1027-0299 Interrupted 186 International Journal of Diabetes and Metabolism 1606-7754 Active 187 International Journal of Diabetes Mellitus 1877-5934 Active 188 International Journal of Endocrinology and Metabolism 1726-913X Active 189 International Journal of Environmental Research 1735-6865 Active 190 International Journal of Environmental Science and Technology 1735-1472 Active 191 International Journal of Health Sciences 1658-3639 Active 192 International Journal of Occupational and Environmental Medicine 2008-6520 Active IMEMR Current Contents EMR Journals List 159 S/N Journal ISSN Status 193 International Journal of Organ Transplantation Medicine 2008-6490 Active 194 International Journal of Pathology 1810-0155 Active 195 IOJ - Iraqi Orthodontic Journal 1816-0581 Interrupted 196 IPMJ - Iraqi Postgraduate Medical Journal 1608-8360 Active 197 Iran Journal of Nursing 2008-5923 Active 198 Iran Occupational Health 1735-5133 Active 199 Iranian Cardiovascular Research Journal 1735-885X Active 200 Iranian Journal of Allergy, Asthma and Immunology 1735-1502 Active 201 Iranian Journal of Arthropod-Borne Diseases 1735-7179 Active 202 Iranian Journal of Basic Medical Sciences 2008-3866 Active 203 Iranian Journal of Cancer Prevention 2008-2398 Active 204 Iranian Journal of Clinical Infectious Diseases 1735-5109 Active 205 Iranian Journal of Dermatology 0021-082X Active 206 Iranian Journal of Diabetes and Lipid Disorders 1726-7544 Interrupted 207 Iranian Journal of Diabetes and Obesity 2008-6792 Active 208 Iranian Journal of Environmental Health Science and Engineering 1735-1979 Active 209 Iranian Journal of Epidemiology 1735-7489 Active 210 Iranian Journal of Health and Environment 2008-2029 Active 211 Iranian Journal of Medical Microbiology 1735-8612 Active 212 Iranian Journal of Medical Physics 1735-160X Active 213 Iranian Journal of Nuclear Medicine 1681-2824 Active 214 Iranian Journal of Nursing and Midwifery Research [IJNMR] 1735-9066 Interrupted 215 Iranian Journal of Nutrition Sciences and Food Technology 1735-7756 Active 216 Iranian Journal of Obstetric, Gynecology and Infertility [The] 1680-2993 Active 217 Iranian Journal of Ophthalmology 1735-4153 Active 218 Iranian Journal of Otorhinolaryngology 1560-1293 Active 219 Iranian Journal of Parasitology 1735-7020 Active 220 Iranian Journal of Pediatrics 2008-2142 Active 221 Iranian Journal of Psychiatry 1735-4587 Interrupted 222 Iranian Journal of Psychiatry and Behavioral Sciences 1735-8639 Active 223 Iranian Journal of Psychiatry and Clinical Psychology [IJPCP] 1735-4315 Active 224 Iranian Journal of Public Health 0304-4556 Active IMEMR Current Contents EMR Journals List 160 S/N Journal ISSN Status 225 Iranian Journal of Radiation Research 1728-4554 Active 226 Iranian Journal of Radiology 1735-1065 Active 227 Iranian Journal of Veterinary Research 1728-1997 Active 228 Iranian Rehabilitation Journal 1735-3602 Active 229 Iraqi Army Medical Journal N/A Interrupted 230 Iraqi Journal of Agriculture 1818-6645 Active 231 Iraqi Journal of Biotechnology N/A Interrupted 232 Iraqi Journal of Community Medicine 1684-5382 Interrupted 233 Iraqi Journal of Medical Sciences 1681-6579 Interrupted 234 Iraqi Journal of Microbiology N/A Interrupted 235 Iraqi Journal of Pharmaceutical Sciences N/A Interrupted 236 Iraqi