New Emirates Medical Journal - Volume 5, Issue 1, 2024

A wide variety of tumors affect the pleura, both primary and secondary. The most common are metastatic carcinomas, usually of pulmonary origin. They manifest as malignant pleural effusion or multifocal pleural lesions. The extrapulmonary source of metastasis is mentioned but occurs less frequently. Pleural primary tumors other than diffuse malignant mesothelioma are either uncommon or rare and have received less attention. The World Health Organization (WHO) classified primary tumors of the pleura into three broad histogenetic classes of neoplasms, namely mesothelial tumors, mesenchymal tumors, and lymphoproliferative disorders.

A 41-year-old male patient was referred to our facility from the prevention medicine department with consolidation in the right lower zone of the chest, diagnosed as a case of encysted pleural effusion to rule out TB. This was discovered during a routine health examination for residency visa renewal. After laps and imaging workup, it was diagnosed as Solitary Fibrous Pleural Tumor (SFPT). The first surgical intervention was hampered by bleeding from the mass itself. Therefore, the patient underwent a second intervention after successful embolization of the arterial supply of the tumor by the interventional radiologist.

Primary pleural neoplasms represent a small but significant group of heterogeneous tumors, many of which may mimic each other. Modern imaging modalities permit diagnosis and play a major role in staging and assessing surgical respectability. Novel molecular and immunohistochemical markers now allow confirmation of diagnosis and potentially form the basis for future targeted therapies. Embolization of tumor perfusion has a lifesaving role when needed.

Caffeine, a stimulant for the central nervous system, is extensively consumed worldwide and can be found in various items such as coffee, tea, chocolate, and energy beverages. In addition to its stimulating properties, caffeine has been shown to provide numerous health advantages, including relief from migraines, treatment for neonatal apnea, and possible protective effects against neurodegenerative diseases and metabolic disorders. Despite its widespread use, the understanding of caffeine's therapeutic uses among healthcare professionals is still quite limited.

This study was conducted to measure the awareness and knowledge regarding the health impacts of caffeine among medical students and interns at RAKMHSU.

A cross-sectional study was carried out over six months (September 2023–April 2024) involving 190 participants selected through purposive sampling. Data were gathered using a structured, pretested questionnaire and analyzed with SPSS v29. Both descriptive and inferential statistical methods, including chi-square and independent t-tests, were employed.

The majority (70.5%) of the participants were female, with an average age of 20.52 years. Although 67.4% acknowledged caffeine's efficacy in migraine management, awareness of its neuroprotective properties (Parkinson's: 22.6%; Alzheimer's: 28.4%) and metabolic advantages was notably low. Students in clinical years exhibited significantly higher knowledge scores compared to their preclinical peers (p = 0.041). However, no significant differences were found based on gender, college affiliation, or residential status.

There are evident gaps in knowledge regarding caffeine’s health benefits among healthcare students, especially concerning its emerging therapeutic roles. These results highlight the necessity for focused educational initiatives within health sciences programs to improve the understanding and application of evidence-based dietary practices.

Cardiac amyloidosis, characterized by amyloid fibril deposition in the heart, often leads to heart failure and has a high mortality rate. The early detection of cardiac amyloidosis is critical for improving patient prognosis; however, the subtle and variable presentations of this condition can make early diagnosis challenging. Echocardiography is pivotal for diagnosing this condition. Through this study, we aim to improve the understanding of the echocardiographic features of cardiac amyloidosis.

This retrospective case series was based on the data of patients diagnosed with amyloid transthyretin-related cardiac amyloidosis (ATTR cardiac amyloidosis) from 2020 to 2024 at the Prince Sultan Cardiac Center in Riyadh, Saudi Arabia. The collected data included demographic characteristics, medical history, laboratory results, medication use, 12-lead electrocardiography results, and echocardiographic parameters.

Fifteen patients (11 males and four females, aged 41–88 years) were included in the analysis. The most common comorbidities were hypertension (seven patients) and atrial fibrillation (nine patients). The key echocardiographic characteristics were increased left ventricular (LV) wall thickness (mean: 19.9 mm), reduced global longitudinal strain (mean: −10%), and apical sparing. Six patients were positive for the 5-5-5 sign and pericardial effusion.

Recognizing echocardiographic features, such as apical sparing and increased LV wall thickness, is essential for the early diagnosis of cardiac amyloidosis. Improved clinical awareness and diagnostic protocols could enhance early detection and patient outcomes.

Coronary artery disease (CAD) is a significant contributor to 50%-70% of cardiac failure cases. Successful reperfusion is linked to improved systolic and diastolic functions.

This study aimed to detect the correlation between ECG parameters (QRS duration and fragmentation, QTc, Tpe, and Tpe / QTc ratio), which were proved to be correlated with improved reperfusion post-PCI and associated with the improvement in systolic and diastolic function.

This prospective research was performed on 54 ischemic cardiomyopathic cases from March 2019 to September 2022. All patients with Ischemic cardiomyopathy (ICM) and an EF less than 40%, along with viable myocardium determined by Dobutamine stress Echocardiography, underwent Complete revascularization of PCI amenable vessels.

There was a statistically significant positive correlation between the QTc interval and EF% after 1 month (r=0.29) and between the QTc interval and the percentage of improvement in both systolic and diastolic functions (EF& E/é) with a more positive correlation with improvement in EF (r=0.35 and 0.27 respectively). A stronger positive and significant correlation between the percentage of improvement in EF% with both Tpe interval, Tpe/QTc ratio, and QRS duration (r= 0.57, 0.50, and 0.58, respectively) was found. Also, there was a positive significant correlation between the percentage of improvement in E/é with both Tpe interval, Tpe/QTc ratio, and QRS duration (r= 0.37, 0.26, and 0.32 respectively)

ECG parameters are capable of predicting improvement of systolic and diastolic functions in ischemic cardiomyopathic patients as observed by improvement in ejection fraction and E/é after PCI compared to before PCI.

With the spread of COVID-19 around the world, this disease became a serious threat to global health and exposed people to coronavirus anxiety and death. Hospitalized patients have faced more anxiety about coronavirus and death, which can affect both the experiences and satisfaction of patients.

