International Archives of Medicine (E-Journal)
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Effect of Protein Supplements on Renal Function and Lipid Profile
No full textBackground: Protein supplements are one of the most frequently dietary supplements used by athletes and non-athletes in Saudi Arabia.
Objective: To assess the knowledge, attitude and practice of Saudi population toward the protein supplements, examine the relationships of practice with education level, effect of protein on kidneys and lipid profile, assess the types and source of protein supplements, assess the correct use of protein supplements according to exercise intensity and determine protein content and heavy metals in protein supplements.
Methods: A national cross-sectional survey was conducted during October-December 2017 on protein supplements users in Saudi Arabia. Moreover, samples of the best selling protein supplements were analyzed to determined total protein and heavy metals content.
Results: A total of 398 filled protein supplements user questionnaire. The wrong practice of use associated with the effect of protein supplements on renal function and lipid profile.The percentage of protein content in isolated whey protein (68.18%) whiles by Kjeldhl analysis (80.55%). Concentrated whey protein contain (72%) and by kjeldhl analysis (77.2%). Hydrolyzed collagen containing (100%) protein and by kjeldhl analysis (91.25%).The amount of heavy metals in isolated whey protein contains arsenic (83 μg/kg), mercury (<10 μg/kg) and lead (18 μg/kg), while hydrolyzed collagen sample contains arsenic (101 μg/kg), mercury (<10 μg/kg) and lead (49 μg/kg).
Conclusion: The current study reveals an evidence for lacking of the awareness, negative attitude and abuse of protein supplements, demonstrates necessity to further education regarding the use and purchasing of protein supplements to ensure the quality of these products.
 
Perception Towards the Use of Smartphone Application (Apps) to Enhance Medication Adherence Among Saudi Pediatrics
Get PDFObjectives: The aim of this study was to measure the importance of smartphone applications (Apps) in medication adherence in children to help parents and caregivers in giving medication to children to maintain a good health and quality of life, and to improve current clinical practices in adherence to medications among Saudi pediatrics.
Methodology: Cross sectional survey to Saudi Arabia population was conducted from March to April 2017(n=405). Data were collected, tabulated and analyzed using Survey Monkey. We present design requirements for building medication reminders that support the routine aspect of medication-taking by linking children’s concerns, (such as games) on taking medications at time.
Results: Of the 405 survey participants, the majority of participants 72.5% were not aware by applications of smart device that make easier to take medicines regularly. Eighty percent of participants preferred a mobile app to help their children take the medicine easily and regularly, and 39.8% of them thought that the child will interact with this game, the majority of them 88.6% don’t have any obstacle hinders the use of these updated applications. Fifty percent of them will encourage young patients, to use such applications (App) to help them in their medication adherence.
Conclusion: Nonadherence to medication is still represents a fundamental health care challenge. The presence of an application makes it easier for parents to give medication to their sick children. Most children love playing games, there is a high probability of their attachment to this application (App) and it will promote children’s medication adherence.
Key words: Patient adherence, Pediatric, Smartphone, Applications, Apps
Medical Ethics Code: an Analysis from Ethical-Disciplinary Cases Against Medical Professionals within the Specialty of Psychiatry
Get PDFObjective: To identify the nature of infractions committed by doctors working within the field of psychiatry, between 2010 and 2016, from the scope of appeals within ethical-disciplinary cases judged at the Plenary Tribunal of the Federal Medical Council, based on the medical ethics code, and to list some elements that make it possible to outline the professional profile of those involved.
Method: This was a document-based investigation in the form of a retrospective and descriptive study. Data were gathered using the Federal Medical Council (CFM) database and from consultation of judgments issued by the Plenary Body of the Medical Ethics Tribunal (TSEM), of the CFM. The investigation used a sample consisting of 206 appeals and 19 referrals, totaling 224 appeals by doctors who underwent trials. We took into account cases judged between April 13, 2010 and August 3, 2016. Three databases were used in the investigation: cases (224); doctors facing charges (191) and cases/penalties (146). Based on the records of the 191 doctors charged, the ethical-disciplinary cases of seven doctors working in psychiatry were analyzed specifically for the present study, whether or not they had a specialist title. Characterization of infractions committed encompassed references to the articles of the medical ethics code most frequently infringed in the field of psychiatry, along with a survey of the motives for these infractions and some characteristics relating to these professionals’ profile.