Journal of Tropical Disease Researches 1814-0823 Interrupted 237 IRCMJ - Iranian Red Crescent Medical Journal 1561-4395 Active 238 Isra Medical Journal 2073-8285 Active 239 JABHS - Journal of the Arab Board of Health Specializations 1561-0217 Active 240 JAMC - Journal of Ayub Medical College - Abbotabad - Pakistan 1025-9589 Active 241 JBMS - Journal of the Bahrain Medical Society 1015-6321 Active 242 JBUMS - Journal of Babol University of Medical Sciences 1561-4107 Interrupted 243 JCPSP - Journal of the College of Physicians and Surgeons Pakistan 1022-386X Active 244 JDT - Journal of Dentistry Tehran University of Medical Sciences 1735-2150 Interrupted 245 JDUHS - Journal of the Dow University of Health Sciences 1995-2198 Active 246 JEMTAC - Journal of Emergency Medicine, Trauma and Acute Care 1999-7086 Active 247 JESN - Journal of Egyptian Society of Nephrology [The] N/A Interrupted 248 JISHIM - Journal of the International Society for the History of Islamic Medicine 1303-667X Interrupted 249 JKCD - Journal of Khyber College of Dentistry 2220-2633 Active 250 JLDA - Journal of the Lebanese Dental Association 1810-9632 Active 251 JLUMHS - Journal of the Liaquat University of Medical Health Sciences 1729-0341 Interrupted 252 JMJ - Jamahiriya Medical Journal N/A Active 253 JMJ - Juba Medical Journal N/A Interrupted 254 JMR - Journal of Medical Research 1728-1962 Interrupted 255 JMS - Journal of Medical Sciences 1996-3262 Active 256 JNP - Journal of Nephropathology 2251-8363 Active IMEMR Current Contents EMR Journals List 161 S/N Journal ISSN Status 257 Joint Centre for Research in Prosthetics and Orthotics [The] N/A Interrupted 258 JOPDAK - Journal of the Pakistan Dental Association Karachi N/A Interrupted 259 Jordan Journal of Pharmaceutical Sciences 1995-7157 Active 260 Jordan Medical Journal 0446-9283 Active 261 Journal du Practicien 1113-5667 Interrupted 262 Journal of Anesthesiology and Pain 2228-6659 Active 263 Journal of Arak University of Medical Sciences - Rahavard Danesh 1735-5338 Active 264 Journal of Basic and Applied Sciences 1814-8085 Active 265 Journal of Basic Medical Sciences N/A Interrupted 266 Journal of Childhood Studies 2090-0619 Active 267 Journal of Clinical Laboratory [The] 1814-411X Active 268 Journal of Community Medicine N/A Interrupted 269 Journal of Dental Medicine - Tehran University of Medical Sciences 1024-641X Active 270 Journal of Dental Research, Dental Clinics, Dental Prospects 2008-210X Active 271 Journal of Dental School - Shahid Beheshti University of Medical Sciences 1735-7683 Active 272 Journal of Dentistry - Shiraz University of Medical Sciences 1728-3426 Active 273 Journal of Dohuk University 1812-7568 Interrupted 274 Journal of Drug Research of Egypt 0085-2406 Active 275 Journal of Environmental Studies 1025-8620 Active 276 Journal of Family and Community Medicine 1319-1683 Active 277 Journal of Family and Reproductive Health 1735-8949 Active 278 Journal of Fundamentals of Mental Health [The] 1028-6918 Active 279 Journal of Gorgan University of Medical Sciences 1562-4765 Active 280 Journal of Guilan University of Medical Sciences 2008-4048 Active 281 Journal of Health Administration 2008-1200 Active 282 Journal of Hepatology, Gastroenterology and Infectious Diseases 1110-0796 Interrupted 283 Journal of