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  Most popular articles (Since February 28, 2018)

 
 
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REVIEW ARTICLE
The Medicinal Mushroom Agaricus bisporus: Review of Phytopharmacology and Potential Role in the Treatment of Various Diseases
Apoorva Bhushan, Mayank Kulshreshtha
January-June 2018, 1(1):4-9
DOI:10.4103/JNSM.JNSM_1_18  
Nature has been a source of medicinal agents for thousands of years and an impressive number of modern drugs have been isolated from natural sources, based on their use in traditional medicine. Since ancient time's plants as well as fungus sources of medicinal compounds have continued to play a dominant role in maintenance of human health. Over 50% of all modern clinical drugs are of natural product origin and play an important role in drug development programs in the pharmaceutical industry. Mushrooms are an important natural source of food and medicine. Traditional aboriginals knew the importance of edible and wild mushrooms, and these are now being screened for their bioactivity in various ailments. We are aiming for this review is to compact a compressive scientific description of pharmacognosy, chemistry, and pharmacology of button mushroom (Agaricus bisporus), depending on published data and other available resources.
  1,684 246 -
ORIGINAL ARTICLES
Gender-Specific profiles of cardiovascular disease in type 2 diabetes mellitus: A cross-sectional study
Reem M Sallam, Samha M Z. Alayoubi, Nasser M Al-Daghri, Alwaleed A Alhammad, Assim A Alfadda
July-December 2018, 1(2):74-81
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.
  1,308 197 -
REVIEW ARTICLE
Pharmacognostical, phytochemical and pharmacological aspects of Quisqualis indica: An update
Mayank Kulshreshtha, Karuna Shanker Shukla, Garima Awasthi Tiwari, Manjul Pratap Singh, Anita Singh
July-December 2018, 1(2):41-47
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.
  1,190 225 -
ORIGINAL ARTICLES
Which stem cells to choose for regenerative medicine application: Bone marrow and adipose tissue stromal stem cells – Similarities and differences
Nehad M Alajez, Dalia Al-Ali, Radhakrishnan Vishnubalaji, Muthurangan Manikandan, Musaad Alfayez, Moustapha Kassem, Abdullah Aldahmash
July-December 2018, 1(2):48-54
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.
  1,061 174 -
Insomnia in primary care settings: Still overlooked and undertreated?
Aljohara S Almeneessier, Bader N Alamri, Faisal R Alzahrani, Munir M Sharif, Seithikurippu R Pandi-Perumal, Ahmed S BaHammam
July-December 2018, 1(2):64-68
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.
  1,060 162 -
Organ donation awareness and attitude among Riyadh City Residents, Saudi Arabia
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
July-December 2018, 1(2):59-63
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.
  1,002 156 -
Assessment of Sleep Quality, Daytime Sleepiness, and Depression among Emergency Physicians Working in Shifts
Sulaiman Alhifzi, Aseel Al-Ghonimy, Malak Al Aboudi, Rawan Al Abdullah, Awad Olaish, Ahmed S BaHammam
January-June 2018, 1(1):17-21
DOI:10.4103/JNSM.JNSM_8_18  
Background: Around-the-clock provision of medical care is needed particularly in acute care areas. Emergency physicians are constantly affected by rotating shifts. Therefore, we conducted this study to assess the sleep quality, daytime sleepiness, and depression among emergency physicians. Methods: This study is a cross-sectional case–control study. Participants were divided into two groups; primary participants were 68 emergency physicians working in a shift work system and the controls were 69 family medicine physicians working in a fixed daytime shift. A self-administered questionnaire was filled by all participants that comprised the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), and the Beck Depression Inventory. Results: Based on the PSQI, around 83.8% of emergency physicians had poor sleep quality, compared to 50.7% in the control group. Daytime sleepiness (ESS >10) was significantly higher in the emergency physicians in comparison to the control group (41.2% vs. 14.5%). A strong correlation was found between poor sleep quality and depression in emergency physicians (r = 0.437, P = 0.001). Conclusion: Emergency physicians working in a shift work system had a significant increase in daytime sleepiness and poor sleep quality. Depressive symptoms were noted among emergency physicians suffering from poor sleep quality.
