Objective: Atopic dermatitis (AD) is a skin disorder clinically seen in the pediatric population. It is well recognized that patients with AD have an increased susceptibility to cutaneous colonization and infection with bacteria, fungi, and viruses. This study was undertaken to investigate the phagocytic activity and chemotactic response of mononuclear and polymorphonuclear leukocytes in severe AD patients. Methods: A total of 50 children with severe AD were selected according to severity scoring of AD (the SCORAD index) and 30 healthy children of same age and sex were also selected as controls. The mononuclear and neutrophilic leukocytes were separated and the phagocytic ingestion of zymosan particles was determined. Migration distance in response tobacterial lipopolysaccharide chemotactic factor was also determined. Immunological disturbance in AD patients was determined by sandwich enzyme-liked immunosorbent assays for total serum immunoglobulin E (IgE), complement 3 (C3) C4. Results: Of 50 AD patients with severe disease activity, 36 patients (72%) showed reduction in mononuclear and neutrophilic phagocytic activity. Children with AD had higher levels of total serum IgE, C3, and C4 compared to healthy children (P < 0.01). Conclusions: The study results demonstrated an inhibition in the chemotactic response and phagocytic activity by mononuclear and/or neutrophilic leukocytes in severe AD patients. We further observed an involvement of perturb complement system in patients with AD. Hence, we clearly showed that AD is exacerbated with compromised immunological response, especially the innate immune response.

Objective: Given that females exhibit a greater prevalence of eating disorders, there is of yet no conclusive evidence whether participation in college athletics exacerbates eating disorders or body shape dissatisfaction. This study assessed how gender and participation in collegiate athletics are associated with increased risk for disordered eating attitudes and body shape concerns in college students. Methods: This study used a cross-sectional research design. A total of 302 students at a Southern US university fully completed the eating attitudes test and the body shape questionnaire during class time or team meetings. Logistic regression was conducted to determine risk differentials for each group. Results: Of 302 students, 65.6% were females and 63.2% were non-athletes. Athletic status was significant as well but became slightly less so with adjustment (unadjusted at OR = 3.14, P < 0.001 vs. adjusted OR = 3.22, P < 0.001). Moreover, it was found that that non-athletic female students are slightly more at risk for disordered eating and significantly more dissatisfied with their body shape (OR = 5.95, P < 0.001). Conclusions: Although there seems to still be many unresolved issues regarding eating disorders, one thing is clear females are at higher risk, and it remains a significant challenge to college health services. College health practitioners should be made aware of the significant effect stress has on freshman in particular.

Objective: Given the health-care cost and prevalence of preventative health disparities across today’s population, it is not surprising that the recent health-care legislation has aimed to address preventative health initiatives. Specifically, weight management counseling is a preventative health initiative that the affordable care act has emphasized. We evaluated motivational counseling (MC) for weight management in a college aged population and to what extent adherence to the program impacts the magnitude of weight loss. Methods: A total of 120 southeastern US college students from 2009 to 2013 participated in weekly counseling sessions lasting 15-30 min focused on weight management. Results: The study findings indicated a 51% greater weight loss in participants with greater adherence to the MC program. There were no differences across gender or race. Conclusion: These findings indicate that motivation counseling is an effect modality for addressing obesity-related preventive health disparities.

Objective: Cyclophosphamide (CYP), a cytotoxic anticancer drug, causes a substantial reduction in leukocytes numbers, called leukopenia. Leukopenia is a major predisposing factor to infections caused by opportunistic pathogens. The aim of the present study is to assess the effects of camel milk consumption against CYP-induced leukopenia and other toxic effects. Materials and Methods: CYP at a dose of 250 mg/kg was injected in the mice through the intraperitoneal route. Each mouse was orally administered with 1 ml of camel milk twice daily for 10 days. The blood was taken from various groups of mice to determine quantitative and qualitative changes in the leukocytes. The protective role of camel milk against CYP-induced toxicity was also assessed by determining the levels of antioxidant enzymes, superoxide dismutase (SOD), and catalase (CAT) in the hepatic tissue homogenates. Results: Mice injected with CYP showed substantial weight loss and a simultaneous depletion of leukocytes. Oral administration of camel milk protected mice against CYP-induced toxicity. The group of CYP-injected mice that received camel milk showed lesser decrease in their weight and leukocyte numbers. CYP-injected mice showed lower levels of SOD and CAT, whereas simultaneous consumption of camel milk resulted in lesser decrease in the levels of SOD and CAT in liver homogenates. Conclusions: The results of the present study suggest that camel milk may have an immunopotentiating role in diseases or conditions associated with leukopenia- or drug-induced toxicities.

