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  Most popular articles (Since February 23, 2018)

 
 
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ORIGINAL RESEARCH ARTICLES
Prevalence of diarrhoea and related risk factors among children aged under 5 years in Sana'a, Yemen
Mabrook Aidah Bin Mohanna, Naijla Al-Sonboli
January-March 2018, 11(1):29-33
DOI:10.7707/hmj.711  
Background: Diarrhoeal disease is one of the most common problems affecting children across the world. This study assessed the prevalence of diarrhoea and related risk factors among children aged <5 years. Methods and Material: A cross-sectional study was conducted over 8 months at Sam Specialized Paediatric Centre and Al-Mamoon Diagnostic Medical Centre, Yemen, involving 1570 children aged <5 years with diarrhoea. Detailed data regarding age, sex, diarrhoeal episodes, family size, education level of mother or female caregiver, breastfeeding and weight were collected. Results: Of 5400 patients seen for different causes, 1570 patients were children aged <5 years presenting with diarrhoea, giving a prevalence of 29.07%. A total of 850 children were boys and 720 were girls, with ages ranging from 6 to 60 months. There were 1325 children aged <12 months, 160 aged 1–2 years and 85 aged 3–5 years. There were 700 (44.59%) children from small families and 870 (55.41%) from large families. A total of 922 (58.73%) children were malnourished and 648 (41.27%) were not. There were 1125 (71.66%) children whose mothers or female caregivers had no or low-level formal education and 445 (28.34%) whose mothers or female caregivers had secondary or high-level education. A total of 651 (41.46%) children were breastfed, 735 (46.82%) were mixed fed and 184 (11.72%) were bottle-fed. Conclusion: The prevalence of diarrhoea in children was high; it was highest in those who were aged <12 months, from a large family, malnourished and not exclusively breastfed, and in those whose mother or female caregiver had no or low-level education. It is important to encourage family planning, a balanced diet, exclusive breastfeeding and maternal education, and to strengthen health intervention programmes, in order to reduce the incidence of diarrhoea.
  2,876 268 -
REVIEW ARTICLES
Prevalence and risk factors of cardiovascular disease in the United Arab Emirates
Hira Abdul Razzak, Alya Harbi, Wael Shelpai, Ahmad Qawas
July-September 2018, 11(3):105-111
DOI:10.4103/HMJ.HMJ_37_18  
Noncommunicable diseases are a cause of great concern in developing countries, particularly cardiovascular disease (CVD). CVD is most commonly attributable to risk factors such as obesity, high-blood pressure (BP), lack of physical activity and smoking. This study aims to summarize previous research on the prevalence and risk factors of CVD in the United Arab Emirates (UAE). Search engines and databases such as PubMed, Scopus and Science Direct, as well as several local journals, were utilised to identify relevant literature. Inclusion was limited to studies published between 2007 and 2016 in the English language and conducted with UAE participants (citizens and/or expatriates). Twenty-one relevant studies were found, including cross-sectional studies (n = 11), population-based studies (n = 3), literature reviews (n = 2) and a case–control study (n = 1). Estimates of the prevalence of CVD are considerably high, although there is insufficient information available on prevalence in the UAE as a whole. Primary determinants of CVD include obesity, smoking and diabetes mellitus. The prevalence of risk factors associated with CVD has increased in the UAE and will continue to increase, as made clear by the reviewed studies and as predicted by projections and future estimates. Some risk factors can be controlled, treated and prevented. Further attention should be given to developing preventative and curative strategies in order to reduce BP, increase physical activity, improve dietary habits and reduce smoking.
  1,897 196 -
CASE REPORTS
Antisynthetase syndrome: A case report and literature review
Khalid Ali Khan, Wedad Nabih Ahmed
April-June 2018, 11(2):87-90
DOI:10.4103/HMJ.HMJ_17_18  
Antisynthetase (AS) syndrome is a rare idiopathic inflammatory myopathy characterised by myositis, Raynaud's disease, fever, interstitial lung disease (ILD), 'mechanic's hands' and arthropathy, and it is associated with the presence of antibodies against aminoacyl-tRNA synthetase especially anti-Jo-1. We report the case of a 31-year-old Egyptian male who presented with fever, mechanic's hands, subclinical myositis, arthritis and ILD. He had been treated previously at another hospital with broad-spectrum antibiotics but without response. He was extensively worked up for infections and found to have mycoplasma infection and strongly positive anti-Jo-1 and anti-Ro/SSA antibodies. AS syndrome was confirmed based on clinical features and laboratory results. The patient was treated with high-dose steroids and subsequently with mycophenolate mofetil and dramatically improved. This case highlights the importance of awareness of this rare condition and that careful examination of the hands can be crucial as mechanics's hands is a unique manifestation of AS syndrome, occurring in ≈20% of cases. Mycoplasma infection may have been a triggering factor in this case.