Hygiene and Health 1735-2363 Interrupted 284 Journal of Infection and Public Health 1876-0341 Active 285 Journal of Injury and Violence Research 2008-2053 Active 286 Journal of Iranian Anatomical Sciences 1728-6158 Active 287 Journal of Isfahan Dental School 1735-255X Interrupted 288 Journal of Isfahan Medical School 1027-7595 Interrupted New IMEMR Current Contents EMR Journals List 162 S/N Journal ISSN Status 289 Journal of Islamic Dental Association of Iran [The] - JIDA 1024-6428 Active 290 Journal of Jahrom University of Medical Sciences 1735-5168 Active 291 Journal of Karbala University 1813-0410 Interrupted 292 Journal of Kerman University of Medical Sciences 1023-9510 Active 293 Journal of Kermanshah University of Medical Sciences (JKUMS) 2251-9068 Active 294 Journal of King Abdulaziz University - Medical Sciences 1319-1004 Interrupted 295 Journal of Lasers in Medical Sciences 2008-9783 Active 296 Journal of Legal Medicine and Forensic Sciences [The] 1110-6468 Interrupted 297 Journal of Mashhad Dental School 1560-9286 Active 298 Journal of Mazandaran University of Medical Sciences 1735-9260 Active 299 Journal of Medical Council of Islamic Republic of Iran 1562-1073 Active 300 Journal of Medical Education 1735-3998 Interrupted 301 Journal of Medical Science - Islamic Azad University of Mashhad 1735-7594 Active 302 Journal of Medical Sciences 1997-3438 Active 303 Journal of Medical Sciences 1682-4474 Interrupted 304 Journal of Medicinal Plants 1684-0240 Active 305 Journal of Modern Rehabilitation 2008-2576 Active 306 Journal of Nephrology Urology and Transplantation N/A Interrupted 307 Journal of Nursing and Midwifery Quarterly - Shaheed Beheshti University of Medical Sciences and Health Services 1605-8941 Active 308 Journal of Ophthalmic and Vision Research 2008-2010 Active 309 Journal of Periodontology and Implant Dentistry N/A Active 310 Journal of Qazvin University of Medical Sciences [The] 1561-3666 Active 311 Journal of Rafsanjan University of Medical Sciences 1735-3165 Active 312 Journal of Rehabilitation 1607-2960 Active 313 Journal of Reproduction and Infertility 2228-5482 Active 314 Journal of Research in Behavioural Sciences 1735-2029 Active 315 Journal of Research in Dental Sciences 2008-4676 Active 316 Journal of Research in Health Sciences [JRHS] 1682-2765 Active 317 Journal of Research in Medical Sciences 1735-5311 Active 318 Journal of Sabzevar School of Medical Sciences 1606-7487 Interrupted 319 Journal of School of Public Health and Institute of Public Health Research 1735-7586 Active 320 Journal of Shaheed Sadoughi University of Medical Sciences and Health Services 1562-272X Active IMEMR Current Contents EMR Journals List 163 S/N Journal ISSN Status 321 Journal of Shahrekord University of Medical Sciences 1735-1448 Active 322 Journal of Surgery [The] 1681-4517 Interrupted 323 Journal of Taibah University Medical Sciences 1658-3612 Active 324 Journal of Tehran University Heart Center [The] 1735-8620 Active 325 Journal of the Arab Board of Medical Specializations 1561-0217 Active 326 Journal of the Arab Dentist N/A Interrupted 327 Journal of the Arab Neonatology Forum 1812-1756 Iterrupted 328 Journal of the Arab Society for Medical Research 1687-4293 Active 329 Journal of the College of Dentistry - Baghdad N/A Interrupted 330 