Despite the availability of modern chemotherapeutic approaches and the power of excellent molecular research and persistent investigative efforts, cancer remains an epidemic and the question – “why is cancer becoming an endemic today?” remains unanswered completely. If we look around, we have hospitals, doctors, nutritionists, health professionals, other than these fitness centers, foods’ supplements, and every possible thing, but if we look at the statistics of the cancer prevalence, which is rising exponentially in all over the globe. Recently, the Centers for Disease Control and Prevention pointed out that the rates of some types of cancers to the year 2020 are reducing or stabilizing, but the overall number of cancer cases and deaths still continues to increase.[1] It is so easy for us to believe on social media, television media, or on the opinion of general people about the factors associated with the onset of cancer such as air pollution, food contamination such as meat, fruits, vegetables, and water stuff are unhygienic. Of course, these are the factors especially air pollution are somewhat associated with cancer.[2] However, there are five major commonalities which are directly associated with the onset of cancer. These commonalities were defined by Luke Coutinho in his excellent FaceTime video on cancer prevalence.[3] Luke Coutinho, he is an award-winning globally renowned Holistic Lifestyle Coach and practicing in the field of Integrative and Lifestyle Medicine (https://www.lukecoutinho.com/). He and his colleagues pulled out the data from hundreds of cancer patients over the past 1 year and have looked for commonality in the lifestyles of the cancer patients before they got cancer.[3] The data were from cancer patients across India, Europe, Mexico, Russia, United States, Australia, Thailand, Vietnam, Taiwan, and Japan. The outcome was very surprising, the data did not show a significant correlation of cancer with obesity, exposure to chemicals, drinking, and smoking. Interestingly, the data showed the direct relation of cancer onset with the five commonalities such as chronic constipation, chronic acidity, sleep deprivation, chronic emotional stress, and sedentary lifestyle.[3] Let us support the data pulled by Luke Coutinho and discuss their correlation with cancer in terms of scientific and general views. Chronic constipation, several reports have shown that the people who have cancer or who develop cancer at some point in their life or at the current point in their life, they have chronic constipation.[4,5] We have to understand that chronic constipation is a major health problem, during its progression, we actually storing toxic waste in our system. These toxic wastes are very harmful for our organs, especially to the liver and kidneys. The unusual storage of toxins in the body is known to produce cancer stimulatory substances,[6,7] which later on initiate or promote mutations that have a direct association with the rapid growth tumor cells.[4-7] Chronic acidity is another commonality that was also reported to play a role in cancer onset and progression.[8,9] It makes sense when our body is acidic, it means that it gives an acidic environment for cancer cells to mutate, spread, and grow faster.[8,9] Third commonality among cancer patients is sleep deprivation, which also has a direct association with the cancer onset. The simple science behind sleeping is the regulation of hormone melatonin.[10] During sleeping, we produce melatonin, which is now well proven as an anti-cancer hormone.[11] Enough sleep produces the right amount of melatonin, which makes our immunity stronger and prevents us from the proliferation of cancer cells.[10,11] Chronic emotional stress is another commonality that was found in most of the cancer patients.[3,12] Luke Coutinho and colleagues analyzed responses of a question that was asked to almost all cancer patients – what was going on in their life for the past 6 months to a year maybe even 2 years before the onset of cancer, as cancer just does not grow overnight. It is accumulating in the body from 6 months to a year or maybe more and they found that extreme emotional stress in most of the studied cancer patients. It does not mean that if we are in stress today, then will have cancer tomorrow. Each one of these cancer patients could point out actually about prolonged chronic emotional stress. For example, some of them were divorced, some were separated from their lovers, some of them lost their children, parents, and some were having property or financial issues, etc. These data have also been well supported by other studies, Chiriac et al. recently published a systematic review on the stress and the incidence of cancer and the data revealed a significant association between stress and cancer.[12] Therefore, it is now confirmed that emotional stress is key to cancer onset. Besides these, sedentary lifestyle is also commonality reported in most of the cancer patients and also found to be well connected with any of the above mentioned commonalities.[3,13] Let us ponder what will happen, if we will have an uninterrupted sedentary lifestyle, we may gain weight, or get acidic or constipated, which land up some sort of emotional stress. These data are also very well supported by various other studies.[13] A study performed by Kerr et al. showed that the lifestyle factors associated with cancer. They reported that physical activity, sedentary behaviors, and diet all are linked to cancer.[13] Let us discuss how we can overcome these commonalities so that we protect ourselves from cancer. The most important thing is the surplus intake of water. Several reports showed that at least 90% of the people have never fallen sick if they had taken care of their water intake.[14,15] Low intake of water reduces the power of immunity and also causes constipation and increased acidity.[14-16] Other than these, less water intake also reduces our control of the brain, which means loss of cognitive thoughts, emotions, and intends to become powerless to handle the day-to-day stress. All mentioned commonalities were reported to be associated with less intake of water and subsequently connected with the onset of cancer.[17,18] Therefore taking water in an appropriate amount not only prevents us from cancer-associated commonalities but also protects us from cancer. Besides water intake, our thoughts also play a major role, if we think that we are sick then we will be sick, let’s talk about the relation of cancer with genetics in this context. We all know that genetics plays a role in the onset of cancer,[19] but it does not mean that if our parents have cancer, we also will have cancer. Luke Coutinho in his conversation described in an excellent way by giving the reference of a book called “The biology of belief written by Bruce Lipton.[20]” This book tells us that we have good genes as well as bad genes, if we create the wrong environment in our body and around, then our bad genes will express themselves. So even if we have inherited cancer genes from our parents, we need to create a good conducive environment inside and outside, this escape us from the expression of cancer-associated genes.[20] Therefore, our thoughts or the environment that we have created have a direct impact on every single gene and that definitely plays a role not only to prevent us from the onset of cancer but also protect from cancer progression. In short, there are several ways described above to prevent us from the cancer onset or to recover from cancer without spending any penny. We need to think about the association of cancer with chronic constipation, chronic acidity, sleep deprivation, chronic emotional stress, or sedentary lifestyle and endeavor to resolve them as early as possible.