  1,019 300 -
STATE OF THE ART REVIEW
Prevention of stroke: Antihypertensives, cholesterol-lowering drugs, antithrombotics, anticoagulation, carotid surgery, and stenting
Michael Brainin
January-March 2018, 11(1):2-12
DOI:10.4103/2227-2437.228869  
Antihypertensive drugs are very effective in secondary stroke prevention. More important than the choice of a class of antihypertensives is to achieve the systolic and diastolic blood pressure targets (<140/90 mmHg in nondiabetics and < 130/80 mmHg in diabetics). In many cases, this requires a combination therapy and lifestyle modification. Statin therapy reduces the rate of recurrent stroke and vascular events. The target range of low-density lipoprotein is 70–100 mg/dL. Patients with transient ischemic attack (TIA) or ischemic stroke should receive antiplatelet drugs. The choices are acetylsalicylic acid (ASA 50–150 mg) or clopidogrel (75 mg). Short-term use of dual antiplatelet therapy (ASA plus clopidogrel) may be considered in patients with acute minor stroke or TIA and high risk of recurrence. Patients with a cardiac source of embolism, in particular atrial fibrillation (AF), should be treated with oral anticoagulation. Options for patients with AF include dose-adjusted warfarin (international normalized ratio 2.0–3.0), apixaban, dabigatran, edoxaban, or rivaroxaban. Patients with contraindications to use oral anticoagulation should receive ASA 100–300 mg/day. Symptomatic patients with significant stenosis of the internal carotid artery (degree of stenosis between 70% and 95%) should undergo carotid endarterectomy. Carotid artery stenting is an alternative to endarterectomy in patients who are unsuitable or at high risk for endarterectomy. Patients should receive ASA before, during, and after endarterectomy or the combination of clopidogrel (75 mg) plus ASA (75–100 mg) and after carotid stenting for 1–3 months. Symptomatic patients with intracranial stenosis or occlusions should be treated with optimal medical management, which includes antiplatelet therapy and high-dose statins (if deemed appropriate). In patients with recurrent events, angioplasty can be considered.
  1,062 195 -
REVIEW ARTICLE
Shoulder ultrasonography accuracy compared with magnetic resonance imaging in the detection of rotator cuff injuries
Mohamed Walaaeldin Elfaal
January-March 2018, 11(1):13-16
DOI:10.7707/hmj.737  
Rotator cuff injuries are common and frequently seen by orthopaedic surgeons. Accurate diagnosis of the injury is crucial for appropriate management. Imaging studies are the cornerstone of diagnosis and have great value compared with clinical assessment alone.
  1,024 151 -
ORIGINAL RESEARCH ARTICLES
Influence of personal characteristics on self-concept and job satisfaction of registered nurses working in cross-cultural settings in the United Arab Emirates
Vimala Edwin
January-March 2018, 11(1):22-28
DOI:10.7707/hmj.718  
Background: Self-concept is vital for the nurses to understand about themselves and their patient in the health care setting. In order to meet the patient needs, it is important that the nurses should possess healthy self-concept that makes them more responsible and be more confident to handle the situations skillfully. Every nurse is an important member of the health care organization to provide quality patient care, their work environment and other related factors are essential to satisfy their job. Objective: The objective of the study was to determine the association of self-concept and job satisfaction of registered nurses working at cross-cultural setting. Study Design and Settings: A descriptive correlational study was conducted with 1061 registered nurses working in selected government hospitals using convenience-sampling method. The registered nurses self-concept and job satisfaction were surveyed using the standardized tool Nurses Self-Concept Questionnaire (NSCQ) and Mccloskey/Muller job satisfaction scale (MMSS). SPSS software version 20 was used to analyze the collected data to report descriptive and inferential statistics. Results: The current study identified that there is a relationship between registered nurses self-concept and job satisfaction and the correlation coefficients were statistically very highly significant (P < 0.001). The association of job satisfaction with sub component of self-concept reveals that Nurses General Self-Concept r = 0.273, P < 0.001, Care r = 0.141, P < 0.001, Staff relation r = 0.320, P < 0.001, Communication r = 0.174, P < 0.001, Knowledge r = 0.218, P < 0.001, and lower association with 'Leadership' (r = 0.063, P < 0.05). Conclusion: The results of this research demonstrated the importance of registered nurses self-concept and its effect on job satisfaction that is essential for nurses to provide effective care to the patients.