The present study investigated the relationship between death anxiety, COVID-19 anxiety, experiences, and satisfaction of patients during the COVID-19 outbreak.

This correlational study was performed on 239 patients admitted to Ali-Ibn Abi-Talib Hospital of Rafsanjani, southern Iran, during the COVID-19 outbreak. The socio-demographic characteristics, Templer death anxiety scale (DAS), Corona disease anxiety scale (CDAS), short-form of the Hong Kong inpatient experience questionnaire (SF-HKIEQ), and patient satisfaction instrument (PSI) were used to collect data. The data were then analyzed using SPSS 25.

10.9% of participants had high COVID-19 anxiety, and 69.0% had high death anxiety. 77.8% of the participants had problems in the inpatient experience. 69.9% of participants were dissatisfied, and 30.1% had moderate satisfaction. A significant negative correlation between death anxiety and COVID-19 anxiety (r = -0.13; p = 0.04) was observed. Death anxiety hurt experiences, and COVID-19 anxiety had a positive impact on patients' experiences. Also, we found a significant positive correlation between experiences and patients' satisfaction. COVID-19 anxiety, age, death anxiety, and infection with COVID-19 predicted 37% of the variance of patients' experiences. COVID-19 anxiety, inpatient experience, and marital status predicted 14% of the variance in patient satisfaction (p < 0.05).

Patients have experienced high levels of death anxiety and moderate levels of COVID-19 anxiety during the outbreak of the COVID-19 pandemic, which has affected their experiences and satisfaction. Professional assistance is needed to improve patient experience and satisfaction during pandemics such as COVID-19 disease. The results of this study may help to prepare suitable future interventions and programs to increase patient satisfaction in hospitals.

Hemolacria, the presence of blood in tears, is an uncommon condition with various underlying etiologies. Although it can be alarming, its occurrence is often linked to a range of medical conditions, particularly in pediatric patients.

We present two pediatric cases involving hematological diseases who developed hemolacria as a manifestation of their underlying conditions. Case 1 includes that of an eight-year-old girl with chronic immune thrombocytopenia (ITP) who developed hemolacria during an episode of epistaxis. Case 2 is of a seven-year-old girl with acute lymphoblastic leukemia (ALL) who presented with hemolacria during maintenance chemotherapy. Both cases illustrate the importance of considering hematological disorders in the differential diagnosis of pediatric hemolacria. 
Both cases were managed using a multidisciplinary strategy tailored to their underlying conditions. Systemic treatments, including intravenous immunoglobulin, thrombopoietin receptor agonists, and chemotherapy, addressed the primary hematological disorders. Localized ocular therapies, such as artificial tears, topical steroids, and antihistamines, were employed to manage symptoms and prevent complications. Supportive care measures, including patient education and infection prevention protocols, were integral to both management plans.

These two cases underscore the importance of recognizing hematological diseases as potential causes of hemolacria in children. Effective management requires a comprehensive, multidisciplinary approach that combines systemic treatment of the underlying disease with targeted local therapies and supportive care. Timely intervention is critical to ensuring favorable outcomes in these rare but significant presentations.

Emotional intelligence (EI) plays a pivotal role in the effectiveness and efficiency of nursing students in their academic and professional pursuits. EI levels differ across academic years and tend to increase with age, often being higher in female students.

This study aimed to assess the EI of RAKMHSU nursing students in the UAE.

This descriptive cross-sectional study used the Schutte EI Scale to assess the EI of 214 undergraduate nursing students. The Schutte EI Scale is a five-point Likert scale comprising 33 questions that yields scores between 33 and 165, including reverse scoring for three questions. Data were analysed using IBM SPSS Version 25.

Approximately 82.7% of the study participants were female and 91.6% were unmarried. The age range of the participants was 18–22 years. Scores of 33–77, 78–121, and >122 on the Schutte EI Scale were considered low, moderate, and high, respectively. No differences were found in the average EI scores of nursing students by academic year. Overall, 68.15% of the students had high EI, 23.83% had moderate EI, and 7% had low EI. The study found no correlation between the EI scores and demographic factors. All EI domain scores except those for emotion perception were consistent between first- and final-year nursing students.

The study showed that many of the nursing students exhibited high EI, which is essential for communication, patient care, and professional development. Further, demographic parameters, including age, gender, and academic year, did not significantly affect the EI scores, suggesting that EI in this cohort of students was stable. Most students demonstrated strong EI, although the perception of the cohort could be improved. These findings highlight the need to integrate EI training in nursing universities to improve students’ emotional abilities, thereby improving patient outcomes and the nursing profession.

Entry-level physiotherapists function as autonomous healthcare practitioners within a complex healthcare system, requiring professional competence in the clinical domain. Physiotherapy (PT) educational programs typically emphasize onsite teaching and use summative assessments to evaluate students' achievement of program objectives and learning outcomes. However, possessing knowledge and skills does not guarantee efficacy or confidence in clinical practice. This study aimed to assess the impact of online teaching approaches (TAs) during the COVID-19 era on the physiotherapy self-efficacy (PSE) of senior FCHS physiotherapy students across three clinical areas: musculoskeletal (MSK), neurological (N), and cardiorespiratory (CR), and to explore the influence of academic factors on PSE scores.

Researchers collected data for this cross-sectional study using a four-section questionnaire. One section specifically addressed the PSE. The study focused on three cohorts of pre-graduation senior PT students at Fatima College of Health Sciences (FCHS) who encountered a combination of onsite, online, and blended TAs due to COVID-19. Nonparametric statistical analysis was employed to analyze the data.

Of the seventeen participating students (68% participation rate, median age 22), the results indicate a statistically significant decrease in self-efficacy from MSK to N and CR clinical areas. The impact of online TAs on PSE varied by course specialty; TAs related to CR specialty courses significantly correlated with PSE scores, showing a preference for onsite TA to enhance self-efficacy over blended and online TAs. Furthermore, greater exposure to clinical cases and verbal encouragement from clinical educators were associated with higher self-efficacy. Physiological reactions, such as body pain, were also found to be influenced by the specific clinical area.

