Kangriddle7835

Background and objective Leishmaniasis is endemic in Saudi Arabia with cases reported in many regions. This review refers to publications on leishmaniasis in Saudi Arabia and discusses issues related to parasite species, clinical manifestation and diagnosis. Methods This research was done at Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia by systematic literature search on PubMed and Google Scholar databases from 1989 to 2018. Selection criteria included original articles reporting on visceral leishmaniasis (VL) or cutaneous leishmaniasis (CL) in Saudi Arabia. Results The search identified 16 eligible articles, six for VL and 10 for CL. VL was reported in areas known to be non-endemic. Leishmania donovani was the main cause for human VL while Leishmania infantum seemed to cause the disease in animals. Dogs were considered the main reservoir hosts and black rats (Rattus rattus) were potential hosts. VL mainly affected infants and young children. Staurosporine in vivo It is important to note that VL diagnosis was based on either invasive parasite detection procedures or serologically using indirect hemagglutination test. CL represented the most frequent clinical form with the main endemic foci reported in the South-West and Eastern regions. CL appeared to have no demographic or socioeconomic restriction; it affected both rural and urban citizens, with the majority occurring among farmers. Travelling was recognized as an important risk factor. Leishmania tropica and Leishmania major were recognized as the main causes for CL. Conclusion This report summarizes the potential risks for VL and CL in Saudi Arabia in areas known to be non-endemic. There are substantial gaps in knowledge and practices in regard to leishmaniasis in Saudi Arabia, highlighting the need for more research and medical surveillance targeting the disease in humans and animals.Background and objective Surgical managements for these suspicious nontoxic swellings requires open conventional method of thyroidectomy by neck incisions that can result in prominent scars and immediate risk usually hemorrhage. However new technological innovations came into practiced that include video assisted minimal invasive endoscopy by axillo-breast approach that gives very promising results with excellent cosmesis. In this study, we compared conventional open surgery with minimal invasive endoscopic techniques and associate various complaints and complications that were encountered in surgery. Methods Sixty patients were enrolled in this comparative study. It was conducted from period February 2018 to February 2019. The patients were randomized alternatively in two groups. Group-I patients underwent conventional lobectomy while Group-II patients were operated endoscopically, Patients having nodules less than 3cm and Thy 1 and 2 were included in this study. Patient having nodules greater than 3cm, Multinodular goiter, recurrent nodule and Thy 3-6 were excluded from the study. Results Patients who underwent endoscopic lobectomy were much more satisfied about scar marks whereas some developed post-operative complications. It included hoarseness of voice in Three (13.62%) patients, two patients developed seroma (9.08%), three patients (13.62%) erythema, whereas no postoperative complications were seen in patients who underwent open thyroid lobectomy. No signs of hypocalcemia noted in both approaches. Conclusions The complications with endoscopic approaches are higher but they are minor and resolved spontaneously within maximum period of six weeks. However scar mark satisfaction was much higher in endoscopic lobectomy group.Objective The aim of study was to investigate the association of IL 1B gene polymorphism with involvement of H. pylori and other gastric diseases. Methods Blood samples of dyspeptic patients were collected from endoscopy department of Allied Hospital Faisalabad from January 2017 to January 2019 and were qualitatively assayed for serological detection of CagA H. pylori antibodies. PCR followed by direct sequencing was performed for proinflammatory IL-1B gene polymorphism detection. Sequence analysis was performed in software SnapGene viewer for haplotypes. Results Demographic characteristics of seropositive patients showed maximum 25% gastritis in age groups of 20-40 years and 41-60 years, predominantly (41.7%) in females. While in seronegative patient's gastritis (33.3%) was found in age group of 20-40 years mainly in males (41.7%). Among studied groups, higher expression of IL-1B-511 genotype (33.3%) polymorphism was found in healthy individuals as compared to H. pylori seropositive (25%) and seronegative (8.3%). While IL-1B-31 genotype showed maximum 33.3% polymorphism rate in seropositive gastric diseased group. Moreover, haplotypes frequencies IL-1B-511CC and IL-1B-31TT were predominantly (20%) found in seropositive gastric diseased group. Conclusions In H. pylori seropositive patients, gastric disease was commonly found, however, gastric disease was not only associated with H. pylori as seronegative patients were also carrying gastric complications. Interleukin IL-1B polymorphism was partially associated with H. pylori infection in studied dyspeptic population.Objectives To identify the risk factors in acute coronary syndrome. Methods It was a case series study, conducted in coronary care unit of Jinnah Hospital, Lahore from January to December 2018. Convenient sampling was used for patients' selection. The serum cardiac enzymes level was measured, and serial ECG was done at admission and repeated if required. Blood samples were collected after an overnight fast of 14 hours and tests were done for total cholesterol and HDL cholesterol. Results Out of 300 patients of acute coronary syndrome, 100 (33.33%) were female and 200 (66.67%) were males. Majority of patients 180 (60%) belonged to age group of 25-40 years. Out of 300 patients 94 (31.33%) had diabetes mellitus, while 139 (46.3%) were