Journal of the Egyptian Medical Association [The] 0013-2411 Interrupted 331 Journal of the Egyptian National Cancer Institute 1110-0362 Interrupted 332 Journal of the Egyptian Public Health Association [The] 0013-2446 Active 333 Journal of the Egyptian Society of Endocrinology, Metabolism and Diabetes [The] 1110-1245 Active 334 Journal of the Egyptian Society of Obstetrics and Gynecology [The] 0258-3216 Interrupted 335 Journal of the Egyptian Society of Parasitology 1110-0583 Active 336 Journal of the Egyptian Society of Pharmacology and Experimental Therapeutics [The] N/A Interrupted 337 Journal of the Egyptian Society of Toxicology 1110-127X Active 338 Journal of the Faculty of Medicine - Baghdad 0041-9419 Interrupted 339 Journal of the Medical Research Institute - Alexandria University 1110-0133 Interrupted 340 Journal of the Royal Medical Services 2078-8703 Active 341 Journal of the Saudi Heart Association 1016-7315 Active 342 Journal of Tropical Nephro-Urology N/A Active 343 Journal of Veterinary Research 2008-2525 Active 344 Journal of Zahedan University of Medical Sciences and Health Services 1735-076X Active 345 Journal of Zanjan University of Medical Sciences and Health Services 1606-9366 Active 346 JPAD - Journal of Pakistan Association of Dermatologists 1560-9014 Active 347 JPC - Journal of Pediatric Club [The] N/A Active 348 JPDA - Journal of the Pakistan Dental Association 1680-2292 Active 349 JPIMS - Journal of Pakistan Institute of Medical Sciences 1683-6928 Interrupted 350 JPMA - Journal of Pakistan Medical Association 0030-9982 Active 351 JPMI - Journal of Postgraduate Medical Institute 1013-5472 Active 352 JPPS - Journal of Pakistan Psychiatric Society 1726-8710 Active IMEMR Current Contents EMR Journals List 164 S/N Journal ISSN Status 353 JRH - Journal of Research and Health 2251-6395 Active 354 JRMS - Journal of Research in Medical Sciences 1735-1995 Active 355 JRRS - Journal of Research in Rehabilitation Sciences 1735-7519 Active 356 JSP - Journal of Surgery Pakistan International 1817-0242 Active 357 Jundishapur Journal of Microbiology [JJM] 2008-3645 Active 358 Jundishapur Journal of Natural Pharmaceutical Products 1735-7780 Active 359 Jundishapur Scientific Medical Journal 2252-052x Active 360 Kasr El Aini Journal of Surgery 0022-9237 Interrupted 361 Kasr El-Aini Medical Journal N/A Active 362 Khartoum Pharmacy Journal N/A Interrupted 363 Kidney Forum 1369-3050 Interrupted 364 KMJ - Kuwait Medical Journal 0023-5776 Active 365 KMUJ - Khyber Medical University Journal 2072-7763 Active 366 KOOMESH - Journal of the Semnan University of Medical Sciences 1608-7046 Active 367 Kufa Medical Journal N/A Interrupted 368 Lahore Journal of Public Health N/A Interrupted 369 Lebanese Science Journal 1561-3410 Active 370 Libyan Journal of Infectious Diseases [The] N/A Active 371 LJM - Libyan Journal of Medicine 1993-2820 Interrupted 372 LMJ - Lebanese Medical Journal 0023-9852 Active 373 Maghreb Medical 0330-258X Active 374 Mansoura Journal of Pharmaceutical Sciences 1110-1318 Interrupted 375 Mansoura Medical Bulletin N/A Active 376 Mansoura Medical Journal 1110-211X Active 377 Maroc Medical 0025-4053 Active 378 MEAJO - Middle East African Journal of Ophthalmology 0974-9233 Active 379 Medical Arabization N/A Active 380 Medical Channel 