The impact of online TAs, implemented during the COVID-19 pandemic, on the self-efficacy of senior PT students is dependent on the specialty of the courses. This impact was most significant in CR specialty courses. Moreover, other factors, such as the sufficiency of exposure to clinical cases and clinical educators’ verbal encouragement, significantly contributed to students' self-efficacy.

The traditional methods are mostly used to detect tracheal localization and to exclude esophageal localization. Therefore, the aim of this study was to investigate the usefulness of epigastric manual compression in the confirmation of esophageal placement of the tube.

Out-of-hospital ETE was performed by experienced paramedics working in the emergency ambulance service, while ETE in the emergency department was performed by emergency medicine residents or emergency medicine specialists with at least 2 years of emergency department experience. Epigastric compression was performed by applying pressure to the epigastric region at least three times (in 5 sec) with the volar side of the intubated patient while the patient was ventilated with a balloon-valved mask. Immediately after ETI was performed, Ultrasonography (USG) was performed as the gold standard confirmation method. If a double path sign was observed and the pleural sliding motion was not seen, it was considered unsuccessful.

A total of 78 patients were included in the study (an equal number of successful and unsuccessful ETE applications). Approximately 59% (n=46) of the patients were female, median age was 73 years (64-80), and 22(28.2%) patients were intubated due to traumatic etiology. The specificity and sensitivity of epigastric fluctuation for esophageal intubations were 83.33% and 60%, respectively. The positive predictive value was 92.31%, and the negative predictive value was 38.46%. Epigastric auscultation airflow sound had a specificity of 86.96% and a sensitivity of 65.45% for esophageal intubation.

Although the fluctuation that occurs in the tube with epigastric compression is not as sensitive and specific as USG, it is a better method than lung auscultation.

Pediatric inflammatory bowel disease [IBD] impacts affected children with many diagnostic, therapeutic, and life challenges. The traditional drugs used for induction and maintenance of remission had many unwanted side effects. Therefore, there was an urgent need for safer, more effective therapeutic strategies. Hence, modifying the gut microbiota [GM] was proposed as an innovative approach based on the theory that restoring the disturbed GM harmony will have a positive impact on IBD activity and remission.

This review aimed to examine each modality used to modify the gut microbiota in children with IBD, addressing their action mode, effectiveness, limitations, and side effects for a more holistic approach to children with IBD.

Four electronic databases were searched, including WOS, Cochrane Library, PubMed, and Scopus, for articles that investigated modulating GM via exclusive enteral nutrition, prebiotics, dietary fiber, probiotics, fecal microbiota transplantation, and antibiotics.

The available evidence was encouraging regarding their effectiveness and safety; however, those studies were hindered by their small sampling size and inconsistency in recruiting cases.

Further work should identify other therapeutic and prognostic avenues for modulating GM for these vulnerable groups.

Ankylosing spondylitis (AS), also known as rheumatic pelvic spondylitis, is considered the primary condition in a group of chronic inflammatory rheumatic diseases collectively referred to as spondyloarthropathies.

This study aimed to explore the association between ABCB1 C3435T polymorphism and the predisposition to ankylosing spondylitis (AS) in the Algerian population. The frequency of this polymorphism was compared between the group of AS and healthy subjects.

A case-control study involving 81 AS patients and 98 controls was conducted. DNA genotyping was done using predesigned probe-based allelic discrimination TaqMan® assays. Allele and genotype frequencies were compared between cases and controls, and statistical analyses were executed using SAS software (version 9.1, SAS Institute Inc., Cary, NC).

No statistically significant differences were observed in the frequencies of ABCB1 genotypes and alleles between AS cases and the control group. In contrast, the recessive model (CC+CT/TT) (OR = 8.99 [11.97-40.99], p = 0.004) was significantly associated with the mixed form of the disease, while the heterozygous 3435CT genotype provided protection against the axial form. Moreover, a positive association was also found between the ABCB1 C3435T polymorphism and BMI (OR: 5.19 [1.41-19.9], p = 0.01).

This is the first study to explore the association of ABCB1 polymorphisms with susceptibility to ankylosing spondylitis in an Algerian population. It was determined that the ABCB1 C3435T SNP does not influence the risk of AS but rather affects the disease phenotype and body mass index (BMI).

Iron-Deficiency Anemia (IDA) is a global burden affecting more than a billion individuals. It is most prevalent due to nutritional deficiencies. Researchers have linked Selenium (Se) to anemia and erythropoiesis.

This interventional-study was designed to investigate the plasma Se concentration and its supplementation impact in IDA patients receiving standard treatment.

In the present study, a total of 215 IDA patients were enrolled from different departments of AIIMS, New Delhi, after getting ethical authorization from the Institutional-Ethical Committee. Iron supplements were administered to patients with only IDA, while a combination of iron and selenium supplements was given to patients with selenium-deficient IDA for 90 days. Parameters such as hemoglobin, hematocrit, RBC count, serum ferritin, transferrin, TIBC, and plasma Se levels were measured on the baseline and the 90th day.

All blood parameters were significantly below the normal reference range on the 0th day. Se levels were found to be higher in the study population {57% (122/215) in IDA}. Further, in low plasma Se IDA patients 26% (55/215), treatment with iron and Se supplements for 90 days significantly improved all blood parameters and led to a subjective improvement of the patient’s well-being.

Selenium levels are variable in patients with IDA, and no correlation can be drawn for the benefit of selenium in the IDA. Further, the high prevalence of nutrition-related disorders such as IDA highlights the need to avoid blind Se supplementation along with iron. These combination in the form of nutritional supplements having Se are rampantly available and sold over the counter. So, supplements with Se shouldn’t be generalized to IDA patients..

CTRI/2023/04/051405

Polycystic Ovary Syndrome (PCOS) is one of the most prevalent endocrinal disorders in the reproductive age of women and is, therefore, a risk factor for Gestational Diabetes Mellitus (GDM). One of the medications used in the management of PCOS is metformin and its use has been proposed to decrease the occurrence of GDM. The purpose of this study focuses on the effects of the dose and duration of metformin treatment on the prevalence of GDM among pregnant women affected by PCOS.

