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   2018| July-August  | Volume 10 | Issue 4  
    Online since August 3, 2018

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Rectal, axillary, and tympanic temperatures inneonates and infants with or without fever
Asma Ali Shagleb, Zinab Ashour Saad, Fauzi Abdalla Sagher
July-August 2018, 10(4):115-118
Objectives: To evaluate the agreement between temperature measured at the axilla or tympanic to rectum using standard techniques. Patients and Methods: We studied 50 neonates and 50 infants admitted to special care baby unit and Pediatric Gastroenterology Department with or without fever. Preterm, sick, malnourished neonates and uncooperative and crying infants were excluded from the study. Verbal consent from mothers was taken before the measurements. To adjust for rectal temperature, 0.55°C added to neonates and 0.65°C to infants' axillary temperature, 0.1°C to neonates, and 0.45°C to infants' tympanic membrane temperature. Results: There was a strong correlation (r) between 0.79 and 0.89 for axillary temperature with rectal temperature in neonates and infants, males and females, and for tympanic temperature with rectal in male infants. However, moderate correlation (r) was between 0.73 and 0.76 for tympanic temperature with rectal temperature in overall neonates and male and female infants. Axillary temperature missed 1% of pyrexia cases, whereas tympanic membrane measurements overestimate pyrexia in 5% of cases. Conclusion: It is safe reliable and convenient to use the axillary route for measurements of temperature in neonates and infants with or without fever.
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Mansour Al Mabrouk Ali Ben Halim (1937–2018)
Elhadi H Aburawi
July-August 2018, 10(4):145-145
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Awareness of predatory journals among physicians from Africa and the middle East: An exploratory survey
Salem A Beshyah, Issam M Hajjaji, Abdulwahab Elbarsha
July-August 2018, 10(4):136-140
Objectives: There is a recent proliferation of predatory journals (PJ) targeting unwary authors and unsuspecting institutions. We evaluated the awareness, attitude, and practices related to predatory publishing among physicians from the Middle East and Africa. Subjects and Methods: An online survey of a convenience sample of physicians was conducted. One hundred and forty responses were received. Of these 76 were complete and they formed the basis of this study. Results: Respondents hold a specialty board or equivalent (46.1%), doctorate (26.3%) or Master (13.2%). Half of the respondents published between 1 and 10 articles and less than a fifth had no prior authorship experience. Respondents are reportedly fully aware (30.3%) or fairly familiar but were not confident with details (43.4%), whereas 26.3% have no clear idea about models of publishing (open access [OA] vs. subscription-only). Nearly one third have never heard about predatory publishing and one in six of the respondents may have heard about it, but they were not sure. 69.7% reported no knowledge of Jeffery Beall and his list. The majority thought it might be somewhat difficult (51.4%) or difficult (24.3%) to distinguish between predatory and legitimate OA journals and 40%–60% affirmed knowledge of features of predatory publishing practices. 50%–60% recognized that PJ target authors in the developing nations. Respondents reported a variable frequency of unsolicited E-mails inviting them to submit articles to suspected PJ or act as reviewers or editors. Only a minority would take further action to protest against such invitations. Many respondents suggested warning young researchers and inexperienced authors about PJ by improved supervision and mentorship practices. Conclusions: There is a low awareness of predatory publishing. There were varying attitudes and practices among respondents.
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Should lack of ethical committee's approval of human research lead to rejection of resulting manuscripts?
Salem A Beshyah, Wanis H Ibrahim, Elhadi H Aburawi, Elmahdi A Elkhammas
July-August 2018, 10(4):105-107
  2,613 283 1
Successful use of a combination of two long-acting basal insulin analogs for the treatment of marked insulin resistance in type 2 diabetes unresponsive to standard therapy
Kamal Abouglila
July-August 2018, 10(4):141-144
Insulin resistance is a major management challenge in patients with Type 2 diabetes (T2DM). A 62-year-old female patient with T2DM caused by insulin resistance is reported. Her hyperglycemia did not respond to conventional combinations of insulin therapy. However, she responded very well to a unconventional use of the combination of two basal insulin analogs with additional short-acting insulin. This approach needs confirmation and elucidation for a potential role in these not very uncommon cases.
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Guillain–Barré syndrome in the United Arab Emirates: A sixteen-year experience of a single center
Salim Yaghi, Waleed S Beshyah, Anas S Beshyah, Aliasgar Lokhandwala, Salem A Beshyah
July-August 2018, 10(4):125-129
Background: Guillain–Barré Syndrome (GBS) is the most common cause of acute flaccid paralysis. We describe clinical characteristics and outcomes of GBS in a region where data are hitherto limited. Patients and Methods: This retrospective study was conducted at Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates. All GBS patients identified between 2000 and 2015 were documented and summarized using descriptive statistics. Results: Fifty-three patients were identified. GBS was 3.1 fold more common in men; median age was 33 (range: 16–79). 47.2% of the patients were previously healthy. Upper respiratory tract infections occurred in 37.7% and gastroenteritis in 18.9%. The most common clinical presentation was bilateral upper and lower limb weakness (47.2%). Vital capacity was low in 63.16% of patients. Classical albuminocytologic dissociation was seen in 19.5% of patients who had a lumbar puncture done. Nerve conduction studies were carried out in 56.6% of cases, and the most commonly observed abnormality was mixed axonal neuropathy. Nearly 60.38% of patients had adverse outcomes. Eight patients (25%) required admission to the intensive care of whom six required mechanical ventilated. Twenty-Four patients (75%) were discharged with residual motor weakness, and five of whom required further rehabilitation. Poor respiratory status on arrival significantly predicted poor outcome. Conclusions: Our results are generally similar to international trends in GBS. Respiratory dysfunction and decreased vital capacity were the only poor prognostic factors identified. Nerve conduction findings were not associated with clinical or prognostic values.
