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   Table of Contents - Current issue
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July-December 2018
Volume 1 | Issue 2
Page Nos. 41-88

Online since Wednesday, June 6, 2018

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REVIEW ARTICLE  

Pharmacognostical, phytochemical and pharmacological aspects of Quisqualis indica: An update p. 41
Mayank Kulshreshtha, Karuna Shanker Shukla, Garima Awasthi Tiwari, Manjul Pratap Singh, Anita Singh
DOI:10.4103/JNSM.JNSM_20_18  
Nature is a big and important source of lots of things, in which plants are the living gifts of nature. Plants play an important role in various fields, but the role of these plants as herbal medicines is a big achievement. Drugs are obtained from plants have very low side effects and very popular in worldwide. Here, this review represents the pharmacology, pharmacognosy, and various molecular aspects of Quisqualis indica which may be helpful in near future based on available published data. This review opens the various doors or acts as a backbone for various researches in near future.
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ORIGINAL ARTICLES Top

Which stem cells to choose for regenerative medicine application: Bone marrow and adipose tissue stromal stem cells – Similarities and differences p. 48
Nehad M Alajez, Dalia Al-Ali, Radhakrishnan Vishnubalaji, Muthurangan Manikandan, Musaad Alfayez, Moustapha Kassem, Abdullah Aldahmash
DOI:10.4103/JNSM.JNSM_18_18  
Background: Clinical use of stromal stem cells in regenerative medicine is increasingly recognized as a promising treatment modality for age-related degenerative diseases based on the promising initial results of clinical trials. However, the magnitude of positive effects observed in these trials has been variable which can be explained by the lack of standardization of the stem cell products “cell product.” Bone marrow-derived stromal (also known mesenchymal) stem cells (BM-hMSC) and adipose tissue-hMSC (AD-hMSC) have been used interchangeably in clinical trials employing stromal stem cells as they were thought to be functionally identical. Methods: In the present study, we performed an extensive side-by-side comparison of BM-hMSC and AD-hMSC for their CD marker expression using FACS analysis, molecular phenotype using global mRNA gene expression analysis, and functional studies for their in vitro differentiation capacity to osteoblasts and adipocytes. Results: We observed both stromal cell populations were CD44+ CD13+ CD90+ CD29+ CD105+ CD14− HLDR−. We also observed that they express common genetic signature consisting of 13,667 genes with enrichment in a number of pathways relevant to stem cell biology, for example, focal adhesion, insulin signaling, and mitogen-activated protein kinase signaling. On the other hand, we observed significant differences in their molecular phenotype with 3282 and 1409 genes differentially expression in BM-hMSC and AD-hMSC, respectively. Further analysis revealed higher expression of genes associated with osteoblast differentiation in BM-hMSC and those of adipocyte differentiation in AD-hMSC which correlated with their differential capacity for osteoblast versus adipocyte differentiation, respectively. Conclusion: Our data suggest that the clinical use of MSC in therapy depend on MSC site of origin, and thus, BM-hMSC are better suited for clinical trials aiming at enhancing bone regeneration. We suggest that molecular phenotype of stem cells is relevant approach for stem cell screening before their clinical transplantation.
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The role of serum levels of thioredoxin and thioredoxin-interacting protein in stroke p. 55
Fawaz Al-Hussain, Muhammad Iqbal, Mohammed Al-Quwayee, Abdullah Bin Jurays, Muhannad Al-Wabel, Saqr Dayes, Fars Al-Manie, Tariq Al-Matrodi, Khalid Al-Regaiey, Shahid Bashir
DOI:10.4103/JNSM.JNSM_3_18  
Aims: Serum level of thioredoxin (TRX), a redox-regulating protein with antioxidant activity, increases under oxidative stress. The present study measured serum levels of TRX and its inhibitor TRX-interacting protein (TXNIP) in patients who experienced first-ever acute ischemic stroke (AIS). Subjects and Methods: We retrospectively enrolled 45 patients who experienced AIS and 33 age- and sex-matched healthy controls. Serum TRX and TXNIP levels in stroke patients and healthy controls were analyzed by performing solid-phase sandwich enzyme-linked immunosorbent assay. Results: Our results showed that mean serum TXNIP levels were significantly higher in stroke patients than in healthy controls (P = 0.044). However, serum TRX levels were not significantly different between stroke patients and healthy controls (P = 0.405). Moreover, we observed a significant positive correlation between TRX and TXNIP levels (R2 = 0.476, P < 0.003). Conclusions: These results suggest that TRX and TXNIP are rapid, inexpensive, and convenient biomarkers of stroke. However, additional studies should be performed to validate these preliminary observations and the role of TRX and TXNIP in AIS.