A cross-sectional survey was carried out on 112 pregnant women diagnosed with PCOS in tertiary care hospitals in Karachi. Data were collected through a structured questionnaire, in which 55 patients received metformin and others did not receive metformin. Both groups were compared for the prevalence of GDM. Chi-square test was used in data analysis at a significance level of p < 0. 05.

GDM was found to be significantly higher in non-metformin group than metformin group (60% vs 40%, P=0.03). The data analysis extended this finding, which concluded that metformin use is inversely related to GDM risk (p = 0.02).

This study shows that metformin therapy reduces the incidence of GDM in pregnant PCOS patients and may be used to prevent GDM in such patients. Such outcomes indicate the possibility of the use of metformin as a means of preventing GDM in this group of patients.

The healthcare sector plays a significant role in the control and mitigation of plastic pollution-associated threats to the environment and human health.

This study aimed to investigate the awareness, pro-environmental behaviors, and strategies for mitigating plastic pollution among nursing students.

A cross-sectional survey was conducted with 210 undergraduate nursing students using a structured questionnaire. Convenience sampling was used to recruit study participants. Data were analyzed using the Statistical Package for the Social Sciences version 26.

The results of the study revealed that the majority of nursing students (71%) had moderately adequate levels of awareness regarding plastic pollution, whereas 70.48% of the students engaged in inadequate levels of pro-environmental behaviors.

The present findings demonstrate the necessity of reinforcing nursing students regarding the reduction of plastic pollution through specific policies and educational involvement. These measures would contribute to further initiatives and encouragement of their student period, future nursing practice, and patient safety at all levels.

Globally, urinary tract infections (UTIs) have attracted the attention of clinicians and have become a serious public health threat. Management of UTIs has become a growing concern for clinicians due to increased antimicrobial resistance (AMR). The present study was conducted to identify the most diagnosed uropathogens causing UTIs among Inpatient Department (IPD) and Outpatient Department (OPD) patients visiting a tertiary care health centre and also to analyse the patterns of prescribed antibiotics based on physicians’ empirical and urine culture-based approach. Furthermore, this study sought to evaluate the sensitivity patterns of selected bacteria against antibiotics used to treat UTIs among patients.

This study was undertaken for a period of three years at the Department of Medicine in collaboration with the Department of Microbiology. Mid-stream clean catch urine samples were collected from UTI suspects from both IPD and OPD patients and processed for culture and susceptibility testing as per standard guidelines. Univariate and bi-variate descriptive statistical techniques were used to analyse the data.

A total of 2400 urine samples were processed for culture and sensitivity testing, out of which 200 samples were found positive. Escherichia coli was the most frequently isolated urinary pathogen in both OPD and IPD patients (55.3% and 74.4%, respectively). Empirically, the most commonly prescribed antibiotic was piperacillin/tazobactam (13%), while the culture-based antibiotic was nitrofurantoin (20%). The findings highlight that more than 95% of isolates of the most prevalent uropathogen E. coli were sensitive to amikacin, ciprofloxacin, imipenem, and nitrofurantoin, whereas more than 90% were sensitive to ceftazidime, cefoperazone sulbactam, and piperacillin/tazobactam.

Increasing resistance to common antibiotics necessitates a reevaluation of both empirical and culture-based antibiotic approaches. The findings of this study are of significant importance and highlight the need to develop a targeted antibiogram for UTI, understand the trends in antimicrobial resistance (AMR), and ensure the rational selection and antibiogram both in empirical and culture-based approaches.

Incidental gastric tumours, including benign gastric adenomyoma (GA) during bariatric surgery, can pose diagnostic and management dilemmas, resulting in misdiagnosis, inappropriate procedures, or even abandoning the procedure.

We report a rare case of an incidental prepyloric GA discovered during a one-anastomosis gastric bypass performed for diabetes management. Preoperative gastroscopy was unremarkable, but intraoperative laparoscopy revealed a mass near the pylorus resembling a gastrointestinal stromal tumour (GIST). An initial histopathological examination was non-confirmatory. However, subsequently, it was confirmed to be a GA. The patient underwent a staged surgical approach, achieving diabetic control during the primary procedure and tumour excision subsequently. This is the first documented case of GA discovered during bariatric surgery.

Gastric tumours identified during bariatric procedures necessitate an individualized approach considering the procedure planned, tumour characteristics, and anatomical location, to achieve the best clinical outcomes.

Digital eye strain (DES), also known as computer vision syndrome (CVS), is a common condition affecting individuals who spend prolonged periods focusing on screens, leading to symptoms, such as dry eyes, eye strain, headaches, and blurred vision. University students, including medical students, increasingly spend more time staring at screens for study and research. Therefore, this study assesses the prevalence and impact of DES among medical students, a group increasingly dependent on digital resources for their studies.

This cross-sectional study was conducted from November 2023 to February 2024 at RAK Medical and Health Sciences University, UAE. A sample of 209 undergraduate medical students was recruited using non-probability convenience sampling. The sample size was calculated based on a 95% confidence level and a ±5% margin of error, representing 46.4% of the eligible population. Data were collected through a validated electronic questionnaire and analyzed using SPSS version 29, employing descriptive and inferential statistics to explore associations between visual symptoms and factors, such as refractive errors, study duration, and ergonomic practices.

Among respondents, 69.9% were female, with a mean age of 19.87 ± 1.58 years. The prevalence of myopia was 49.7%, while hypermetropia and astigmatism were reported at 2.9% and 6.7%, respectively. A striking 92.8% experienced at least one DES symptom, with tired eyes (71.3%) and eye strain (58.9%) being the most common symptoms. Significant correlations were observed, including dry eyes associated with myopia (p = 0.002) and difficulty refocusing linked to hypermetropia (p = 0.029). Ergonomic practices revealed that 80.4% of students used screens closer than recommended, which correlated with increased eye strain (p = 0.001) and tired eyes (p = 0.044). Moreover, adherence to the 20-20-20 rule was low (3.8%), associated with heightened symptoms.

This study highlights a high prevalence of DES symptoms among medical students, related to inadequate ergonomic practices. These findings emphasize the necessity for targeted interventions to enhance eye health and ergonomic awareness in this population. Future research should evaluate the effectiveness of such interventions.