  2,425 236 1
Use of donors at age extremes for simultaneous pancreas-kidney transplant
Clifford Akateh, Elmahdi Elkhammas, Ronald Pelletier, Amer Rajab, Mitchell Henry, Ashraf El-Hinnawi
July-August 2018, 10(4):108-114
Introduction: There is a shortage of optimal pancreatic donors for simultaneous pancreas and kidney transplant (SPKT), as such there is interest in utilizing donors at extremes of age to expand the donor pool. We sought to evaluate outcomes in SPKT from pediatric donors (PDs) to older donors (ODs). Patients and Methods: We identified patients who underwent simultaneous pancreas and kidney transplant at a single, high-volume institution from 1988–2013. We evaluated for differences in transplant organ function (estimated glomerular filtration rate [GFR], serum glucose, and urine amylase), early (technical) graft loss, and patient and graft survival. Results: A total of 729 SPKT were performed during the study, with 32 PDs, 652 standard donors (SDs), and 45 ODs. Renal function was slightly worse in OD. Otherwise, graft function was similar between all three groups at up to 5 years. There was no difference in censored survival analyses for both kidney and pancreas allografts. There was comparable short-term and long-term patient survival among all groups. Conclusions: Overall, the use of pancreas from pediatric and ODs for SPKT has comparable outcome to SDs. Kidneys from donors above 50 may have lower GFR, but otherwise, have comparable long-term patient and graft survival.
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Clinical value of adipose tissue-derived stem cells application in healing of experimental diabetic and nondiabetic burn
Randa Samir Hana, Heba Atia Yassa
July-August 2018, 10(4):119-124
Objectives: The mechanisms underlying delayed healing in diabetes are not completely understood and biomarkers to identify and to treat such pathways are needed. The aim of the present study is to assess the clinical effect of adipose tissue-derived stem cells in accelerating third-degree burns healing in diabetic and normal mouse model and to restore skin integrity. Assessment of healing by Serpin B3 and keratinocyte growth factor-1 (KGF-1) as novel biomarkers and possible molecular targets of impaired diabetic wound healing. Materials and Methods: Forty male mice were set up as an experimental model for third-degree burn. They were randomly divided into four groups as follows: the control group, the diabetic (received high-fat diet) burnt group, the diabetic burnt group treated with adipose tissue-derived stem cells, and the nondiabetic burnt group treated with adipose tissue-derived stem cells. The rate of burn healing, the degree of angiogenesis, and collagen formation were evaluated by histological examination, Serpin B3 (enzyme-linked immunosorbent assay), and KGF-1 measured by real-time polymerase chain reaction. They were sacrificed after the 3rd week for tissue sampling. Results: Adipose tissue-derived stem cells accelerate the healing of experimental burns. Serpin B3 was upregulated in adipose tissue-derived stem cells treated burns associated with denser collagen deposition, angiogenesis, and increased expression of KGF-1. Hair growth occurred in adipose tissue-derived stem cells-treated groups but not in the untreated groups. Conclusion: Adipose tissue-derived stem cells represent an effective treatment for burn healing especially in resistant diabetic burns. High Serpin B3 and KGF-1 were found to be valuable biomarkers of successful healing in diabetic burns.
  2,231 252 1
The profile of eye disease in palestine: An 8-year experience at St. John Eye Hospital, Hebron
Riyad George Banayot
July-August 2018, 10(4):130-135
Objectives: We aimed to profile the spectrum of eye conditions and document the change in cases presenting at St John Eye Tertiary Hospital, Hebron, Palestine. Patients and Methods: Charts of all new patients who presented to St. John Eye Hospital, Hebron, Palestine, between 2006 and 2013 were reviewed retrospectively. Age at presentation, sex, and clinical diagnosis were extracted from medical records. Data were stored and analyzed. Results: The records of 33,183 patients were included in the study. Female:male ratio was 1:1. Patients aged 10–19 years were the largest group (18%–24%). Refractive errors were the most common disorders seen (22%–32%). This was followed by followed by conjunctival diseases (20%–24%) and cataract (8%–13%). Diabetic patients represented 7% of the total. Proliferative and nonproliferative diabetic retinopathy increased over the study period. Refractive errors and cataract were more frequent in females than males, while ocular trauma was more prominent in males than females. Conclusions: The most common cause of ocular morbidity in this study was refractive errors. Most of the morbidities seen in this study were either treatable or preventable. Programs that raise the capacity of health providers and screening programs should be conducted regularly and preferably in partnership with all health service providers.
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