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Organ donation awareness and attitude among Riyadh City Residents, Saudi Arabia p. 59
Aws Almufleh, Rasha Althebaity, Ali S Alamri, Nada A Al-Rashed, Eman H Alshehri, Lina Albalawi, Reem Alameer, Eman Hajr, Ismail A Raslan, Faisal A Alsaif
DOI:10.4103/JNSM.JNSM_5_18  
Introduction: Organ donation is widely contentious among the Saudi population though remains largely understudied. In the aim to understand the public perception of organ donation, willingness to donate, and the reasons for donation refusal, we carried out this study. Methodology: A cross-sectional questionnaire-based study was conducted on a stratified-by-region random sample of 2596 Saudi residents in Riyadh area between 15 and 70 years of age in March 2010. The main outcomes were rates of organ donation awareness, willingness to donate, and awareness of Islamic opinion permitting organ donation. Secondary exploratory analysis was performed to determine reasons for organ donation refusal. Results: Seventy-six percentage of the sample had some background knowledge of organ donation; however, 41% were unwilling to donate their organs, with only 30.1% of our sample having had a prior knowledge about Islamic opinion about organ donation. Overall, of those who had background knowledge of organ donation, 79.5% thought that organ donation was important or very important. Respondents who are women, older, more educated, and in higher income group were more likely to be aware of organ donation (P < 0.05) and those younger than 35 years old were more likely to be unaware of the Islamic opinion (P < 0.001). The most cited reasons for donation refusal included the desire to be buried with complete parts (43.8%) (i.e., not disfigured), having an incomplete idea about brain death (24%), and because they thought that it was forbidden in Islam (15.1%). Conclusion: The level of organ donation awareness was comparatively high, but knowledge of the Islamic views of organ donation lacked among high portion of our sample, which partially explains the high organ donation refusal rate. There remains a large need to promote public awareness about the importance of organ donation and to clear the confusion of the Islamic view.
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Insomnia in primary care settings: Still overlooked and undertreated? p. 64
Aljohara S Almeneessier, Bader N Alamri, Faisal R Alzahrani, Munir M Sharif, Seithikurippu R Pandi-Perumal, Ahmed S BaHammam
DOI:10.4103/JNSM.JNSM_30_18  
Background: Insomnia is a major medical problem that is often associated with low health status and increased health-care utilization. Therefore, we conducted this study to determine the frequency of insomnia in a population presenting to the primary healthcare (PHC) clinics for health problems other than sleep disorders. Methods: We interviewed 336 consecutive patients attending PHC face-to-face by trained medical students. Validated questionnaires were used to evaluate insomnia, sleep quality, and daytime sleepiness. The insomnia questionnaire classifies patients into three categories: (1) no insomnia, (2) Level I insomnia with the absence of daytime dysfunction, and (3) Level II insomnia with the presence of daytime dysfunction. Results: Level I insomnia was reported by 19.3% and Level II by 57.1%. Patients with insomnia were older and had worse sleep quality. Apart from a higher prevalence of hypertension among patients with insomnia, there was no difference in other comorbidities between those with insomnia and no insomnia. None of the included patients has reported his/her complaint of insomnia to the treating general practitioner (GP), and none of them was diagnosed with insomnia by the GP. Conclusion: Insomnia and daytime dysfunction are very common in primary care population. Despite the frequent visits of these patients to PHC, none of them has reported that he/she complains to his/her GP, and therefore, did not receive any treatment for insomnia. Education of GPs is necessary to improve recognition, diagnosis, and treatment of insomnia.