ADHD (attention-deficit hyperactivity disorder) is a developmental disorder characterized by inattention and distractibility, as well as hyperactivity.

This study investigated the prevalence of ADHD in male and female students of primary school in Babol (Iran).

This study was a cross-sectional study. The studied population was school-aged children (7-12 years old) in the urban areas of Babol city. A total of 1469 primary school students were included in the study during 2021-2022. In this research, the Revised Conners' Parent Rating Scale (CPRS-R) was used to investigate ADHD disorder.

The prevalence of ADHD in the present study was 9.9% (146 people). ADHD subgroups, in the order of prevalence, included mixed type (67 people, 4.6%), hyperactivity-impulsive type (43 people, 2.9%), and then inattentive type (36 people, 2.5%). ADHD prevalence among males and females was 13.4% and 7%, respectively. This was 1.9 times higher in male students than in female students. ADHD subgroups in male students, in order of prevalence, included mixed type (44 people, 50%), impulsive hyperactivity type (32 people, 36.36%), and inattentive type (12 people, 13.63%), and in female students, ADHD subgroups were inattentive type (24 people, 41.37%), mixed type (23 people, 39.65%), and hyperactivity-impulsive type (11 people, 18.96%). ADHD was seen mostly in students with illiterate parents (p≤0.001).

It seems that the prevalence of ADHD in children of elementary schools in Babol was not significantly different from the prevalence reported in other cities of Iran and globally.

Medically-complicated obesity, a major public health issue due to the ineffectiveness of traditional treatments, is increasingly managed through bariatric surgery. This study investigates the knowledge of clinical year students about bariatric surgery at RAKMHSU. It aims to assess their awareness and understanding of this crucial intervention for severe obesity and its related health risks.

This cross-sectional study was conducted over three months at RAK Medical and Health Sciences University (RAKMHSU) and utilized a survey to assess perception regarding bariatric surgery among clinical year students from RAK College of Medical Sciences (RAKCOMS) and RAK College of Nursing (RAKCONS). A pre-validated questionnaire was employed, and participants were randomly selected. Data analysis focused on the reliability of the tool and the student’s perception.

The study included 197 participants, comprising 162 medical and 35 nursing students. Significant differences emerged in three areas: nursing students preferred daily exercise more (Q6), believed in the greater likelihood of weight regain post-surgery (Q9), and were more aware of disease susceptibility (Q13) compared to medical students. Correlation analysis revealed that students who felt body shape affected self-confidence had better bariatric surgery knowledge and BMI calculation experience. Notable correlations were found between specific questions, with significant positive correlations observed among nursing students but not medical students.

Obesity is a global epidemic with rising prevalence, including in the UAE, where 43% of expatriates are overweight and 32.3% obese. Environmental factors, such as low physical activity due to climate and cultural norms, exacerbate the issue. Our study revealed good knowledge of BMI among participants, reflecting awareness of obesity's risks. However, concerns about bariatric surgery safety persist, with 32% of participants wary of complications. Despite this, the most recognized bariatric surgery is a viable option for medical conditions like PCOS. Educational interventions are essential to address misconceptions, promote informed decisions, and bridge gaps in exercise habits and referral practices.

In conclusion, while many medical and nursing students demonstrate a solid understanding of bariatric surgery, hesitations and misconceptions persist. Continuous education is essential to address these concerns, enhance knowledge, and align perceptions with clinical advancements. By doing so, future healthcare professionals can make informed decisions and provide better care for patients with severe obesity, ultimately improving outcomes and fostering greater acceptance of evidence-based surgical interventions.

Prediabetes is associated with an increased risk of diabetes. However, there is currently no cohesive picture of the prevalence of prediabetes and its risk factors in Afghanistan. Therefore, we conducted a study to examine the prevalence of prediabetes and its risk factors among adult outpatients in Afghanistan.

We conducted a cross-sectional study on outpatients aged 18 years or over (n=1766) from April 2023 to October 2023. The sociodemographic characteristics and clinical variables of the patients were collected through an interview-based survey. Regression analysis was used to examine the association between prediabetes and its risk factors.

The study included 54.6% females and 45.4% males, with a mean age of 48.9 (±10.8). The prevalence of prediabetes was 27.9%. Males were more likely to have prediabetes with increased odds (OR = 1.48; 95% CI: 1.17–1.89; p < 0.001) compared with females. There were higher odds of having prediabetes for overweight or obese (OR = 2.10; 95% CI 1.15-3.84; P = 0.016), smoking (OR = 7.26; 95% CI 3.00-11.05; p < 0.001), hypertension (OR = 2.76; 95% CI 2.00-3.81; p < 0.001), and high cholesterol levels (OR = 1.48; 95% CI 1.16-1.90; P = 0.002), compared to participants without prediabetes.

The prevalence of prediabetes in our study was high. Risk factors that were related to prediabetes included male gender, obesity or overweight, smoking, hypertension, and high cholesterol levels. Focusing control and prevention efforts on these risk factors linked to prediabetes can significantly reduce its prevalence and mitigate future consequences.

Nasopharyngeal carcinoma (NPC) is a prevalent cancer in Algeria, where it ranks as the most common cancer of the aerodigestive tract in men, with an incidence rate of 5.1 cases per 100,000 persons per year. The etiology of NPC is multifactorial. Thus, this research aims to identify specific dietary risk factors prevalent in the western Algerian region.

We conducted a case-control study comprising 120 incident cases of histologically confirmed nasopharyngeal carcinoma, carefully matched with 120 controls.

Nasopharyngeal cancer, more common in males (average age 45.2 ± 2.5 years), is linked to consuming traditionally preserved foods (khlii, salted fats, boiled milk, processed meats), elevating NPC risk. Significant associations include hot chili peppers, citrus fruits, and dried vegetables, while increased fruit and coffee intake reduces risk. High-temperature cooking and fried food show a strong link. Multivariate analysis identifies hot chilli, citrus fruits, fresh fruits, and coffee as the key factors significantly associated with NPC.

This research provides essential insights for implementing primary prevention measures to combat nasopharyngeal carcinoma effectively. By identifying specific dietary risk factors prevalent in the western Algerian region, healthcare authorities can focus on targeted interventions to reduce the burden of NPC in this population.

Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive treatment modality that is gaining prominence due to the limitations of existing pharmacotherapy approaches. To date, there is a paucity of research examining the awareness of rTMS among psychiatrists in the Arabian Gulf region. In this region, treatment resistance is prevalent due to the cultural attribution of psychological distress to somatic factors and the stigma associated with pharmacotherapy.

This study aims to assess the comprehension and attitudes of psychiatrists towards rTMS and determine the factors that contribute to their knowledge of rTMS in Oman.

A quantitative, observational, cross-sectional study was conducted utilizing an online survey. The survey collected demographic information, and a validated measure was used to assess variations in knowledge and attitudes towards rTMS. Univariate analysis and multiple linear regression were performed to identify risk factors associated with knowledge levels.

Fifty psychiatrists participated in this study, resulting in a response rate of 53%. The mean age of the participants was 32.7±4.3 years (range: 26.0–41.0), with more than half being female (n=28, 56.0%) and classified as residents (junior/senior) (n=25, 50.0%). Most of the sample was Omani (n=45, 90.0%) and were employed in tertiary hospitals (n=38, 76.0%). The mean scores for knowledge and attitudes towards rTMS in this sample were 14.5±3.8 and 22.5±6.3, respectively. The linear model indicated that senior residents and older participants had a higher level of knowledge than junior residents (β=4.65, p<.001). Furthermore, participants who had access to an rTMS device at work demonstrated a higher level of knowledge than those who did not (β=1.88, p=0.027).

Three factors significantly influence the knowledge of psychiatrists about rTMS: their educational level, access to an rTMS device at work, and the availability of standardized training in rTMS.

Bronchial asthma, a chronic inflammatory condition, poses significant health challenges for children. Proper management of childhood asthma requires the knowledge, attitudes, and practices (KAP) of the caregivers. This study assesses the KAP of caregivers in the management of asthmatic and non-asthmatic children in the UAE.

A cross-sectional study was conducted in Ras Al Khaimah over four months, involving 182 children aged 6-16 years. Data were collected through a pre-validated KAP questionnaire distributed to caregivers of asthmatic and non-asthmatic children across schools, parks, and private clinics. Descriptive statistics were used to analyze the responses.

Among caregivers of asthmatic children, 77.1% demonstrated adequate knowledge, while 45.83% held a positive attitude towards asthma. In contrast, caregivers of non-asthmatic children had lower knowledge (37%) and attitudes (26.88%). Lack of adequate knowledge led to poor asthma management practices, with only 75% of caregivers conducting regular follow-ups. Better caregiver knowledge was associated with improved asthma control, while misconceptions and negative attitudes led to suboptimal care.

Significant gaps in caregiver KAP were identified, with a need for targeted educational programs to enhance asthma management. Improving caregiver understanding and attitudes through regular physician visits and educational initiatives is crucial for optimizing asthma outcomes in children.

Social anxiety disorder (SAD) is an excessive and irrational fear of social situations, leading to an avoidance of those situations. Individuals with SAD may fear acting in a certain way or exhibiting anxiety symptoms in front of others, which can significantly impact their daily functioning and quality of life. Among medical students, SAD can negatively influence academic performance, particularly in exams, and lead to employment difficulties. The COVID-19 pandemic introduced unique stressors, including social isolation and the transition to online learning, which may have exacerbated anxiety-related conditions. Understanding the prevalence and associated factors of SAD during this period is essential to develop targeted interventions for students. Thus, this work aimed to assess the prevalence and demographic correlates of SAD among medical students at the College of Medicine and Health Sciences at Sultan Qaboos University (SQU) in Oman during the pandemic.

A questionnaire-based cross-sectional study was conducted from September to October 2020 in SQU, College of Medicine and Health Sciences. Medical students from all academic years were invited to complete demographic data and the Liebowitz social anxiety scale (LSAS). The LSAS is a 24-item self-rating scale to assess SAD. An analysis using a Chi-square test was performed to obtain the factors associated with SAD.

A total of 558 students completed the questionnaire, of which 348 were female (62%). The total prevalence of SAD was 64%, whereas moderate grade SAD accounted for 27% of the participants, marked grade 19%, severe grade 11%, and very severe grade 7%. Among the students who had the disorder, 71% suffered a generalized subtype of SAD. A significant association between SAD and phase of study (p<0.001), age group (p<0.001), and gender (p<0.001) was found. Phase 1 (69%) exhibited the highest prevalence, followed by phase 2 (66%) and phase 3 (48%). Among the age groups, 17-19 years group (67%) demonstrated the highest prevalence, followed by age groups 20-22 (64%) and 23-25 (46%). In terms of gender, females (70%) were more likely to display SAD symptoms than males (52%).

The results of this study indicated a high prevalence of SAD among medical students and showed a significant association between SAD and the phase of study, age group, and gender. These results could help justify the establishment of targeted mental health interventions to support medical students in managing their anxiety, which can ultimately result in an improvement in their academic performance and overall quality of life. University administrators and psychologists should aim to develop supportive programs for students.

Integration of research into medical education is crucial for cultivating physician-scientists capable of advancing medical breakthroughs. It is imperative to take these measures for early medical students to establish a strong research foundation for future healthcare professionals.

This study investigated the impact of early research exposure on pre-clinical medical students at Gulf Medical University (GMU). A sample size of 85 MD students participated in the study, which spanned six months. In GMU, early exposure to research begins with sessions integrated into the Medical Education and Lifelong Learning (MEL) course during the first year, covering the structure and function of different sections of a research paper and practical application through Journal Article Discussions (JADs) in journal clubs in the 2nd year.

The intervention involved the evaluation of these measures through pre-validated MCQs and a self-administered questionnaire. MCQ results revealed that over 70% of students scored above 40% on research knowledge assessments. Additionally, a questionnaire comprising open and close-ended questions revealed that most of the students reported a positive agreement in understanding research structures.

The findings underscored the necessity of incorporating research into medical curricula to enhance students' research competencies and foster a positive attitude toward research. This study highlighted the importance of early research exposure in developing future physician-scientists.