  989 142 -
REVIEW ARTICLES
Anaesthetic challenges in complicated labour: Unruptured intracranial aneurysm
Ira Shrivastava
April-June 2019, 12(2):52-56
DOI:10.4103/HMJ.HMJ_43_18  
Intracranial aneurysms are uncommon during pregnancy. Haemodynamic stress during pregnancy is a key factor in the multifactorial pathogenesis of cerebral aneurysm, contributing to the risk of aneurysm formation, progression and rupture. Successful management requires multidisciplinary care; anaesthetists require knowledge of obstetric anaesthesia, neuro-anaesthesia and critical care. The incidence of subarachnoid haemorrhage in pregnancy is 0.01%—0.05%, with a maternal mortality rate of 11% in treated cases and a foetal mortality rate of 5% in treated cases.[1] Definitive treatment involves either open neurosurgical clipping or endovascular therapy, maintaining stable transmural pressure in the aneurysm to prevent rupture. Very few cases have been reported in the literature, and guidelines for the management of intracranial aneurysm during pregnancy and evidence-based recommendations for obstetric anaesthesia in patients with unruptured intracranial aneurysm during labour do not exist. A review of the literature reveals varying results, differing on a case-by-case basis, for the treatment of intracranial aneurysms during pregnancy and labour. Reducing risks associated with intracranial aneurysm must focus on both mother and child. This review encourages the establishment of formal guidelines for an algorithmic approach to manage the intracranial aneurysm during pregnancy and labour.
  1,009 116 -
The shoulder-pacemaker treatment for functional posterior shoulder instability
Philipp Moroder, Victor Danzinger
October-December 2018, 11(4):151-154
DOI:10.4103/HMJ.HMJ_79_18  
Functional posterior shoulder instability (Polar Type III) can lead to posterior subluxation and/or dislocation during shoulder movement. Disturbed activation of external rotators and periscapular muscles generating a force imbalance in the shoulder can result in instability, weakness and pain as the leading symptoms patients present. Recommended conservative treatment is often ineffective, alternative surgical treatment may diminish function even further and aggravate pain. The implementation of the Shoulder-Pacemaker was evaluated in a prospective clinical trial. Patients suffering from functional posterior shoulder instability refractory to previous treatment options should regain glenohumeral shoulder stability after our conservative therapeutic training regime with the Shoulder-Pacemaker. 19 cases with therapy-resistant functional posterior shoulder instability had been included in the Shoulder-Pacemaker therapy-concept. Previously all patients were treated unsuccessfully with at least 3 months of regular physiotherapy. Failed surgical stabilization attempts were not an exclusion criterion. Prior to treatment, a fluoroscopy was performed for diagnosis assurance as well as the evaluation of current MR-Imaging for excluding structural defects. The Shoulder-Pacemaker therapy consisted of a 3- to 6- weeks conservative treatment regime with electric muscle stimulation and regular physiotherapy. For longitudinal evaluation of shoulder function, a specifically developed questionnaire including SSV, ROWE and WOSI score was assessed. After treatment, all patients were very satisfied and fully recommended the Shoulder-Pacemaker therapy. All cases improved in all scores assessed and patients had been able to return to physically demanding and even sporting activities. Patients with completed 3-month follow-up achieved a Rowe score of 92 ± 14, SSV of 95 ± 6%, and WOSI score of 372 ± 181 [Figure 1]. In 2 out of 19 cases the training was not completed because of lack of compliance. No complications were observed. The Shoulder-Pacemaker therapy is a very effective treatment option in patients with functional posterior shoulder instability. Even if previous conservative or surgical stabilization attempts failed, the Shoulder-Pacemaker therapy successfully re-established glenohumeral stability and seems to have a long-lasting effect. Because of the short time of follow up, these results remain preliminary.