Results: Among the findings from this investigation, infractions of the articles of the medical ethics code can be highlighted, such as article 30 “[...] Use of the profession to corrupt customs and to commit or favor crime [...]” and article 40 “[...] Taking advantage of situations arising from the doctor-patient relationship to obtain physical, emotional, financial or any other advantage [...]”. The professional profile of those involved in these cases was also shown: the average age was 49.8 years, and all of these professionals were male. The mean length of time since graduation among the psychiatrists with appeals to the plenary body of the TSEM was 31.28 years at the time of judgment. The punishment handed down most frequently was to strike these professionals off the register, reaching the percentage of 42.9%. Among the five professionals with specialist titles, four complemented their studies with specializations, after the episode that originated the ethics charges.
Conclusion: The data gathered showed that the professionals were punished for irregularities in the sphere of ethics, including issues going beyond technical and/or scientific competence. This makes it possible to highlight that punishments proportional to the seriousness of the infraction act were applied, along with the importance of bioethics in medical training and the need for specialization, from the results of the judgments on ethical-professional cases before the plenary body of the TSEM.
 
Maternal hemodynamic responses to two different types of moderate physical exercise during pregnancy: a randomized clinical trial
Get PDFBackground/Aim: Maternal hemodynamic responses (heart rate, systolic and diastolic blood pressure) were compared during two types of moderate-intensity physical exercise.
Methods: A randomized clinical trial compared 120 pregnant women performing physical exercise on a treadmill (n=64) or stationary bicycle (n=56). In 44 of these women (n=23 treadmill; n=21 bicycle), blood pressure was monitored for 24 hours following exercise. Repeated-measures analysis compared maternal heart rate, systolic and diastolic blood pressure before, during and in the 24 hours following exercise in both groups.
Results: Maternal heart rate increased significantly (p<0.001) with both types of exercise (from 84 at rest to 112 bpm on the treadmill and from 87 at rest to 107 bpm on the bicycle), without exceeding the limit of 140 bpm. Systolic pressure increased from 110 at rest to 118 mmHg on the bicycle (p=0.06) and from 112 at rest to 120 mmHg on the treadmill (p=0.02). Systolic pressure dropped steadily following exercise, reaching its lowest level (104 mmHg) after 14 hours, increasing thereafter and returning to pre-exercise levels by the 19th hour. Diastolic pressure increased during exercise irrespective of the type of exercise (p=0.27), from 70 at rest to 75 mmHg on the bicycle (p=0.39) and from 70 at rest to 76 mmHg on the treadmill (p=0.18), with the lowest level (59 mmHg) being at the 13th hour.
Conclusions: A slight increase in blood pressure levels was found during exercise; however, this was not clinically significant and was followed by a substantial hypotensive effect that lasted around 19 hours.
Register: Clinical Trials NCT01383889
Midaortic syndrome and hypertension in childhood revealed by enuresis: a case report
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Middle aortic syndrome (MAS) results from a diffuse narrowing of the distal thoracic or abdominal aorta commonly involving both the visceral and renal arteries. Congenital, acquired, inflammatory, and infectious etiologies have been described. Symptoms occur within the first three decades of life. Revelation modes are dominated by hypertension, lower extremity claudication, and mesenteric ischemia. We herein report a pediatric case of MAS with an original revelation mode that has never been described before in medical literature
Suicide in Children and adolescents: a review of articles about this topic
Get PDFNowadays, depression in adolescents is understood to be a common, disabling and recurrent disease, with a high level of morbidity and mortality. Thus, it is an important public health problem. Suicide is the act of intentionally ending one’s own life. It is related to biological, social, environmental factors and to the personal history, so, is a complex and multifactor phenomenon. The lack of research and literature with this population hinders the comprehension of the phenomenon and so the improvement of interventions in the field of prevention and care for survivors. This paper reviews on clinical and epidemiological aspects of suicide in Children, definitions and expressions of suicide among adolescents people are presented, identifying possible risk factors and prevention interventions are discussed.