  915 92 -
VIEWPOINT
The Human Milk: Prejudice versus Science
Khalid A Altirkawi
January-June 2018, 1(1):10-12
DOI:10.4103/JNSM.JNSM_6_18  
Exclusive breastfeeding for the nutrition of healthy term infants is currently considered as the gold standard. Indeed, the widely held prejudice against human milk is something of the past. However, the universal acceptance of this fact on mothers' part is still to be achieved. Meanwhile, the widespread of baby-friendly hospital initiative movement makes it increasingly harder to question the safety or efficacy of this practice, even in the face of some concerning reports of unwanted outcomes. Apparently, there is a need for better compliance with safe sleep instructions while actively promoting breastfeeding practices. In some specific situations, breastfeeding becomes impractical, extremely difficult, or even contraindicated. Using a suitable formula in these circumstances becomes a must. Given all of this, a greater emphasis should be placed on efforts to improve the quality of currently available formulas and/or creating new ones that better meet the nutritional needs of all infants.
  864 143 -
EDITORIALS
Welcome to the Inaugural Issue of the JNSM: Let's Dream Big
Ahmed S BaHammam
January-June 2018, 1(1):1-1
DOI:10.4103/JNSM.JNSM_4_18  
  828 147 -
ORIGINAL ARTICLES
Research Productivity of Health-care Institutions of Saudi Government: Ten-year Based Bibliometric Analysis
Walid A Zaher, Sultan A Meo, Majid Abdulrahman Almadi, Khalid Fouda Neel
January-June 2018, 1(1):13-16
DOI:10.4103/JNSM.JNSM_16_18  
Background: Saudi Arabia has recognized the significance of scientific research in social, health-care, and economic transformation and has established a large number of advanced research institutes. This study aimed to investigate the research progress of various universities and research institutes of Saudi Arabia during 2006–2016. Methods: In this bibliometric analysis, we investigated research publications published by a number of well-recognized health-care institutions and research centers to authenticate the scientific research productivity in Saudi Arabia during 2006–2016. The Saudi public institutions were selected based on their research activity in the field of medical and health science. The research publications were recorded from Institute of Scientific Information-Web of Science, Thomson Reuters (Clarivate Analytics). Results: During 2006–2016, King Saud University (KSU) published the highest number of publications (9954) followed by King Faisal Specialist Hospital and Research Center (KFSHRC) (3886). Moreover, King Abdulaziz Medical City published 685 articles, King Fahad Medical City 486, King Khaled Eye Specialist Hospital 425, Riyadh Military Hospital 165, and Prince Sultan Cardiac Centre and Research Centre published 108 articles. KSU's contribution to medical and health sciences was 63.4% followed by KFSHRC at 24.7% and the rest of the institutions contributed 12% of research publications. Conclusions: In Saudi Arabia, KSU produced the highest number of research articles during 2006–2015. This high research productivity shows the leadership visionary approach, proper spending of the research funding, and their faculty members' contributions.
  833 119 -
The impact of the “Brain Drain” involving Saudi physicians: A cross-sectional study
Marya Alsuhaibani, Amjad Alharbi, Saleh K Alqaryan, Turki Aldress, Majed Alharbi, Sami Alharethy
July-December 2018, 1(2):69-73
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.
  857 71 -
The role of serum levels of thioredoxin and thioredoxin-interacting protein in stroke
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
July-December 2018, 1(2):55-58
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.
  770 151 -
EDITORIALS
The Jewel in the Crown
Khalid Fouda Neel, Majid Abdulrahman Almadi
January-June 2018, 1(1):2-3
DOI:10.4103/JNSM.JNSM_11_18  
  778 105 -
CLINICO-PATHOLOGICAL PEARLS
A snoring man with an abnormal sexual behavior during sleep
Aljohara S Almeneessier, Ahmed S Bahammam
July-December 2018, 1(2):85-88
DOI:10.4103/JNSM.JNSM_36_18  
  774 108 -
ORIGINAL ARTICLES
Prevalence of Hearing Loss and Tinnitus with Correlation to the Usage of Protective Hearing Equipment among Airport Workers
Ahmed H Saleem, Ghassan Alkharboush, Othman Almazyed, Saud AlHilal, Ibrahim Alnajashi, Tawfeq Al-Andejani, Murad Al Momani, Abdulrahman Hagr
January-June 2018, 1(1):31-35
DOI:10.4103/JNSM.JNSM_9_18  
Objectives: Epidemiological studies have shown that tinnitus and occupational hearing loss are common symptoms in the working population. Only few studies have assessed the aforementioned symptoms in this population, none of which have assessed airport field workers (AFWs), thus the need for our study. Methods: A cross-sectional study was conducted among AFWs at King Khalid International Airport in Riyadh. The sample size was calculated to be 380. Each was asked to fill a self-administered questionnaire and undergo pure-tone audiometry to assess hearing level. The questionnaire assessed the participants' demographics, usage of protective hearing equipment (PHE) as well as prevalence and characteristics of tinnitus if present. Results: Of all field workers, 300 (78%) have agreed to participate in the study. A number of 180 (60%) participants believe that PHE prevents noise-related hearing loss. Of all participants, 114 (38%) workers use PHE. No association was found between the participants' belief regarding PHE benefits and their usage of the equipment (P = 0.473). Tinnitus was reported by 81 (27%) of the whole sample. Most of the participants, i.e., 171 (57%) were found to have hearing impairment (>25 dB HL) at low frequencies (0.5, 1, and 2 kHz) in comparison to 144 (48%) at high frequencies (4 and 8 kHz). Conclusion: Even with relatively good knowledge about the importance of PHE, only few workers actually use them. Thus, frequent audiometric screening tests as well as enforcement of PHE usage by AFWs need to be introduced by the airport administrations.