  935 126 -
Updates on the role of imaging in the assessment of crohn's disease
Mohamed Walaaeldin Elfaal
April-June 2019, 12(2):47-51
DOI:10.4103/HMJ.HMJ_41_18  
As initial studies reported that magnetic resonance imaging (MRI) was useful for the evaluation of the small intestine, this modality has become increasingly important in the diagnosis, assessment and exclusion of small bowel disease. The use of MRI for the assessment of inflammatory bowel disease is increasing, at the expense of the current primary imaging modality and computed tomography (CT) enterography. MRI has many advantages over CT, including a lack of radiation exposure, lower prevalence of adverse events, availability of dynamic information, higher resolution and better soft-tissue contrast. New MRI techniques, including diffusion-weighted imaging, spectroscopy, motility study, positron-emission tomography-MRI and molecular imaging, are currently under investigation to improve the diagnosis, follow-up and management of the disease.
  929 130 -
ORIGINAL ARTICLES
Prevalence of vestibular migraine in Dubai
Teja Deepak Dessai, Samer Sakka Amini, Faisal Asad, Helen Kutty
January-March 2019, 12(1):19-22
DOI:10.4103/HMJ.HMJ_42_18  
Introduction: A vast number of adult persons suffering from vertigo associated with migraine are reported on a daily clinical practice. However, clinical identification of VM still remains hindered in Dubai due to dearth of agreement in diagnostic criteria. Aim: The aim of this study is to determine the prevalence of VM in the general population of Dubai. Methods: A total of 218 adult persons who visited outpatient otolaryngology and rhinology clinic in a given year 2017 with a complaint of vertigo were retrospectively studied and accounted in research. Further, labelling of each person was done based on the presented symptoms. Results and Discussion: To calculate the prevalence of VM, total number of each diagnosis was counted and was further subjected to a formula to calculate prevalence. Out of the 218 persons considered in the study, 30 were diagnosed with migraine (2 persons with migraine alone and 28 persons with VM). This accounts to a prevalence of 0.9% migraine alone and 12.8% VM in a clinical setting for 1 year. Conclusion: The high prevalence of VM in a clinical setup for 1 year hints toward the need for careful diagnosis of a person.
  936 86 -
EDITORIAL
Secondary stroke prevention offers now more choices and is critical to reduce the burden of recurrent stroke and death
Michael Brainin
January-March 2018, 11(1):1-1
DOI:10.4103/2227-2437.228868  
  816 187 -
ORIGINAL ARTICLES
Investigating the role of the histone deacetylases-inhibitor suberanilohydroxamic acid in the differentiation of stem cells into insulin secreting cells
Ibrahim Elsharkawi, Divyasree Sandeep, Ahmed El-Serafi
January-March 2019, 12(1):10-14
DOI:10.4103/HMJ.HMJ_29_18  
Introduction: The United Arab Emirates has the second incidence of diabetes in the world. The current diabetes management plans are associated with many complications and do not provide a cure. Stem cells offer hope for permanent alleviation of this health problem through the possible differentiation into insulin-secreting cells. The current methods for the differentiation do not produce homogeneous beta-cell populations. Histone deacetylation is an epigenetic silencing mechanism that can render many genes irresponsive to the induction protocols. This study aimed at investigating the effect of the histone deacetylase inhibitor suberanilohydroxamic acid (SAHA) on the production of functional beta cells, based on a mesenchymal stem cells model. Methods: MG63 cells were treated for three consecutive days with SAHA, followed by a three-steps of beta cells differentiation protocol, with media-contained retinoic acid, epidermal growth factor, nicotinamide and exendin-4 at different stages. Then, glucose-stimulated insulin secretion was conducted to assess the functional state of the differentiated cells. Results: Pretreating the cells with SAHA enhanced the insulin production and secretion in comparison to the control (PBS) and the vehicle dimethyl sulfoxide, as shown by the immunofluorescence detection of insulin and the transcription factor “PDX1”, as well as an increase in insulin secretion in the media. Gene expression analysis showed that SAHA pretreated cells had more induction of the studied markers when challenged with high glucose level. Conclusion: Such findings indicate a novel approach to enhance the ability of stem cells to differentiate into insulin-producing cells with potential therapeutic implications.