 
The Cardiovascular Involvement In The Zika Virus Infection
No full textThe evidences highlight that 13.5% of the echocardiographic studies performed in children with congenital Zika virus infection presented amendments of congenital heart disease (CHD). Several recent studies have shown that the pathogenesis of neurological complications of the Zika virus, as Guillain-Barre Syndrome, in relation to other clinical manifestations there are still no conclusive findings. Scientific studies have observed the possibility of cardiac involvement be underdiagnosed due to the mercy of the infection per ZIKV, in their majority
Haemorrhage of gross domestic product from disability-adjusted-life-years among 15-59 year olds in Kenya
Get PDFBackground: This article estimates non-health gross domestic product (GDP) losses associated with Disability-Adjusted Life Years (DALY) lost among 15-59 year olds (most productive age bracket) in Kenya in 2015.
Methods: This study employs the lost output or human capital approach (HCA) to convert the DALYs lost from all causes into their monetary equivalents. The magnitude economic haemorrhage from each disease was obtained by multiplying the per capita non-health GDP in International Dollars by the total number of DALYs lost in a specific age group (15-29 years, 30-49 years, 50-59 years). Per capita non-health GDP equals per capita GDP minus total health expenditure in 2015. Data on DALYs and per capita total health expenditure were obtained from the World Health Organization and per capita GDP data was from IMF databases.
Results: Kenya lost 9,405,184 DALYs among 15-59 years olds in 2015. That DALY loss caused a haemorrhage in GDP of Int$ 29,788,392,419. Approximately 48.6% of the GDP haemorrhage resulted from communicable diseases and nutritional conditions, 37.4% from non-communicable diseases, and 14.0% from injuries.
Conclusion: There is need to augment domestic and external investments into national health systems and other systems that meet basic needs (education, food, water, sanitation, shelter) to reduce disease burden.
Key words: Non-health GDP, economic haemorrhage, disability-adjusted life year (DALY
Article Retraction Notice
No full textThis article was retracted in pursuance of the policies of the journal
Primary hyperparathyroidism and non-medullary thyroid cancer- A review
No full textBackground:
The association of thyroid disease and primary hyperparathyroidism is well described, with thyroid carcinoma being reported in 2-15% of cases. The most commonly associated carcinoma is non-medullary thyroid cancer. While the association of PHPT and medullary thyroid cancer (MCT) is well known, that of NMTC, despite its increasing incidence, is still not established. Our study is a review of incidence and underlying mechanisms of non-medullary thyroid cancer associated with PHPT. Also, best imaging tools for concomitant diagnosis is reviewed to ensure an adequate plan of care.
Methods & findings:
A search was done using two databases: Medline & Embase. The search conducted from the period of 2008 until April 2018 yielded a total of 142 studies. After an adequate screening, 26 studies were reviewed.
Incidence of DTC in association with PHPT in the literature ranged between 0.91% and 17.6%. The main histological thyroid malignancy found is micropapillary carcinoma. Despite its less aggressive presentation, these microcarcinomas may grow or develop nodal metastases on follow up. Although bilateral neck exploration with hemi/total thyroidectomy carries the risk of temporary recurrent laryngeal nerve injury or hypoparathyroidism, permanent complications are rare especially when compared to re-do neck surgery. Recently, parathyroid surgeries are going towards minimal invasive procedures, requiring an adequate imaging tool to ensure diagnosis of both diseases. Multiple risk factors for concomitant diseases were hypothesized, the more robust are the common embryologic origin and activation of angiogenic growth factors.
Conclusion:
NMTC is frequently associated with PHPT especially in endemic goiter areas. With the high prevalence of micropapillary carcinoma and its risks, a partial/total thyroidectomy in addition to parathyroidectomy may be warranted. With the recent need of adequate diagnostic tools, combining both Technetium Sestamibi scintigraphy and thyroid ultrasound improved sensitivities and accuracy of diagnosis, but dual-isotope scintigraphy (I-123 sodium iodide/ 99mTc-sestamibi) seems an attractive modality in hyperparathyroid patients with concomitant suspicious thyroid nodules. However, further studies for validation may be needed