  767 76 -
Quality of Sleep in Children with Epilepsy
Fahad A Bashiri, Shahid Bashir
January-June 2018, 1(1):28-30
DOI:10.4103/JNSM.JNSM_2_18  
Background: Sleep disorders are a common concern among pediatric epilepsy patients. This study aimed to assess the sleep quality in children with epilepsy. Subjects and Methods: The present study examined parent-reported sleep problems in 34 children (20 boys and 14 girls; age 4–14 years) with epilepsy. Children's Sleep Habits Questionnaire (CSHQ) assesses sleep patterns with 33 sleep disturbance items, and each item is rated on a 3-point scale (99 total score) that describes the frequency of the behaviors. A score of 41 was used as a cutoff for identification of poor and good sleeper. Results: Epilepsy poor sleepers (based on CSHQ score) have more sleep impairment than epilepsy good sleepers (CSHQ score) (P < 0.04), and the CSHQ subscores are as follows: night awakenings (P < 0.03), sleep duration (P < 0.04), daytime sleepiness (P < 0.04), sleep-onset delay (P = 0.02), and bedtime resistance (P = 0.02). Conclusions: Although sleep problems are known to be common among young children with epilepsy, the results of this work may provide the basis for focused studies to gain deeper understanding of sleep disturbances in this population.
  720 77 -
Epistaxis: What Do People Know and What Do They Do?
Ahmed H Saleem, Abdullah M Alahwal, Ahmed A Al-Sayed, Manal I Bin-Manie, Hani Z Marzouki
January-June 2018, 1(1):22-27
DOI:10.4103/JNSM.JNSM_10_18  
Aim: The aim of this study is to assess the current knowledge of the first-aid management of epistaxis and misconceptions among the general Saudi population. Methods: A survey questionnaire was developed and was distributed through text message, E-mail, social networks, various websites, and web forums among the Saudi population. Responses were collected over a period of 2 months. Knowledge was assessed based on correct responses to six main questions. Five to six correct answers were considered as excellent knowledge, 3–4 as good knowledge, and 2 and below as poor knowledge. Results: There were 1760 individuals who responded to the survey, 577 (32.8%) were males. There were 828 respondents (47%) who received information on the first-aid management of epistaxis, the most common source of information was through a relative or a friend (15.7%). Only 199 respondents (11.3%) will apply pressure to control epistaxis, 99 (5.6%) knows where to correctly press, and 84 (4.78%) will correctly tilt the head forward. There were 132 respondents (7.5%) who thought that patients should be brought to the ER in all cases of epistaxis. There were 1111 respondents (63.2%) who have poor knowledge of first-aid management of epistaxis. Conclusion: There is poor knowledge of the first-aid management of epistaxis in the surveyed Saudi population. Increased awareness and information dissemination programs on the first-aid management of epistaxis can improve knowledge and recall among the general population.
  677 58 -
BRIEF REPORT
Cerebral injury in diabetic ketoacidosis: Is there a room for conservative management?
Riad A Sulimani, Anwar A Jammah, Ibrahim M Ghozzi, Hadil A Alotair, Suleiman A Al-Mohaya, Tarek E Ashour
July-December 2018, 1(2):82-84
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.