Background : There is no established antenatal intervention that reduces the risk of preeclampsia and preterm delivery in gestational diabetes mellitus (GDM) mothers and hyperbilirubinemia, hypoglycemia, and hospitalization in their newborns. Henceforth, this study aims to study how these risks change on prenatal vitamin D supplementation. Methods : Randomized parallel arm trials comparing these interventions' effect on the above outcomes were searched in the PubMed, Embase, and Scopus, irrespective date, and language of publication. Each eligible trial's risk of bias was assessed using the Cochrane collaboration tool. Using random-effects meta-analysis, the risk of the outcomes was compared. Results : Six eligible Iran-based trials of about 476 participants were included in this review. Four trials complemented vitamin D along with other nutrients. Overall, the risk of bias was low in these trials. The newborns of antenatal vitamin D recipients have a reduced risk of hyperbilirubinemia (RR=0.46; 95% CI: 0.33, 0.64; I 2 =0%) and hospitalization (RR=0.46; 95% CI: 0.32, 0.65; I 2 =0%) than those who did not receive the supplement. The rest of the outcomes didn’t vary between the compared interventions. The results remained unchanged on using a fixed-effect meta-analysis, repeating the meta-analysis while eliminating a trial each time, and on imputation analysis. An auxiliary meta-analysis comparing the intervention with placebo also suggested a decreased risk of hyperbilirubinemia (RR=0.43; 95% CI: 0.30, 0.62; I 2 =0%) and hospitalization (RR=0.44; 95% CI: 0.30, 0.62; I 2 =0%). Conclusion : Newborns of GDM mothers who received vitamin D as a sole or co-supplement antenatally, have a decreased risk of hyperbilirubinemia and hospitalization.

Objectives. The purpose of this study was to examine the association between abnormal Hemoglobin (Hb) level and stroke severity (as assessed by NIHSS). The study furthers aimed to describe the demographic and clinical characteristics of stroke patients in the middle region of Saudi Arabia. Methods. We performed a retrospective review of all medical records of the stroke patients who were treated at a major hospital in Qassim province between 2016 and 2018. Reviewed data (n=400) included demographics, Hb level on admission, type of stroke (ischemic vs. hemorrhagic), stroke risk factors, and NIHSS scores. ANOVA test was used to assess the Univariate association between NIHSS and Hb level. Regression statistics were utilized to examine the effect of abnormal Hb level on NIHSS scores while controlling for the other study variables. Data were analyzed using SPSS. Results : Sixty-nine percent of the patients were men. More young women than men (≤39 years) had a stroke. Ischemic stroke is considerably more common than hemorrhagic stroke (a ratio of 12.7:1). ANOVA test showed that the mean score of NIHSS was significantly lower among patients with a normal Hb level. Regression showed that NIHSS scores were significantly associated with abnormal Hb level, in terms of low and high level. Conclusions. This study demonstrated further evidence of the association between abnormal Hb level NIHSS. Thus, our results emphasize the predictive importance of Hb level on identifying individuals who might be at higher risk of worse neurological outcomes after stroke. Physicians need to be cognizant of the negative effect of abnormal Hb level on the outcomes of stroke patients.