Objectives: The aim of the present study was to test cutting efficiency of different materials against conventional alumina in an air abrasion system. Materials and Methods: The powder samples were divided into three groups: Group 1 - alumina (control), Group 2 - 45S5 bioactive glass, and Group 3 - hydroxyapatite. 30 microscope glass slides of 0.5 mm thickness were used as an alternative of human enamel and were also divided randomly into these three groups. The time taken by the abrasive particles to cut a hole through the microscope glass slide was recorded with a stop watch. In addition, morphology of the particles was observed through scanning electron microscopy (SEM). A t-test was used to compare the times taken to cut a hole through the microscope glass slides, and the level of significance was set at P < 0.05. Results: The mean time taken to cut a hole through the microscope glass slide was 2.96 s and 23.01s for Groups 1 and 2, respectively, whereas powder of Group 3 did not cut after 120 s. The differences between cutting times of Groups 1 and 2 were statistically significant (P < 0.05). The SEM micrographs revealed coarse angular shape for particles of Groups 1 and 2 but Group 3 particles were with round ends and presence of smaller particles was also observed in Groups 2 and 3. Conclusion: The alumina particles demonstrated excellent cutting efficiency followed by 45S5 particles. The use of bioactive glass particles should be encouraged for cutting purposes whenever a shortage of time for practitioners is not a concern.

Objectives: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most common causes of liver cirrhosis and hepatocellular carcinoma. Medical, applied medical science, and dental students constitute a high-risk group for HBV and HCV infections during their training or at the beginning of their careers. This study aimed to explore senior health science students’ knowledge of and attitudes toward these infections. Methods : Between December 2014 and December 2015, a cross-sectional survey was conducted among senior health science at the College of Medicine, the College of Dentistry, and the Laboratory Section of Applied Medical Sciences in Qassim University, Al-Qassim, Saudi Arabia. A validated questionnaire was randomly distributed to male and female senior students to test students’ knowledge of the general information on hepatitis B and C as well as their attitudes toward hepatitis B and hepatitis C patients and the disease in general. Results: A total of 205 respondents were invited, but only 180 participated in this survey. Higher knowledge was positively correlated with a higher belief in providing equitable care to hepatitis B/C patients and general anxiety about handling such patients (P < 0.004). Higher beliefs in equity and anxiety predicted higher knowledge when everything else was held constant. Conclusion: We found a positive relationship between knowledge levels and attitudes toward HBV and HCV patients. We therefore encourage health science colleges to offer more lectures on HBV and HCV to improve students’ knowledge and thereby improve their attitudes.

Objective: Percutaneous coronary intervention has been effective in increasing longevity of patients with cardiovascular disease. However, the evidence shows that the quality of life after the intervention is still lower than optimal level. The quality of life can be affected by various factors. The aim of this study is to determine the quality of life and its related factors in patients undergoing coronary angioplasty. Methods: This cross-sectional study was performed on 106 patients undergoing coronary angioplasty during 2015-2016. This study population included all patients who referred to a cardiac clinic in Rasht, Iran, were passed 3 months after their angioplasty. Research samples met the inclusion criteria and were willing to participate to the study, were selected gradually (continually). Research tools were a self-structured questionnaire regarding factors associated with the quality of life and the MacNew quality of life questionnaire. Data were collected through asking patients questions and using patient’s medical records. Data analysis was conducted using descriptive and inferential statistics. Results: The results of multivariate linear regression analysis showed that independent variables of age (P = 0.0001), the number of diseased vessels (P = 0.0001), and the number of comorbidities (P < 0.05) were the most important factors associated with the quality of life. Conclusion: Health-care professionals can play an effective role in promoting the quality of life of patients undergoing coronary angioplasty by modifying lifestyle based on the related factors and to provide comprehensive care programs, especially for elderly.

Objectives: The objective of this study is to determine and compare antibacterial efficacy of aqueous extracts of black, green, and lemon tea of a commercially available brand. Materials and Methods: The well-diffusion method was used to evaluate the antibacterial efficacy of commercially available black tea, green tea, and lemon tea at three different concentrations (1.5 g, 5 g, and 7.5 g) against Streptococcus mutans and Lactobacillus acidophilus. After incubation in appropriate culture medium, diameter of zone of inhibition was measured to assess the antibacterial efficacy of tea. Results: Maximum zone of inhibition was found with lemon tea (27 mm) followed by green tea (26 mm) and black tea (13 mm) against S. mutans and L. acidophilus. Zone of inhibition was highest at 7.5 g concentration (1 and half tea spoon) for lemon tea followed by green tea and black tea. Results were statistically analyzed with the analysis of variance (ANOVA). For pairwise intergroup multiple comparisons, bonferroni test was applied. The difference between black tea, green tea, and lemon tea were statistically significant (P < 0.001) at 5% of level of significance. Conclusion: Lemon tea at 7.5 g concentration was more effective followed by green tea and black tea against S. mutans and L. acidophilus.

