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   2017| January-June  | Volume 2 | Issue 1  
    Online since August 13, 2020

 
 
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ORIGINAL ARTICLES
Unique case of dental practice negligence using calcium hydroxide intracanal medicament: A case report
Adel S Alobaid, Rayan O Alnefaie, Mutassim A Elnager
January-June 2017, 2(1):26-31
DOI:10.4103/1658-743X.291935  
Safe dental practice is based on the rule of do no harm. Procedural errors in endodontics are mainly based on wrong case selection with underestimation of case difficulty. The aim of this report was to discuss a case of negligence in dental practice leading to multidisciplinary treatment and pain management approach. This case reported to emergency clinics at King Khalid University, College of Dentistry (KKUCOD) after an accident of overextrusion of calcium hydroxide (Ca(OH)2) from tooth # 22 extended distally to greater palatine foramen area without sinus communication. Patient pain was unbearable and needed strong acting pain medication. The tooth was treated with nonsurgical endodontic with buccal perforation repair followed by surgical endodontic to establish apical seal and remove the extruded material. Then a full thickness palatal flap was needed to remove the extended material. This approach was effective in alleviating patient pain. Such incidence could have been avoided if a safe practice rules were strictly followed thus case difficulty assessment form must be used in such cases.
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CASE REPORTS
Application of topical timolol 0.5% solution for management of rosacea-related flushing and erythema: A case report
Tahani S Magliah, Esraa Turkistani
January-June 2017, 2(1):32-34
DOI:10.4103/1658-743X.291936  
Rosacea is a common chronic skin condition that affects the face, characterized by flushing, redness, pimples, pustules and dilated blood vessels. Some treatment options for rosacea can improve symptoms and sometimes control the disease from getting worse. A female Saudi patient aged 41 years presented with flushing for the past two months. She has been diagnosed as a case of erythrematotelangiectatic rosacea, for which she received metronidazole topical gel twice daily, but she developed skin irritation after two weeks’ application. Topical timolol 0.5% ophthalmic solution 0.5% (one drop on each side of the face over the cheeks, twice per day for 8 weeks) was tried with her. Eight weeks later, the patient showed marked improvement. She denied complaining of skin irritation, flushing attacks, redness or any medication-related side effects. No systemic symptoms due to topical application were documented. She also expressed her satisfaction with treatment. Topical timolol (0.5%) solution can provide subjective improvement in cases of erythrematotelangiectatic rosacea associated with flushing and erythema, with no documented systemic or local side effects. However, further studies are still needed to settle its efficacy among patients with different phases of rosacea.
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ORIGINAL ARTICLES
Assessment of primary health care physicians’ knowledge and practices about diabetes mellitus in Aseer Region, Kingdom of Saudi Arabia
Mohammed Abadi S. Alsaleem
January-June 2017, 2(1):1-8
DOI:10.4103/1658-743X.291932  
Objective: To assess primary care physicians’ knowledge and practice related to diabetes mellitus in Aseer Region, Kingdom of Saudi Arabia (KSA). Subjects and Methods: A total of 153 primary health care (PHC) physicians were included from Aseer Region. Each participant physician was interviewed using a study questionnaire that comprised personal characteristics data sheet and PHC physicians’ assessment of knowledge (15 questions) and practices (10 questions). Results: Excellent knowledge and practice grades were attained by32.7% and 23.5%, respectively, while unsatisfactory knowledge and practice grades were attained by 8.5% and 22.2% of PHC physicians. PHC physicians who had significantly more “excellent” knowledge grades were older (p<0.001), non-Saudi (p<0.001), higher qualified (p=0.001), with more postgraduate experience (p<0.001), with better grades of practice (p<0.001), and those who attended courses on diabetes (p=0.006). PHC physicians who had significantly more “excellent” practice grades were older (p<0.001), non-Saudi (p=0.041), having Doctorate/Fellowship (p<0.001), having more years of postgraduate experience (p=0.001), seeing more diabetic patients (p<0.001), and those who attended courses on diabetes (p=0.008). Conclusions: PHC physicians’ knowledge and practice grades are suboptimal. Better knowledge and practice grades about diabetes are present among older, non-Saudi, higher qualified PHC physicians, with more postgraduate experience, better grades of practice, and those who attend courses on diabetes. Continuing medical education should be enforced for all PHC physicians, especially Saudi, younger, newly graduated PHC physicians.
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Umbilical cord blood leptin concentration - What does it imply?