Crush syndrome is the second most common cause of death in earthquakes, following direct trauma. Crush syndrome develops when toxic substances released after tissue injury or crushing reach the bloodstream. The aim of this study was to investigate factors associated with morbidity and mortality in patients rescued from the rubble after the February 6 earthquake and admitted to our hospital who had crush syndrome by retrospectively analyzing their data.

Hemodialysis, fasciotomy, and other parameters during hospitalization and time to transfer to a ward or death of 36 adult patients with crush syndrome who were rescued from the rubble and hospitalized after the February 6 earthquake were retrospectively analyzed.

Thirty-six patients were included in the study. There was no significant correlation between the mortality of patients according to their time of rescue or need for fasciotomy, dialysis, or inotropes (p=0.767, p=0.294, p=0.625, p=0.865, respectively). There was a high inverse correlation between the time of rescue and time to death. There was a weak inverse correlation between the time of rescue and hospitalization duration (r=-0.767 and r=-0.341, respectively). There was a significant correlation between the need for inotropes and mortality (p<0.001). No one who didn't need dialysis passed away. Dialysis was necessary for all six of the deceased individuals. We can conclude that one significant factor in predicting death in CS patients is the requirement for dialysis.

Crush syndrome, which develops in patients rescued from the rubble alive, is a life-threatening condition. It is an important syndrome and an important cause of mortality for earthquake victims. Further large-scale studies are needed to elucidate the association of time of rescue, the need for fasciotomy and hemodialysis, and other factors with mortality.

Despite significant advancements in COVID-19 treatment and prevention, immunocompromised individuals, particularly those with hematological malignancies, remain at high risk for severe infection and suboptimal vaccine response. Pre-exposure prophylaxis strategies for these vulnerable populations have been limited. Monoclonal antibodies, proteins designed to target specific antigens, offer a promising preventive solution for individuals unable to mount a sufficient immune response to vaccination. However, there is a critical unmet need to establish clear patient selection criteria for pre-exposure prophylaxis with monoclonal antibodies in these groups. This consensus statement explores recent research to address this gap, outlining profiles of patients most likely to benefit from monoclonal antibody-based prophylaxis.

The consensus statement was developed through a rigorous process, utilizing a pre-Delphi search method and a modified Delphi technique to gather expert opinions. This approach ensured a comprehensive and informed consensus among experts in the field. Initially, nine distinct patient categories requiring pre-exposure prophylaxis with monoclonal antibodies were identified. Through iterative rounds of expert feedback, discussion, and refinement, these nine categories were expanded and subdivided into twelve more specific groups of hematological malignancies and immunocompromised disorders. This refinement aimed to better capture the diverse patient profiles requiring prophylaxis, providing a more detailed framework for the targeted administration of monoclonal antibodies.

The study resulted in the panel members agreeing on nine categories for the use of monoclonal antibodies in COVID-19 prevention for high-risk patients. Achieving consensus among experts is crucial as it reflects the collective validation of evidence-based recommendations that can be reliably applied in clinical practice. A 100% agreement was reached for HIV and AIDS, underscoring the unanimous recognition of the vulnerability of this group to severe COVID-19 outcomes. Similarly, 96% agreement was reached for patients on immunomodulatory drugs (IMiDs), and 90.5% for those with hematological diseases, highlighting strong expert support for prophylaxis in these categories. Immunodeficiencies and renal conditions garnered 86% agreement, indicating broad, although slightly more varied, expert consensus on these groups. Lastly, 80% of the panel supported patients with solid organ cancer, liver conditions, rare neurological disorders, and severe life-limiting neuro-disabilities, reflecting recognition of their elevated risk despite more diverse opinions for these categories.

This consensus statement offers healthcare professionals in the UAE a clear, evidence-based framework for the use of monoclonal antibodies in preventing COVID-19 among patients with hematological malignancies and immunocompromised conditions. By outlining specific patient categories, the statement provides a practical guide that enables clinicians to make informed decisions about pre-exposure prophylaxis, ensuring that high-risk individuals receive timely and appropriate protection. The consensus not only enhances the ability of healthcare providers to identify and prioritize at-risk populations, but also optimizes patient outcomes by streamlining preventive measures in clinical practice. In addition, these findings lay the groundwork for future research and the development of standardized protocols, ultimately improving the management of vulnerable populations in the ongoing fight against COVID-19.

Among women of reproductive age, Polycystic Ovarian Syndrome (PCOS) is a common endocrine condition marked by insulin resistance, metabolic abnormalities, and hormonal imbalances. Infertility, irregular menstrual periods, acne, hirsutism, and obesity are among the symptoms that this illness frequently causes. Traditional PCOS therapies usually include drugs like insulin sensitizers and oral contraceptives, which can have negative side effects and might not deal with the underlying causes of the condition. This study aims to examine the etiology of PCOS and the effectiveness of natural management techniques in reducing symptoms and enhancing general health outcomes.

The objective of this study is to comprehend the pathophysiology and underlying mechanisms of PCOS, including hormonal and metabolic factors, assess the effectiveness of natural management strategies, such as dietary changes, herbal supplements, physical activity, and lifestyle interventions, in managing symptoms, investigate the effects of particular diets and lifestyle changes on insulin sensitivity, inflammation, and hormonal balance in PCOS patients, compare natural strategies with conventional treatments to determine the advantages and disadvantages of each treatment, identify research gaps, and suggest areas for future study.

A thorough examination of pertinent literature, including clinical studies, randomized controlled trials, and meta-analyses published in peer-reviewed journals, was a part of the search approach. Studies on the pathophysiology of PCOS, traditional therapies, and natural management strategies were found using databases like PubMed, Scopus, and Web of Science.

The review concentrated on studies conducted within the last 15 years to guarantee that the most recent findings were included. This study intends to shed light on the possible advantages of incorporating natural methods into PCOS care by combining the available data and comprehensive treatment choices.

In summary, PCOS is a common and complex disorder that affects women's health worldwide. Effective management requires knowledge of its symptoms, risk factors, and underlying mechanisms. Women can be empowered to manage PCOS better and enhance their general well-being by emphasizing a holistic approach that incorporates lifestyle changes and natural therapies.