  895 91 -
ORIGINAL RESEARCH ARTICLES
Complication rates of thyroidectomy by an experienced, high-volume thyroid surgeon in a private hospital in Abu Dhabi, United Arab Emirates
Zahoor Ahmad, Ammar Kutaiman, Youssef Hassan, Peshraw Amin, Mohammad Amjad Khan
January-March 2018, 11(1):17-21
DOI:10.7707/hmj.735  
Background: Thyroidectomy is one of the most common endocrine surgical procedures; it is performed by surgeons of various specialities including general surgeons, endocrine surgeons, ear, nose and throat (ENT) surgeons and head and neck surgeons. Thyroidectomy carries a significant and immediate risk of complications, some of which can be life threating. Improved surgical techniques and surgeons experienced in thyroid surgery can significantly reduce morbidity and mortality. Objective: The objective of this prospective study was to determine the overall complication rate and demonstrate that a permanent complication rate of 0% can be achieved. Study Design and Settings: The study was carried out between January 2013 and May 2015 and involved 228 patients. All patients were assessed preoperatively by an endocrinologist and an ENT surgeon for vocal cord functions; all were operated on by the same surgeon, who had >10 years' experience and performed over 100 thyroidectomies per year. Patients were followed up at 6 months to record any complications. Data were analysed using SPSS version 13.0 (IBM, Armonk, NY, USA) and a Chi-squared test was used to calculate P values. Results: There was an overall complication rate of 16.23%; 15.8% of patients experienced transient hypocalcaemia and 0.4% experienced post-operative bleeding. There were no permanent complications, and the rate of both recurrent laryngeal nerve injury and wound infection was 0%. Conclusion: We conclude that the rate of complications of thyroidectomy can be significantly reduced and the rate of permanent complications reduced to 0% if the procedure is performed by an experienced, high-volume surgeon with a special interest in thyroid surgery.
  833 126 -
REVIEW ARTICLES
Update on neuroimaging in psychiatric disorders
Mohamed Walaaeldin Elfaal
April-June 2018, 11(2):50-55
DOI:10.4103/HMJ.HMJ_13_18  
Psychoradiology is a newly emerging filed describes the application of the neuroimaging techniques in analysing psychiatric conditions. Previously in psychiatry only gross structural abnormalities, that might cause psychosis, could be detected. Neuroimaging was used to detect and to differentiate depression from neurodegenerative disorders or brain tumours. Recently, functional neuroimaging, mostly in the form of functional magnetic resonance imaging, molecular neuroimaging with positron-emission tomography or single photon emission tomography, facilitates the identification of therapeutic targets, the determination of the dose of a new drug needed to occupy its target in the brain, following up the effect of the treatment and the selection of patients for clinical trials.
  820 126 -
Current concepts in the management of anorectal malformations
Carlos A Reck-Burneo
July-September 2018, 11(3):100-104
DOI:10.4103/HMJ.HMJ_66_18  
Anorectal malformations (ARMs) occur in approximately 1 of every 5000 newborns and management still differs widely among practitioners. In this review, we adress some of the current accepted concepts in management. Missmanagement can have devastating consequences such as faecal incontinence, urinary incontinence and sexual disfunction. We briefly review common pecularities of the most common cases the and initial management oft he newborn. In this article I intend to present a brief overview without going into details but hopefully will motivate interest and further reading. Further the recommendation is made that case referal to a centre with a high volume load provides the highest benefits fort he patient in the form of better prognosis and long term management.