Objectives: The study was aimed at assessing adherence to prescribed antihypertensive medications and its associated factors. Methodology: Institutional-based cross-sectional study was conducted in four public hospitals which were selected by lottery method. Systematic random sampling was used to select the study subjects. Data were checked, cleaned, and entered into Epidata software version 3.1 and were imported to SPSS version 21 software for analysis. The results of the descriptive statistics were expressed as percentages and frequencies. Associations between independent variables and dependent variable were analyzed using bivariate and multivariate analysis. The study was conducted from February 15 to April 15, 2016. Results: The study included 404 respondents with 97% response rate. 210 (52%) were male and mean age was 54 ± 10.77 years. The respondents’ adherence to antihypertensive medications was 66.8%. The medication-related adherences were found to be better in females, patients who had comorbidities and have been knowledgeable about the disease and was poor among young adult respondents. Conclusion: This study found out a 66.8% adherence to prescribed antihypertensive medications. This figures show that medication adherence (MA) rates are low. The factors impeding or enhancing the outcome variable was thoroughly analyzed. Sex, age, number of types of medications, and knowledge were associated with MA. Educational sessions that especially focus on MA and ongoing support for patients should be designed. Studies which assess all the components of self-management should be conducted for comparison among different subgroups.  

Background: About 30% of stroke survivors clinically have depressive symptoms at some point following stroke and anxiety prevalence is around 20-25%. Objective: The purpose of this brief report is to evaluate a pilot trial of a constructive integrative psychosocial intervention (CIPI) over standard care in post-stroke depression or anxiety. Methods: Patients were randomly assigned to either CIPI (n = 23) or standard care (n = 19). Patients were assessed using the Hospital Anxiety and Depression Scale at the 1st, 3rd, and 6th months to monitor changes of mood. Results: A Wilcoxon signed-rank test indicated that compared to admission baseline, patients with the intervention had significantly normal post-stroke depression symptom levels at the 1st, 3rd, and 6th months (P < 0.005). Conclusion: CIPI appears to be of incremental value in treating depression as well as anxiety in subacute care.

Poor health information system has been identified as a major challenge in the healthcare system in many developing countries including sub-Saharan African countries. Electronic health record (EHR) has been shown as an important tool to improve access to patient information with attendance improved quality of care. However, EHR has not been widely implemented/adopted in sub-Saharan Africa. This study sought to identify factors that affect the adoption of an EHR in sub-Saharan Africa and strategies to improve its adoption in this region. A comprehensive literature search was conducted on three electronic databases: PubMed, Medline, and Google Scholar. Articles of interest were those published in English that contained information on factors that limit the adoption of an EHR as well as strategies that improve its adoption in sub-Saharan African countries. The available evidence indicated that there were many factors that hindered the widespread adoption of an EHR in sub-Saharan Africa. These were high costs of procurement and maintenance of the EHR system, lack of financial incentives and priorities, poor electricity supply and internet connectivity, and primary user’s limited computer skills. However, strategies such as implementation planning, financial supports, appropriate EHR system selection, training of primary users, and the adoption of the phased implementation process have been identified to facilitate the use of an EHR. Wide adoption of an EHR in sub-Saharan Africa region requires a lot more effort than what is assumed because of the current poor level of technological development, lack of required computer skills, and limited resources.

Dental diseases have detrimental effects on the functionality and quality of life of individuals. In addition, a strong relationship has been established between various oral and systemic diseases. In fact, the prevention and treatment of dental caries and periodontal disease have been shown to reduce the risk of diabetes and heart disease significantly. This goes beyond the role of oral health as a means to identify early manifestations of systemic diseases in the oral cavity. It highlights the necessity of maintaining an optimal oral hygiene to significantly modify the risk factors for serious systemic diseases. The use of oil pulling can be frequently found in ancient medical text and is supported by recent studies for its efficacy and long-term use for maintaining and improving oral health. This article provides an overview on the concept of oil pulling or oil swishing, its mechanism of action and a summary of the evidence available, which highlights the role of oil pulling in specific oral diseases. The goal of this review is to highlight the ancient procedure that has the potential to be used as an adjunct to conventional chemical means of dental plaque control, such as mouth rinses. Incorporating oil swishing as a component of daily oral hygiene can significantly improve oral and general health, specifically in lower socioeconomic groups and rural communities that may have interrupted access to health-care services and dental products such as dentifrices and mouth washes due to various factors; availability and affordability being the most important.