The study investigated the impact of incorporating fruits or fruit juices into the diets of prediabetic individuals to mitigate oxidative stress. Previous research presented divergent approaches, making replication of findings challenging. This study aimed to evaluate whether advising the consumption of two low-calorie fruits daily could improve oxidative stress, glycemic control, and anthropometric measurements in prediabetic individuals.

An open-label, parallel, randomized controlled trial was conducted at a medical college hospital in Mangalore, Karnataka, India. Thirty participants, aged 40-70 years, with impaired fasting glucose or impaired glucose tolerance, were recruited through screening of first-degree relatives of patients with type 2 diabetes. Participants were randomly allocated in a 1:1 ratio to either the intervention group, which consumed two low-calorie fruits daily or a wait-list control group. The inclusion criteria were adults aged 40-70 years with prediabetes. Exclusion criteria included a history of diabetes, chronic diseases, normal glucose tolerance, smoking, alcohol use, recent antioxidant/vitamin use, and participation in dietary trials within the past year. Outcomes included plasma vitamin C levels and blood pressure, oxidative stress markers, glycemic parameters, and anthropometric measures. Over three months, measurements were taken at the beginning and end of the study. Statistical analysis was performed using the Wilcoxon signed-rank test and Mann-Whitney U test, with a significance level set at p < 0.05.

The mean age of participants was 43.1 ± 10.1 years in the intervention group and 44.7 ± 9.6 years in the control group. The intervention group demonstrated a significant 15% increase in plasma vitamin C levels (mean change: 4.0 µmol/L; p = 0.021; 95% CI: 1.2–6.8), whereas the control group experienced a 9% decrease. Systolic blood pressure decreased significantly in the intervention group (mean change: -3.0 mmHg; p = 0.04; 95% CI: -4.5 to -1.5), while the control group showed an increase. No significant differences were observed between groups in terms of oxidative stress markers, glycemic parameters, or anthropometric measures.

Overall, our study provided insights into the effects of incorporating low-calorie fruits into the diet of individuals with prediabetes. While improvements in vitamin C levels and systolic blood pressure were observed, there were no significant changes in oxidative stress, glycemic status, anthropometry, and other antioxidant measures. These findings contribute to the existing literature on the potential benefits of fruit consumption in individuals with prediabetes, highlighting the importance of vitamin C as a biomarker and its potential role in blood pressure regulation and cardiovascular benefits. This study also highlights plasma vitamin C as a promising biomarker for assessing the effects of fruit supplementation. Additionally, this study suggests that broader dietary and lifestyle modifications may be necessary to achieve comprehensive metabolic improvements, particularly in prediabetic individuals.

(CTRI/2011/05/001739).

The global impact of COVID-19 resulted in widespread illness and death. The rapid evolution of SARS-CoV-2, accompanied by increased transmission caused by Variants of Concern (VOC), became a significant concern in the post-pandemic.

This study has been conducted to evaluate the performance of multiplexed real-time reverse transcription-PCR (RT-PCR) assays for COVID-19 detection and the use of specific mutation RT-PCR-based approach to identify VOC in SARS-CoV-2 positive samples in the northern part of the UAE.

We selected 200 respiratory specimens tested between October 2022 to January 2023, at the Pure Lab, COVID Screening Lab, Al Qassimi Women's and Children's Hospital, Sharjah, UAE. We evaluated the performance of four commercially available RT-PCR kits for COVID-19 detection. Further, the positive samples were used to identify variants by variant detection kit as required for mutations in Spike protein (HV 69-70 DEL, N501Y, E484K, K417N) to identify Omicron, British and SARS-CoV-2 wild type (WT) E Gene variants, respectively.

In the post-pandemic period, 153/200 (76.5%) positivity was observed. There was a higher prevalence of COVID-19 among males, accounting for 52% of the cases, in comparison to females 48% aged between 20-40 years. Variant analysis showed that 50 samples were detected for the SARS-CoV-2 OMICRON variant (B.1.1.529), 4 samples were detected for the SARS-CoV-2 British variant (B.1.1.7), however, 99 samples were detected for SARS-CoV-2 wild type (WT) E gene with no mutation.

This study demonstrates the efficacy of a rapid and cost-effective RT-PCR assay designed to detect spike mutations to effectively contribute to public health response efforts. Additionally, by performance evaluation of PCR kits for COVID-19 detection with the Cycle Threshold (CT) values obtained from diagnostic PCR, we can gather valuable insights into the viral load of samples. This information helps us gauge the extent of transmission and assess the severity of the disease within the population.

This study examines the factors contributing to the shortage of medical doctors teaching medical students despite their crucial role in training the future medical workforce.

To analyze the factors behind the lack of medical doctors in the training of medical students, we used ‘phenomenology’ to understand clinical educators' lived experiences and their constructed meanings. Within the domain of phenomenology, we applied hermeneutic (interpretive) phenomenology. The experiences of eight clinical educators at the Gulf Medical University were explored through interviews and analyzed using Interpretative Phenomenological Analysis (IPA) and Socio-Cognitive Career Theory (SCCT).

The findings revealed that entry into medical education often occurred serendipitously due to inadequate career counseling and the undervaluation of the field. Acquiring a postgraduate qualification in medical education contributed to professional growth of the participants by enhancing expertise and fostering a stronger professional identity. Key motivators included a passion for the field, student interaction, support from colleagues, and an encouraging working environment. Clinical educators faced challenges, particularly when they compared their careers to those of practicing clinicians. These challenges included perceived undervaluing of their field, an unclear professional identity, slower career progression (notably in the UAE) and low income. Furthermore, clinicians who serve as educators as well, often struggle with insufficient time dedicated to teaching responsibilities. Coping strategies involved cultivating a positive work environment and maintaining optimism. Growing awareness and a positive outlook for medical education were noted.

This study uncovered the underlying issues faced by clinical educators through their lived experiences. To change the status quo, we propose facilitating medical students and young doctors in joining the field of Medical Education early in their careers. This can be achieved by providing strong career counseling and establishing clear entry and progression pathways in the field of Medical Education, through medical universities and health centers. Medical educators should be facilitated by providing an encouraging environment, acknowledging their medical education-related qualifications, and improving remuneration.