  816 116 -
New teeth in 1 Day: Transition from a failing dentition to immediate full-arch implant restoration (All-On-4®)
Werner Millesi, Dieter Busenlechner, Rudolf Fuürhauser, Robert Haas, Georg Mailath-Pokorny, Bernhard Pommer
April-June 2018, 11(2):43-45
DOI:10.4103/HMJ.HMJ_34_18  
Patients with hopeless residual dentition due to advanced periodontal disease or failing fixed or removable partial dentures frequently present with difficulties and concerns regarding the provisional phase until their final prosthetic restoration. As removable dentures are generally not preferred – not even as a provisional – the transition to a fixed rehabilitation should be quick, aesthetically appealing and restoring function in terms of chewing as well as phonetics. The immediate All-on-4® implant treatment concept at the Academy for Oral Implantology in Vienna (Austria) relies on implant placement at the day of tooth extraction and immediate fixed restoration within a few hours. The key factor is the placement of angulated implants (to avoid vital anatomic structures as well as invasive bone grafting procedures) that allows for immediate occlusal loading due to the increased anchorage in the native jawbone. Highly aesthetic provisional implant bridges can thus be provided at the day of surgery.
  755 137 -
Hope for escape from a prison of bone: Cellular and molecular targets for fibrodysplasia ossificans progressiva
Frederick S Kaplan
October-December 2018, 11(4):144-150
DOI:10.4103/HMJ.HMJ_78_18  
The progressive pathological metamorphosis of one normal organ system into another is unique to fibrodysplasia ossificans progressiva and unveils a pathophysiologic process that can be exploited for therapy of disabling extraskeletal ossification. Here, we review the recent remarkable insight from medical research and the potential of targeted therapy for this rare condition as well as for many common forms of heterotopic ossification.
  720 152 -
New teeth in one day: Immediate implant replacement of a single tooth using the copy-abutment technique
Werner Millesi, Dieter Busenlechner, Rudolf Fürhauser, Robert Haas, Georg Mailath-Pokorny, Bernhard Pommer
April-June 2018, 11(2):46-49
DOI:10.4103/HMJ.HMJ_33_18  
Losing teeth – particularly in the aesthetic zone of the anterior maxilla – represents a great dilemma for a patient and a challenge for the attending dentist. Immediate placement of dental implants at the day of tooth extraction is an established treatment concept that offers the possibility to provide fixed provisional crowns within few hours. Troublesome removable prostheses can thus be avoided, and the psychological trauma of tooth loss is minimised. The Copy-abutment technique was developed at the Academy for Oral Implantology in Vienna (Austria) and guarantees the best possible preservation of soft-tissue aesthetics by immediate implant restoration using custom-made abutments composed of highly aesthetic zirconia ceramic. On the basis of a modern all-digital workflow and a close cooperation with the affiliated dental laboratory, it is possible to provide the patient with a new tooth in just 1 day.
  718 138 -
Vascular anomalies
Julia Roka, Kurosh Paya
July-September 2018, 11(3):91-93
DOI:10.4103/HMJ.HMJ_51_18  
Vascular anomalies are rare congenital anomalies partly belonging to the Orphan diseaeses. Due to the intensive collaboration of the ISSVA a common categorization based upon histopathological attributes could be established. We present a short overview of the classification, manifestations and the diagnostic and therapeutical options.
  766 84 -
ORIGINAL ARTICLES
Oral health risks associated with recreational and professional scuba diving: A pilot study
Carolina Duarte, Aml Abu-Youssef
April-June 2018, 11(2):65-69
DOI:10.4103/HMJ.HMJ_19_18  
Introduction: The pressure experienced during diving can cause a variety of pressure-induced injuries to the head, face and oral regions. The most common oral complications are odontocrexis (dislodgement of dental restorations), barometric-related dental pain caused by air bubbles and increased pressure at the restoration–tooth interface or by flaring of periapical infections, temporomandibular joint disorders caused by heavy or poorly designed mouthpieces and cross-contamination of pathogens caused by improper disinfection of shared equipment. Objective: This study aims to identify the most common effects of frequent pressure variation on the oral health of divers from Ras Al Khaimah (RAK) Police and assess the in vitro survival of composite and amalgam restorations. Materials and Methods: A questionnaire eliciting demographic, occupational and barotrauma-related information was completed by members of RAK Police and the data were analysed. High-quality composite and amalgam restoration were performed on extracted teeth before exposure to 0.5–0.6 MPa at 37°C, simulating deep-diving conditions and repeated seven times for 10 min. Survival of the restorations was monitored. Results: Questionnaire data revealed that deep divers experience periodontal damage, enamel fissures and odontocrexis of metal and composite restorations, which could be associated with diving depth and frequency. These observations were supported by the in vitro assessment. Odontocrexis was observed earlier and more severely in amalgam restorations than in composite restorations. Increased pressure during diving can, therefore, affect the integrity of both amalgam and composite restorations, but composite restorations can withstand increased pressure for a longer duration than amalgam restorations before eventually showing damage, as observed both in vitro and in vivo. Conclusion: Divers with more experience and who dive deeper are affected to a greater extent by barotrauma than those with less experience or who do not dive as deep. Composite restorations are considered safer than amalgams for patients who dive.