1681-5491 Interrupted 381 Medical Forum Monthly 1029-385X Active 382 Medical Journal of Ahmed Maher Teaching Hospital [The] N/A Interrupted 383 Medical Journal of Basrah University [The] 0253-0759 Active 384 Medical Journal of Cairo University [The] 0045-3803 Active New New IMEMR Current Contents EMR Journals List 165 S/N Journal ISSN Status 385 Medical Journal of Islamic World Academy of Sciences 1016-3360 Active 386 Medical Journal of Mashad University of Medical Sciences 1735-4013 Active 387 Medical Journal of Tabriz University of Medical Sciences and Health Services 1608-5671 Interrupted 388 Medical Journal of Teaching Hospitals and Institutes [The] 1110-2039 Interrupted 389 Medical Journal of the Islamic Republic of Iran 1016-1430 Active 390 Medical Journal of Tikrit University [The] N/A Interrupted 391 Medical Principles and Practice 1011-7571 Active 392 Medical Sciences Journal of Islamic Azad University 1023-5922 Active 393 Medical Spectrum [The] 0254-8534 Interrupted 394 Medicine Today 1813-9876 Active 395 MEJC - Middle East Journal of Cancer 2008-6709 Active 396 Middle East Journal of Anesthesiology 0544-0440 Active 397 Middle East Journal of Digestive Diseases 2008-5230 Active 398 Middle East Journal of Family Medicine N/A Interrupted 399 Minoufia Medical Journal 1110-2098 Active 400 MJFCT - Mansoura Journal of Forensic Medicine and Clinical Toxicology 1110-5437 Interrupted 401 Modares Journal of Medical Sciences, Pathobiology 1562-9554 Active 402 Mother and Child 0379-2617 Interrupted 403 Neonatology 1687-0492 Interrupted 404 Nephro-Urology Monthly 2251-7006 Active 405 Neurosciences 1319-6138 Active 406 New Egyptian Journal of Medicine [The] 1110-1946 Active 407 New Iraqi Journal of Medicine [The] 1817-5562 Active 408 Nursing and Midwifery Research 1753-5001 Interrupted 409 Ofogh-E-Danesh 1735-1855 Active 410 Oman Journal of Ophthalmology 0974-620X Active 411 Oman Medical Journal 1999-768X Active 412 Omdurman Journal of Pharmaceutical Sciences N/A Interrupted 413 PAFMJ - Pakistan Armed Forces Medical Journal 0030-9648 Active 414 Pakistan Heart Journal 0048-2706 Active 415 Pakistan Journal of Biochemistry 0300-8185 Interrupted 416 Pakistan Journal of Chest Medicine N/A Interrupted New IMEMR Current Contents EMR Journals List 166 S/N Journal ISSN Status 417 Pakistan Journal of Clinical Psychology 1019-438X Active 418 Pakistan Journal of Community Medicine [The] N/A Interrupted 419 Pakistan Journal of Health N/A Interrupted 420 Pakistan Journal of Medical and Health Sciences 1996-7195 Active 421 Pakistan Journal of Medical Ethics N/A Active 422 Pakistan Journal of Medical Sciences 1682-024X Active 423 Pakistan Journal of Neurology N/A Interrupted 424 Pakistan Journal of Obstetrics and Gynaecology N/A Interrupted 425 Pakistan Journal of Orthodontics, Pediatric and Community Dentistry 1608-134X Interrupted 426 Pakistan Journal of Otolaryngology - Head and Neck Surgery 0257-4985 Active 427 Pakistan Journal of Pathology 1024-6193 Active 428 Pakistan Journal of Pharmaceutical Sciences 1011-601X Active 429 Pakistan Journal of Pharmacology 0255-7088 Interrupted 430 Pakistan Journal of Physiology 1819-270X Active 431 Pakistan Journal of Psychology 0030-9869 Active 432 Pakistan Journal of Scientific and Industrial Research 0030-9885 Stopped 433 