suffering from hypertension. Out of 290 patients 95 (32.7%) had family history of coronary artery disease. Out of 298 patients 125 (41.9%) were smokers. Conclusion Acute coronary syndrome in age group of 18- 40 Years showed a male predominance with major modifiable risk factors; Hypertension followed by Diabetes mellitus, smoking and Dyslipidemia. Positive family history a non-modifiable risk factor in patients of ACS was also a common finding.Objective The aim of our study was to compare the success rates of suture selection, recovery times and pain associated with local wound infection and seton placement in patients undergoing cutting seton placement for complex anal fistula. Methods The study included a total of 90 patients who were admitted with the diagnosis of complex anal fistula between January 2015 and July 2018. Results The first session and other revision appointments demonstrated that the number of patients who required fistulotomy was significantly higher in group-1 as the seton failed to complete the transection (p = 0.001). When the patients were asked to rate pain for 3 different conditions according to numeric rating scale (NRS), the patients in group-2 had significantly higher pain in all 3 cases compared to the patients in group-1 (p 0.001). The impact of the suture material on local infection was examined and it was determined that the results of cultures for seton material were significantly more positive in group-1 (p = 0.001). Conclusions We conclude that a multi-stage tight seton placement with silk material can lead to satisfactory results by aiming to shorten the cutting time of silk seton.Objective To assess age standardized prevalence of tobacco use in urban and rural areas of Pakistan. Methods This is a sub-study of second National Diabetes Survey of Pakistan (NDSP) 2016-2017. Prevalence of tobacco, ex-tobacco and non-tobacco users was determined in urban/rural areas of four provinces (Punjab, Sindh, Khyber Pakhtunkhwa, and Baluchistan) of Pakistan amongst people aged greater than or equal to 20 years. Information regarding tobacco and non-tobacco users were obtained from second NDSP (2016-2017) predesigned questionnaire. Detailed methodology for demographic, anthropometric and biochemical parameters remained same as reported in second NDSP (2016-2017). Results The age-standardized prevalence of tobacco use in Pakistan was found to be 13.4%. Tobacco use in urban areas was 16.3% and rural areas was 11.7%. Tobacco use in urban and rural males was 26.1% and 24.1%, while in females was 7.7% and 3.1%, respectively. The age-standardized prevalence of ex-tobacco use in Pakistan was found to be 2.3%. Ex-tobacco use in urban areas was 2.6% and rural areas was 2.3%. Similarly, ex-tobacco use in urban and rural males was 4.6% and 4.6%, while in females was 0.7% and 0.5%, respectively. Multinomial logistic regression analysis shows that increasing age does not relate towards addiction of tobacco. Males were found to be 7 times (OR 6.94, 95% CI 5.68-8.49) and urban residents twice (OR 2.09, 95% CI 1.73-2.52) more tobacco users than females and those living in rural areas, respectively. From the likelihood ratio test, all variables were found to be statistically significant except for dysglycemia, dyslipidemia and hypertension. Conclusion The prevalence of tobacco use is high. As a sub paper of a large national survey, this evidence is expected to serve as an important tool to plan larger studies leading in turn to develop strategies for a successful tobacco control program in the country.Objective To evaluate the success rate of Transcanalicular Diode laser assisted Dacryocystorhinostomy (TC-DCR) in cases of acquired nasolacrimal duct obstruction (NLDO). Methods This Quasi-Experimental study was conducted in Armed Forces Institute of Ophthalmology (AFIO) Rawalpindi, from July 2018 to April 2019. In this study, 73 patients of chronic dacryocystitis secondary to acquired NLDO were treated by TC-DCR under general anaesthesia. Follow up examination was done after one day, one week and three months. Silicone tubes were removed three months after surgery and syringing of lacrimal system done to confirm patency of lacrimal passages. Success of the procedure was documented as absence of epiphora and patent nasolacrimal duct on syringing. Results Seventy three patients (males 27; females 46) were included in this study. Mean age of these patients was 51.6+21 years. On completion of this study which was three months after surgery, we found subjective improvement (absence of epiphora) in 86.3% patients and objective improvement (successful irrigation of lacrimal passages) in 93.2% patients. Conclusion TC- DCR is a minimally invasive technique of doing Dacryocystorhinostomy and imparts more than 90% success rate. It has additional advantages of good cosmetic results, low complication rate and short surgery and convalescence time.Background and objective A large number of university teachers in Saudi Arabia comprise of expatriates. Their experiences are unique in context of the challenges and benefits of academic expatriation. The purpose of this study was to describe the experiences of expatriate university teachers in Saudi Arabia. Methods A qualitative descriptive design was used based on in-depth interviews with academic expatriates, recruited through snowball sampling in a Health Science University in Saudi Arabia. The study was conducted from 12 September 2019 to 20 October 2019 after IRB approval. Graneheimian inductive approach was used for content analysis of the data. Standard principles of trustworthiness were applied. Results Three major themes emerged as 'conscious venture', 'spirit at work' and 'coping strategies'. Each theme had 2-3 subthemes, populated by 14-23 statements. Conclusion Expatriate faculty members described antecedents for their motivations at work. They shared their experiences regarding job adjustments, work environment and professional commitment.