  705 136 -
REVIEW ARTICLES
Hippocampus dysfunction may explain symptoms of fibromyalgia syndrome
Yasser Emad, Yasser Ragab, Alaaabou-Zeid , Johannes J Rasker
October-December 2018, 11(4):166-168
DOI:10.4103/HMJ.HMJ_82_18  
In fibromyalgia (FM) a combination of symptoms frequently exists, including impaired cognition, memory changes, widespread pain, and disrupted sleep rhythm, with no sufficient explanations for these bizarre symptoms. Many theories have been developed and it is still not clear whether FM is a chronic stress syndrome caused by many factors, including society or just a part of the spectrum of chronic pain. FM is the second most common rheumatic disorder behind osteoarthritis and, though still widely a puzzling syndrome, is now considered to be a central nervous system disorder, which is responsible for amplified and intensive pain. Over the years, three main ideas of hippocampal function have dominated the literature: Response inhibition, episodic memory, and spatial cognition. Given that the hippocampus plays integral roles in memory, cognition, and sleep regulations the later functions may be influenced by prolonged stress know to exist in FM syndrome. Moreover the hippocampus is an integral component of the limbic system, and as such may contribute to the negative affect and avoidance motivation experienced during pain experience and chronic stress. The aim of the current review is to focus on the physiological roles of the hippocampus and its relation to symptoms production in FM syndrome.
  733 86 -
ORIGINAL ARTICLES
Prevalence and characteristics of supernumerary teeth in patients from Ras Al Khaimah: A retrospective study from a Teaching Dental Hospital in the UAE
Fatema Almuheiri, Carolina Duarte
July-September 2018, 11(3):116-119
DOI:10.4103/HMJ.HMJ_20_18  
Context: Supernumerary teeth are teeth that exceed the normal dental formula. They have variable characteristics and may cause a number of clinical complications. In the Middle East, a prevalence of 0.3%–2.14% has been observed; however, the number of studies of this condition is limited in the region. Aims: This study aimed to examine the prevalence and characteristics of supernumerary teeth in patients from Ras Al Khaimah with consideration of demographic variations. Setting and Design: The study was performed at RAK College of Dental Sciences Dental Clinic. The radiographic database from two consecutive years was used as study sample. Subjects and Methods: A total of 2925 panoramic radiographs were analyzed to identify supernumerary teeth, and demographic-clinical data were extracted from patient files. Statistical Analysis: Data were analyzed using nonparametric tests. P ≤ 0.05 was considered statistically significant. Results: A prevalence of 0.75% was observed. Affected patients were predominantly South Asian males. The teeth were mostly supplemental, para-premolars, and impacted with low incidence of distomolars and no difference in occurrence in the maxilla or mandible. Occurrence of multiple supernumerary teeth was low and restricted to one jaw. Conclusions: This study suggests that one of every 133 patients will have impacted supernumerary teeth that can be expected in the premolar area of the maxilla/mandible, which should be considered when planning community oral health diagnosis and dental treatment strategies.