Pakistan Journal of Scientific and Industrial Research Series A: Physical Sciences 2221-6413 Active 434 Pakistan Journal of Scientific and Industrial Research Series B: Biological Sciences 2221-6421 Active 435 Pakistan Medical Journal 0031-000X Interrupted 436 Pakistan Ophthalmology 0259-3661 Interrupted 437 Pakistan Oral and Dental Journal 1012-8700 Active 438 Pakistan Paediatric Journal 0304-4904 Interrupted 439 Pan Arab Journal of Neurosurgery 1319-6995 Active 440 Pan Arab Journal of Orthopaedic and Trauma [The] 1607-4912 Active 441 Pan Arab Medical Journal N/A Interrupted 442 Payavard - Salamat 1735-8132 Active 443 Payesh - Health Monitor 1680-7626 Active 444 Pejouhandeh: Bimonthly Research Journal 1735-1022 Active 445 PJC - Pakistan Journal of Cardiology 1016-1244 Interrupted 446 PJMR - Pakistan Journal of Medical Research 0030-9842 Active 447 PJO - Pakistan Journal of Ophthalmology 0886-3067 Interrupted 448 PJPH - Pakistan Journal of Public Health 2225-0891 Active IMEMR Current Contents EMR Journals List 167 S/N Journal ISSN Status 449 PJS - Pakistan Journal of Surgery 0258-8552 Active 450 PMJ - Palestinian Medical Journal N/A Interrupted 451 Population Bulletin of ESCWA 0258-1914 Interrupted 452 Population Researches and Studies N/A Active 453 Population Sciences N/A Interrupted 454 Population Studies 1110-1342 Interrupted 455 Proceedings N/A Interrupted 456 Professional Medical Journal - Quarterly [The] 1024-8919 Active 457 PUJ - Parasitologists United Journal 1687-7942 Active 458 Qatar Medical Journal 0253-8253 Active 459 Qom University of Medical Sciences Journal 1735-7799 Active 460 Quarterly Journal of Medical Ethics 2008-4374 Active 461 Quarterly Journal of Medical Law N/A Active 462 Quarterly Journal of Relief and Rescue 4544-2008 Active 463 Razi Journal of Medical Sciences 2228-7043 Active 464 Rehabilitation International N/A Interrupted 465 Research Centre Bulletin 1019-5335 Interrupted 466 Research Journal of Aleppo University - Medical Sciences Series N/A Interrupted 467 Revue Maghrebine de Pediatrie [La] 0330-7611 Active 468 Revue Maghrebine d'Endocrinologie - Diabete et de Reproduction [La] N/A Active 469 Revue Marocaine de Chirurgie Orthopedique et Traumatologique N/A Interrupted 470 Revue Marocaine de Medecine et Sante 0251-0758 Interrupted 471 Revue Marocaine des Maladies de L'Enfant N/A Interrupted 472 Revue Tunisienne d'Infectiologie 1737-8958 Active 473 Risafa Medical Journal N/A Interrupted 474 RMJ - Rawal Medical Journal 0303-5212 Interrupted 475 Salmand - Iranian Journal of Aging 1735-806X Active 476 Sana'a University Journal of Medical Sciences N/A Interrupted 477 Saudi Epidemiology Bulletin 1319-3965 Interrupted 478 Saudi Heart Journal 1018-077X Interrupted 479 Saudi Journal of Disability and Rehabilitation 1319-6499 Interrupted 480 Saudi Journal of Gastroenterology [The] 1319-3767 Active IMEMR Current Contents EMR Journals List 168 S/N Journal ISSN Status 481 Saudi Journal of Oto-Rhino-Laryngology Head and Neck Surgery [The] 1319-8491 Interrupted 482 Saudi Journal of Sports Medicine [The] 1319-6308 Interrupted 483 Saudi Medical Journal 0379-5284 Active 484 Scientific and Research Journal of Army University of Medical Sciences - J.A.U.M.S. 1727-1789 Active 485 Scientific Journal of Al-Azhar Medical Faculty [Girls] [The] 