  552 87 -
Endoscopic Ultrasound-guided Biliary Drainage: A Tailored Approach
Majid Abdulrahman Almadi, Motib H AlAbdulwahhab
January-June 2018, 1(1):36-40
DOI:10.4103/JNSM.JNSM_12_18  
Although endoscopic retrograde cholangiopancreatography (ERCP) remains the gold standard method to achieve biliary drainage (BD) in cases of obstruction, some situations preclude this option. Alternatively, percutaneous BD is associated with a number of limitations and more recently associated risks have been found to be higher than those with nonconventional interventions such as endoscopic ultrasound-guided BD (EUS-BD). EUS-BD encompasses a number of interventions and approaches depending on the underlying cause and position of obstruction. We present a case series of six cases where EUS-BD was used when ERCP was not possible or failed at a tertiary care academic center. We also describe the different types of EUS-BD based on the nomenclature that has been proposed by the Asian EUS group (AEG). In all the cases that were presented, EUS-BD was successful with no complications or adverse events. The intervention resulted in resolution of biliary obstruction and the patients underwent the planned treatment for their underlying disease. In this case series, we introduced the concept of EUS-BD to the nonspecialist and illustrated the variability of the procedure and its agile nature when applied in the right setting and with the proper expertise and the importance of the presence a complete team approach by different specialists when caring for these patients.
  504 54 -
REVIEW ARTICLES
Fundamentals of laparoscopic surgery: Principles, implementation, and comparison to other modalities
Abdulaziz Alkanhal
January-March 2019, 2(1):5-9
DOI:10.4103/JNSM.JNSM_14_18  
The minimally invasive laparoscopic surgery has gained popularity among various surgical specialties. However, unique skills are required to perform it. These skills are not transferable from open approach and are associated with a steep learning curve. Therefore, they need to be obtained in a safe-simulated environment. Fundamental laparoscopic surgery program is currently considered the gold standard for assessing laparoscopic skills and a mandatory requirement for board certification in the United States and for promotional advancement of residents in different surgical residency programs. Despite its proven benefits and its superiority when compared to other training models, challenges exist related to its implementation outside North America. The lack of sufficient eligible examiners is the major obstacle. Once overcome, one can aspire to achieve the remaining standards required for full implementation.
  380 80 -
ORIGINAL ARTICLES
Does physicians' gender have any influence on patients' choice of their treating physicians?
Ghadah Alyahya, Hind Almohanna, Abdullah Alyahya, Mubarak Aldosari, Laila Mathkour, Abdulrahman Aldhibaib, Youssef Al-Namshan, Najwa Al-Mously
January-March 2019, 2(1):29-34
DOI:10.4103/JNSM.JNSM_28_18  
Objectives: The purpose of this study was to determine whether physicians' gender has any influence on patients' choice of their treating physician. Methods: A survey was conducted in different public places in Riyadh, Saudi Arabia, to determine preferences for the gender of a physician under various health-care aspects. Results: Three thousand and fifteen people participated in this cross-sectional survey. The majority of participants had no gender preference regarding their physician's attitude and professional competence. However, 49.8% of the female participants preferred a female physician and 37.4% of the male participants preferred a male physician when discussing family and psychological problems. Regarding general and genital examination, 65.8% and 86.4% of women and 53% and 67.5% of men, respectively, preferred to be examined by a physician of their same gender. The majority of women preferred a female physician during breast examination (90.1%) and delivery (71.4%). With regard to medical specialties, men preferred a male general surgeon (48.6%), male urologist (65.1%), and male orthopedic surgeon (54.4%). On the other hand, women preferred a female urologist (58.1%) and had no gender preference regarding their general surgeon (48.1%) and orthopedic surgeon (51.4%). Conclusion: Findings of this study highlight the difference in participants' choice for the gender of their treating physician in different medical specialties. Women participants preferred a female physician for psychosocial counseling and when visiting a gynecologist, obstetrician, or urologist. In addition, women of childbearing age favored a female physician during delivery. Men preferred a physician of the same gender when being treated by a urologist, general surgeon, or orthopedic surgeon.