  708 105 -
ORIGINAL ARTICLE
Streptozotocin-induced molecular and metabolic targets in pancreatic beta-cell toxicity
Arwa Munassar Thabet Al-Nahdi, Annie John, Haider Raza
April-June 2019, 12(2):65-71
DOI:10.4103/HMJ.HMJ_54_18  
Background/Aim: The prevalence of diabetes is on the rise globally causing excessive burden on the health systems. Pancreatic beta-cell mass destruction/neogenesis/proliferation (seen in type1diabetes) and/or malfunction (type 2 diabetes) have been implicated in the aetiology, pathology, progression as well as in responses towards therapies and disease managements. Oxidative stress and alterations in mitochondrial energy metabolism play important roles in diabetes-induced cellular complications. Several studies, including our own, have suggested that Rin-5F pancreatic beta cells are extremely susceptible to oxidative stress due to excessive production of endogenous and exogenous reactive oxygen/nitrogen species (ROS/RNS) and low antioxidant defences, particularly, associated with GSH metabolism. Our aim was to investigate the molecular mechanism of streptozotocin (STZ), a beta cell-specific antibiotic, cytotoxicity in pancreatic cells. Methods: Rin-5F cells were treated with STZ under varying conditions to study oxidative stress-related changes. Results: Our studies have suggested that treatment of Rin-5F cells with STZ, inhibits cell survival and induces cytotoxicity by altering cellular survival and apoptotic signalling and gene expressions. Increased oxidative stress with increased DNA fragmentation and oxidative protein carbonylation were seen in STZ-treated cells. We also observed that beta cells treated with high glucose (up to 25mM) exhibited enhanced cytotoxicity. Cells exposed to conditions mimicking diabetes (hyperglycaemia) were under elevated oxidative stress and showed increased apoptosis and altered redox homeostasis leading to increased cytotoxicity. N-acetyl cysteine (NAC) treatment attenuated these changes in STZ-treated cells. Conclusion: These results may have implications in understanding the mechanism of beta cell survival/death in response to potential therapeutics/managements as well as in the aetiology and pathophysiology of diabetes.
  707 104 -
REVIEW ARTICLES
Paediatric urology: Emerging challenges
Felix Naegele, Josef Oswald
July-September 2018, 11(3):94-99
DOI:10.4103/HMJ.HMJ_59_18  
Medical advancements in paediatric urology are moving at a rapid pace, understanding natural history in congenital malformation of the urinary tract in infancy has changed our diagnostic as well therapeutic approach. Additionally more efficient diagnostic options have evolved our therapeutic in particular surgical approach toward minimally invasive options in children. Interdisciplinary teamwork are the needs of the moment applies above all to children with complex congenital malformations such as disorders of sexual development, urethral valves, cloacal extrophy or complex congenital deformities of the upper urinary tract. This short summary give insights into the current diagnostic discussion as well minimal invasive concepts of most important disease patterns in paediatric urology.
  709 87 -
ORIGINAL ARTICLE
Study of fourier transform infrared of adding metallic nanofillers on heat cure acrylic resin treated by microwave
Makarem M Abdulkareem, Amer A Taqa, Nadira A Hatim
April-June 2019, 12(2):57-64
DOI:10.4103/HMJ.HMJ_70_18  
Background: Polymethylmethacrylate (PMMA) has been the most popular material for the construction of denture bases since 1937. This is largely due to its favourable although not ideal characteristics. Aims of the study: To study the structural characterisation using Fourier transform infrared (FTIR) of adding aluminium oxide (Al2O3) and silver nanofillers on heat cure acrylic powder treated with microwave radiation and microwave-treated PMMA powder ground by micronizer. Materials and Methods: PMMA powder was treated with microwave radiation at a power level of 360 watt for ¾ h. The obtained PMMA powder was then grinded using a domestic blender group (V). The next step is particle size reduction of the microwave-treated PMMA powder using micronizer group (M). Two concentrations of Al2O3and Ag nanoparticles (NPs) were added separately into untreated PMMA powder group (P) and microwave-treated PMMA powder group (V and M) compared with the control group. The structural characterisations of all experimental groups are determined by FTIR. The samples were divided into 15 groups, one sample for each group. Results: The FTIR analysis has confirmed that the structural behaviour of both microwave and micronizer groups showed that there were no changes in the regions of the band locations for C=C and C=O when compared with the control one. The infrared spectra of all acrylic groups with (Al2O3and Ag) NPs additives showed all of the unique peaks attributed to the PMMA. These bands appeared in the same regions of the acrylic except the carbon double bond carbon (C=C) were absent in the infrared spectrometer chart. Conclusion: The FTIR test charts provide strong evidence that there are no chemical changes in all experimental groups. Except for the C=C band from the methacrylate group did not appear in samples containing NPs, which in turn indicates that the residual monomer of these groups is remarkably decreased.
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