Objectives: In late 2019, a novel respiratory disease was identified as it began to spread rapidly within China’s Hubei Province soon thereafter, being designated Coronavirus Disease 2019 (COVID-19). Unfortunately, trends in cases and rates of infection have been consistently misunderstood, particularly within the media, due to little, if any, statistical analysis of trends. Critical analysis of data is necessary in order to determine how to best manage local restrictions particularly if there are resurgences of infection. As such, researchers have been calling for data-driven, statistical analysis of trends of disease in order to provide more context and validity for significant policy decisions. Methods: This quantitative study sought to explore different statistical methods that can be used to evaluate trend data to improve decision-making and public information on the spread of COVID-19. Analyses were conducted using Spearman’s rho, Mann-Whitney U tests, Mann-Kendal tests, and Augmented Dickey-Fuller tests with follow up Kwiatkowski–Phillips–Schmidt–Shin tests.  Results. The results indicated a mix of both surprising and expected findings. Variations among COVID case reporting for each day of the week were identified but not deemed significant. Spearman correlation data appeared to perform well in identifying monotonic trend while Mann-Kendal tests appeared to provide the most intelligible results. Conclusions. This study provides examples of statistical tools and procedures to more thoroughly examine trends in COVID-19 case rate data. It is advocated that such metrics be made available to health and policy stakeholders for potential use for public health decisions.

Objectives: The present study is considered the first study that aims to estimate the spread of COVID-19 pandemic in the Eastern Mediterranean Region and to predict the pattern of spread among KSA in comparison to Iran and Pakistan. Methodology: Data during the period from 29 January till 14 April 2020 was extracted from 76 WHO situational reports and from the Worldometer website. Numbers of populations in each country was considered during data analysis. SIRD Model and Smoothing Spline Regression model were used to predict the number of cases in each country. Results: SIRD model in KSA yieldedβ = 2e-0.6, γ = 0.006 and m= 0.00038 and R 0 = 0.00029. It is expected that by the 1 st of May 2020 that number of cumulative infected cases would rise to 16848 in KSA, and to 11825 in Pakistan while in Iran, it is expected that the number mostly will be100485. Moreover, the basic reproduction number R 0 is expected to decrease by time progression. Conclusion: The cumulative infected cases are expected to grow exponentially. Although R 0 is expected to be decreased, the quarantine measures should be maintained or even enhanced.

Objective: Publications are the cornerstone of the dissemination of scientific innovation and scholarly work, but published works are mostly behind paywalls. Therefore, many researchers and institutions are searching for alternative models for disseminating scholarly work that bypass the current structure of paywalls. This study aimed to determine whether a self-published open access journal, the International Journal of Health Sciences (IJHS), has been able to reach a global audience in terms of authorship, readership and impact using the open access model. Methods: All IJHS articles were retrieved and analyzed using scientometric methods. Using the keywords from abstracts and titles, unsupervised clustering was performed to map research trends. Network analysis was used to chart the network of collaboration. The analysis of articles’ metadata and the visualizations were performed using R programming language. Results: Using Google Scholar as a source, the general statistics of IJHS from inception to 2019 showed the average citation per article was 11.29, and the impact factor of the journal was 2.28. The results demonstrate the obvious local and global impact of a locally published journal that allows unrestricted open access and uses an open source publishing platform. The journal’s success at attracting diverse topics, authors, and readers is a testament to the power of the open access model. Conclusions: Open source is feasible and rewarding and enables a global reach for research from under-represented regions. Local journals can help the Global South disseminate their scholarly work, which is frequently ignored by commercial and established publications.

Objective: The psychological construct of hope is an important determinant for mental health and well-being. The availability of valid and reliable instruments to measure hope is therefore critical. Despite a large number of psychometric studies on the Herth Hope Index (HHI), its construct validity has not yet been determined. Therefore, this paper aimed to conduct a systematic review of the psychometric properties of the HHI. Method: Databases such as PubMed, Science Direct, Google Scholar, Magiran, SID, IranDoc, and IranMedex, were evaluated systematically using the terms “Herth Hope Index”, “psychometric”, “validity”, “reliability”, and related terms (with the use of OR and AND operators) and no restrictions on the year of publication. A total of 13 eligible studies were found published between 1992 and 2018 in the USA, Portugal, Switzerland, Iran, Germany, Petersburg, Japan, the Netherlands, Lima, Peru, and Norway. The methodology used in the available studies included principle component analysis (N = 6), maximum likelihood estimation (N = 5), and principal axis factoring (N = 1).One study didn’t point the methodology.   Results: Four studies reported the total extracted variances to be less than 50%, six studies reported variance between 50% and 60%, and three papers reported variance that exceeded 60%. Of the papers that examined the factor structure of the HHI, two studies reported a one-factor solution, seven reported two factors, and four reported a three-factor solution. Although the HHI is the most widely translated and psychometrically tested tool in languages other than English, psychometric variations in factor solutions remain inconsistent. Conclusion: Findings highlight the need for future research that appraises the validity of the HHI in different countries, and how the measure relates to other scales that evaluate hope.

We present a case of a giant intra-abdominal pseudocyst in a 24-year-old male as a complication of ventriculoperitoneal (VP) shunt. Ultrasonography and computed tomography abdomen detected a 20 × cm 14.5× cm 9 cm thin-walled cystic lesion with few septae occupying a large space in the left side of the abdomen with a VP shunt tip within it. Histopathological findings suggested a pseudocyst. However, multiple epithelioid cell granulomas on cyst wall resulted in a diagnostic dilemma.