Total pancreatic lipomatosis (PL) is an unusual entity of pathologic significance and speculative origin. It refers to complete replacement of pancreatic parenchyma by fat cells. Fat replacement may vary from mild fatty infiltration to massive replacement of the pancreas by adipose tissue, resulting in malabsorption syndrome due to pancreatic insufficiency. We present a case of a 60-year-old elderly woman with atypical abdominal complaints, diabetes mellitus, weight loss, and steatorrhea. Abdominal computed tomograms were diagnostic of PL. Magnetic resonance imaging verified this impression. The patient improved clinically after the 8-week trial of high-dose oral pancreatic enzyme replacement therapy. There is a marked reduction of steatorrhea and weight gain. This case report focuses on pathophysiology, diagnosis, and treatment guidelines of PL.

Crouzon syndrome is the most common syndrome among the craniosynostosis group. Crouzon syndrome accounts for about 4.8% of all of them. It commonly has autosomal dominant inheritance with complete penetrance and variable expressivity from subtle to severe forms and characterized by craniosynostosis, exophthalmos, and hypoplastic maxilla with relative mandibular prognathism. Mutation of the fibroblast growth factor receptor-2 gene is responsible for the occurrence of this rare genetic disorder. Our paper reports the diagnosis of this rare syndrome in a young female patient based on clinical and radiographical features. Prompt and timely management of the syndrome has enabled this patient to lead a normal life despite the syndrome.

The concept of big data refers to the capture and storage of large amounts about users and their usage behaviors for the purpose of offering personalized services based on predictions. Big data usage spans a wide array of fields that ranges from biomedical data, government usage, online commerce, education, research, and politics, just to mention a few. The ever-growing scope of big data presents new challenges that the current methods of privacy self-management are failing to adequately deal with. This tremendous growth of data is creating opportunities as well as new challenges unknown to the medical community before.1-4 Few years before, it was unimaginable that one can wear a device that  records his heart rate, rhythm, temperature, tremor frequency, physical activity, and sleep rhythm. Combining these data with the medical records,  with the travel records, with the data of social networks, with the purchases history as well as with many other services that record our interaction with the technology is not difficult but is actually happening. The future promises even more sources of data and sensors that can record innumerable functions. Unfortunately, the rapid pace of development in data science is not met with due understanding of the legal, ethical, and cultural issues associated with collection, storage, and studying these data.2,3 When it comes to studying medicine, there are well-established guidelines and organizations that govern this issue such as Ethical National Committee of BioEthics (NCBE) on living creature and good research practice in Saudi Arabia, Data Protection Act in the United Kingdom, and EU Directive 95/46/EC in Europe. These guidelines are always used as the basis for granting ethical approvals for studies working with these types of data. However, there are many sides of data usage that are beyond these guidelines. Privacy self-management (notice and consent) gives users the option to control their data by allowing or revoking access to their data by opting in or out. However, this is not always the reality, because personal data are always collected, used, and analyzed and at times shared or abused. Consent is always not read, and if read not always completely understood, and if not accepted by the user he might have no access to a certain service, or choose an inappropriate alternative, or sometimes the lack of  an alternatives, this makes agreeing to the terms obligatory and no more of an option. The failure of consent has been widely discussed and acknowledged.5 In an ideal world, transparency should be applied to all stages of working with data. The stakeholder groups should be adequately informed about purposes of the data captured, how it is collected, stored, transferred, or processed. They should also be informed about the way data will be analyzed if any third parties or companies will participate in data processing. Users should be given clear guarantees that data will not be sold or transferred to other institutions or legal entities without proper consent. However, reality is far more complex, the data collected today might be useful 5 years later when a new algorithm is discovered that can use the data for a certain prediction, at that time we cannot get back to the users and tell them what their data are being used for. Which calls for new ways that can guarantee users rights, enable research, define what the future data usage can be and how the whole process can be governed and supervised, and cases of abuse are identified and properly handled.1-4 The rapid growth of biomedical information necessitates the orchestrated efforts of all parties involved in research to understand the legal, ethical, and cultural challenges facing us. The old rules do not help solve the emerging problems. We need new policies that are crafted – not just for the current challenges – but with the future in mind.