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The impact of the “Brain Drain” involving Saudi physicians: A cross-sectional study p. 69
Marya Alsuhaibani, Amjad Alharbi, Saleh K Alqaryan, Turki Aldress, Majed Alharbi, Sami Alharethy
DOI:10.4103/JNSM.JNSM_32_18  
Objectives: This study aimed to elucidate the brain drain phenomenon involving Saudi medical students by assessing their characteristics and intentions and related factors. Materials and Methods: A cross-sectional survey-based study conducted at Qassim University, Saudi Arabia. The subjects included 150 prefinal or final year medical students, who completed a modified version of a questionnaire developed by Akl et al. Results: Ninety-six students intended to study abroad with 48 and 33 planning to study in Canada and the USA, respectively. Country preference differed according to class ranking, and 69% and 33.3% of students in the top and bottom thirds of the class intended to study in Canada (P = 0.047). Male students were more likely to express the intention to study abroad. However, women were significantly more likely to remain abroad relative to males (P < 0.001). The only factor associated with intention to study abroad was the year of study and those in the final year were 60% less likely to express an intention to study abroad relative to those in prefinal years (P = 0.012). Conclusion: Most of our individuals intended to study abroad. It was varied according to gender differences. The primarily destination is Canada. This could present a challenge in meeting the high demand for staff in the health-care service in Saudi Arabia and exacerbate the current shortage of physicians in future.
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Gender-Specific profiles of cardiovascular disease in type 2 diabetes mellitus: A cross-sectional study p. 74
Reem M Sallam, Samha M Z. Alayoubi, Nasser M Al-Daghri, Alwaleed A Alhammad, Assim A Alfadda
DOI:10.4103/JNSM.JNSM_34_18  
Context: Cardiovascular disease (CVD) is a chronic macrovascular complication of diabetes mellitus (DM). Factors unique to a group of patients might imply specific differences in the manifestation and/or severity of type 2 DM (T2DM) and CVD. Increasing our knowledge of these factors is critical in designing more robust preventive and/or management approaches for such groups. Aims: The aim of this work is to investigate the gender differences among diabetic patients with and without CVD. Settings and Design: T2DM patients (64 men and 50 women) were recruited and subdivided according to the presence or absence of CVD as a complication to diabetes. Subjects and Methods: Biochemical measurements (glucose, insulin, HbA1c, lipid profile, and liver and kidney function tests), complete blood count, prothrombin and activated partial thromboplastin times, platelet aggregation, tissue factor pathway inhibitor, and plasminogen activator inhibitor-1 (PAI-1) were assessed. Platelet activation was assessed by flow cytometry and aggregation assay. Statistical Analysis Used: Microsoft Excel and SPSS were used for data analysis. Results: Among the assessed parameters, changes in anthropometry, platelet indices, and PAI-1 were detected. Age, body weight, body mass index, and systolic blood pressure (BP) were significantly higher in women with CVD than in those without. Conclusions: The critical association between patients' weight and BP and the development of CVD particularly in diabetic women emphasizes on the need to intensify the efforts for better management of obesity and hypertension specifically among diabetic Saudi women to minimize their CVD risk.
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BRIEF REPORT Top

Cerebral injury in diabetic ketoacidosis: Is there a room for conservative management? p. 82
Riad A Sulimani, Anwar A Jammah, Ibrahim M Ghozzi, Hadil A Alotair, Suleiman A Al-Mohaya, Tarek E Ashour
DOI:10.4103/JNSM.JNSM_15_18  
Diabetic ketoacidosis is a manifestation of decompensated glycemic control. Two cases are outlined, representing severe cerebral edema in one case and multiple cerebral infarcts in the other. Favorable outcome was achieved in both cases with conservative management, excluding the immediate use of mannitol in the first patient and the use of thrombolytic or full anticoagulant therapy in the second.
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CLINICO-PATHOLOGICAL PEARLS Top

A snoring man with an abnormal sexual behavior during sleep p. 85
Aljohara S Almeneessier, Ahmed S Bahammam
DOI:10.4103/JNSM.JNSM_36_18  
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