Harish C Chandramoorthy, Ahmed Al-Hakami, Abdullah Abu Sham
January-June 2017, 2(1):9-14
DOI:10.4103/1658-743X.291937  
Objective: The significance of the placental or umbilical cord leptin levels remains unresolved in spite of their well-documented function. In the current study we investigated, whether, leptin concentration that mirrors the fetal health is influenced by type of birth, placental weight, cord length, sex, weight, pO2 and pH parameters. Methods: Umbilical cord blood samples were collected post placental delivery (n=40) from both normal and caesarian deliveries with all demographical information. Leptin concentration was determined form cord blood plasma, while fresh cord blood was used for blood gas analysis. Results: The average leptin concentrations of male and female fetal umbilical cord were 16.6 ± 1.6 and 18.2 ± 0.6 ng/ml respectively. The maximum threshold of the umbilical vein leptin concentrations were 15.3 ± 0.6 and 18.3 ± 1.2 ng/ml in male and females respectively. There was a direct relationship observed with the birthweight and leptin concentration. The mean pH 7.117 ± 0.02 and pO2 19.74 ± 2.01 mmHg did not significantly correlate with leptin levels. Discussion: Leptin concertation were significantly high in normal delivery than caesarian section. Placental weight or umbilical cord length did not affect the leptin concentration. We did not observe any significant alteration in pH or pO2 levels influencing leptin. However, the most remarkable correlation was leptin with birth weight, which explains the best utilization of the maternal fuel resources in the development of the fetus. We did observe a level in female babies. Conclusion: Overall, the placental leptin concentration mirrors the health status of the fetus and weight metabolism.
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Awareness of sexually transmitted diseases among male medical students in King Khalid University, Abha
Awad S Samaghan, Rishi Kr Bharti, Hassan Al-Musa, Shweta Chaudhary, Abdulelah A H. Alqahtani, Naif D A. Alshehri, Abdulmajeed A A. Abuhabshah, Abdulrhman J D. Abuhabshah
January-June 2017, 2(1):20-25
DOI:10.4103/1658-743X.291934  
Objective: To assess the knowledge of male students about STDs. Study Design: This cross-sectional study was conducted in King Khalid University after taking the clearance from the ethical committee using a self-administered questionnaire. Results: Around 31.13% participants knew that a person who has genital herpes must have open sore to transmit this infection whereas 21.85% students aware of its trans-placental transmission to baby. Nearly one third (32.45%) respondents gave the correct response regarding the HIV transmission through a person carrying STDs,Whereas 21.19% knew that there is no vaccine for Chlamydia. More than half of the participants 54.97% were aware of Human Papilloma Virus. Nearly one third the students (28.48%) had knowledge that having anal sex increases a person’s risk of getting Hepatitis B and only 22.53% were aware about the vaccine that can protect from Hepatitis B. Conclusion: Academic activities like workshops, seminars and quizzes about raising the awareness should be organized by the experts and encourage the students to make effective participation.Adolescent health education programmes focused on STDs should be included in medical curriculum.
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Clinical diagnostic challenges of pilomatricoma: Retrospective study from Southern Region of Saudi Arabia
Mubarak Al-Shraim
January-June 2017, 2(1):15-19
DOI:10.4103/1658-743X.291933  
Objective: To analyze the clinicopathological features of PMC, including the patient age at clinical presentation, gender, anatomical location, tumor size, preoperative clinical and histopathologic diagnosis. Methods: This is a retrospective study to analyze all cases of PMC diagnosed in two hospitals from August 2008 to January 2017 in Southern Region, Saudi Arabia. Detailed medical records and histopathologic material review were done for all cases of pilomatricoma. Cases were identified using the search engine of each hospital electronic filing system. Results: 23 cases with an age range from 8 to 68 years (mean 28.8). The majority of patients were in their second (39%) and fourth (26%) decades of life with a female to male ratio of 1.2 to 1.1. Majority of the cases were noted in the neck (43.5%), followed by head region (30%). The tumor size ranged from 0.3 to 4.0 cm (mean 1.6). The most common preoperative clinical misdiagnosis was sebaceous cyst (34.8%). All cases were confirmed histopathologically as pilomatricoma. All tumors were excised surgically. Conclusions: PMC has a wide variety of clinical presentations and is commonly misdiagnosed with other dermatological conditions. PMC should be included in the differential diagnosis of nodules, particularly in the head and neck region. Increasing the clinical awareness and familiarity with the tumor may lead to accurate clinical diagnosis.
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