1110-2381 Interrupted 486 Scientific Journal of El-Minia Faculty of Medicine [The] 1110-2446 Interrupted 487 Scientific Journal of Forensic Medicine 1027-1457 Interrupted 488 Scientific Journal of Iranian Blood Transfusion Organization [The] 1027-9520 Active 489 Scientific Journal of Kurdistan University of Medical Sciences 1560-652X Active 490 Scientific Medical Journal 1110-5607 Active 491 Scientific Nursing Journal 1812-2388 Interrupted 492 SDJ - Saudi Dental Journal [The] 1013-9052 Active 493 SGH Medical Journal 1658-2489 Interrupted 494 SJA - Saudi Journal of Anaesthesia 1658-354X Active 495 SJO - Saudi Journal of Ophthalmology 1319-4534 Active 496 SJPH - Sudanese Journal of Public Health 1990-7567 Active 497 Smile Dental Journal 2072-473X Active 498 Social Welfare Quarterly 1735-8191 Interrupted 499 Sohag Medical Journal 1110-7529 Active 500 South Valley Medical Journal 1110-7529 Interrupted 501 SPJ - Saudi Pharmaceutical Journal 1319-0164 Active 502 SQUMJ - Sultan Qaboos University Medical Journal 2075-051X Active 503 SST - Sante et Securite au Travail N/A Active 504 Strides in Development of Medical Education 1735-4242 Active 505 Sudan Journal of Medical Sciences 1858-5051 Active 506 Sudan Medical Journal 0491-4481 Active 507 Sudan Medical Monitor 1858-5000 Active 508 Sudanese Journal of Dermatology 1815-3941 Interrupted 509 Suez Canal University Medical Journal 1110-6999 Active 510 Tabib Attifil Alarabi N/A Interrupted 511 Tanaffos 1735-0344 Active 512 Tanta Medical Journal 1110-1415 Interrupted IMEMR Current Contents EMR Journals List 169 S/N Journal ISSN Status 513 Tanta Medical Sciences Journal 1687-5788 Interrupted 514 Teb Va Tazkie 1608-2397 Active 515 Tehran University Medical Journal [TUMJ] 1683-1764 Active 516 Toloo-e-Behdasht 1728-5127 Interrupted 517 Trauma Monthly 2251-7464 Active 518 Tunisie Medicale [La] 0041-4131 Active 519 University of Aden Journal of Natural and Applied Sciences 1606-8947 Active 520 Urology Annals 0974-7796 Active 521 Urology Journal 1735-1308 Active 522 Veterinary Medical Journal 1110-1423 Active 523 Yafteh Journal 1563-0773 Active 524 Yemeni Journal for Medical Sciences [The] N/A Interrupted 525 YHMRJ - Yemeni Health and Medical Research Journal N/A Interrupted 526 YJMHR-Yemeni Journal of Medical and Health Research N/A Interrupted 527 YMJ - Yemen Medical Journal N/A Interrupted 528 Zagazig Journal of Forensic Medicine and Toxicology 1687-160X Interrupted 529 Zagazig Journal of Pharmaceutical Sciences 1110-5089 Interrupted 530 Zagazig Medical Association Journal 1110-2322 Interrupted 531 Zagazig University Medical Journal 1110-1431 Interrupted 532 Zanco Journal of Medical Sciences 1995-5588 Active Last update September 2012 New ISSN: 2071-2510 IMEMR Current Contents September 2012 Vol. 11 No.2 Providing Access to Health Knowledge to Build a Healthy Future For further information contact: World Health Organization Regional Office for the Eastern Mediterranean Health Publications, Production & Dissemination (HPD) Library & Health Literature Services (LHL) Abdul Razzak Al-Sanhouri Street, P.O. Box 7608, Nasr City, Cairo 11371, Egypt http://www.emro.who.int/lin e-mail: hpd@emro.who.int Tel: +20 2 22765047 Fax: +20 2 22765424 http://www.emro.who.int/information-resources/imemr/imemr.html Vol. 11 No. 3