  386 65 -
REVIEW ARTICLES
Direct current stimulation and epilepsy in Kingdom of Saudi Arabia: Opportunity and challenges
Abdulrahman Al-Thaqib, Ali Mir, Raidah S Albaradie, Shahid Habib, Shahid Bashir
January-March 2019, 2(1):10-13
DOI:10.4103/JNSM.JNSM_21_18  
Transcranial direct current stimulation (tDCS) is one type of neuromodulation, which is an emerging technology that holds promise for the future studies on therapeutic and diagnostic applications in treatment of neurological and psychiatric diseases. Epilepsy is a major problem with devastating effects on patients and their caregivers and has a tremendous socioeconomic impact on families and health-care systems in the Saudi Arabia and worldwide. tDCS is a low-cost, noninvasive portable neuromodulation technique which can transiently decrease or increase cortical excitability in humans and which was invasively demonstrated to reduce epileptiform discharges in animals. This article reviews the tDCS as tools of neuromodulation for epilepsy and discusses the opportunities and challenges available for clinicians and researchers interested in advancing neuromodulation therapy. The aim of this review is to highlight the usefulness of tDCS and to generate an interest that will lead to appropriate studies that assess the true clinical value of tDCS for epilepsy among local clinician and scientist.
  382 61 -
Celiac disease in children
Anjum Saeed, Asaad Mohamed Assiri, Huma Arshad Cheema
January-March 2019, 2(1):23-28
DOI:10.4103/JNSM.JNSM_39_18  
Celiac disease (CD) is a chronic enteropathy due to ingestion of gluten and related products leading to villous injury and its various manifestations. It has a strong genetic tendency with the presence of human leukocyte antigen (HLA-DQ 2, DQ 8) in more than 98% of these patients with CD. Western studies documented 0.5%–1% prevalence of CD but it is not an uncommon condition in the Arabic peninsula. Classical gastrointestinal (GI) manifestations are common in the toddler's age group while non-GI manifestations predominate in the adolescents and older children. High-risk groups and associated conditions need special considerations for screening CD. European and Americans guidelines are available for diagnosing these children and recommend to screen with anti-tissue transglutaminase antibodies which have got very high sensitivity and specificity. North American guidelines recommend to do small bowel biopsies and interpreted by Marsh grading. Gluten-free diet for the rest of life is still a recognized therapy for these children under the supervision of an expert dietician dealing with CD. National awareness programs and seminars may help in identifying this underdiagnosed condition to avoid morbidity and mortality related to this lifelong disorder.
  381 48 -
ORIGINAL ARTICLES
Comparison of flow cytometric and immunohistochemical immunophenotyping data for diagnosis of B-cell neoplasms and classic hodgkin's lymphoma
Fatma Saeed Alqahtani, Karim Hamda Farhat, Mashael Marzouq Alshebly
January-March 2019, 2(1):35-40
DOI:10.4103/JNSM.JNSM_22_18  
Objective: This study was aimed to compare the results of immunophenotyping by flow cytometry (FC) and immunohistochemistry (IHC) in the diagnosis of B-cell lymphomas and classic Hodgkin's lymphoma (cHL). Methods: This was a retrospective cohort study of 280 patients with chronic B-cell neoplasms and cHL performed between 2008 and 2013. Percentages of B- and T-cell markers detected by FC and IHC were compared regardless of the final diagnosis. Results: FC and IHC results were obtained from 280 patient medical records. There were 155 (55.4%) patients with non-Hodgkin's lymphoma (NHL), 110 (39.3%) with cHL, and 15 (5.4%) with chronic lymphocytic leukemia (CLL). Disparity between FC and IHC was observed for CD19 expression in cHL group where 73.6% (n = 81) CD19 expression was detected by FC and 59.1% (n = 65) detected by IHC (P < 0.02). In NHL group, a higher percentage (81.3%; n = 126) of CD19 was detected by FC as opposed to 61.3% (n = 95) detected by IHC (P < 0.0001). CD19 expression was no different between the two groups. CD20 expression assessed by FC (61.3%; n = 95) was lower than 85.2% (n = 132) detected by IHC in NHL group (P < 0.0001). Whereas no differences were observed in cHL, IHC performed better (100%; n = 15) than FC (66.7%; n = 10) for CD20 detection in CLL group (P < 0.01). In cHL and NHL groups, flow cytometric detections of CD21 of 61.8% and 56.1% were higher than 46.4% (P < 0.02) and 41.9% (P < 0.01) detection rates by IHC. No disparities were observed between FC and IHC detection rates for CD5, CD10, CD23, and CD30 expressions. Conclusion: There was a considerable amount of disparity between FC and IHC results, warranting further evaluation.
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CLINICO-PATHOLOGICAL PEARLS
Brain abscess due to streptococcus intermedius in a young patient secondary to partially treated sinusitis
Ahmed J Alzahrani, Hanan A Habib, Sherif M F. Elwadtidy, Badr A Mona, Ali M Somily
January-March 2019, 2(1):54-56
DOI:10.4103/JNSM.JNSM_40_18  
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