Assessment of the knowledge,attitudes, and practices among UNRWA health staff in Jordan concerning mental health programme pre-implementation: a cross-sectional study

Background

Mental health is a major public health priority, particularly among refugees worldwide. The United Nations Relief and Works Agency for Palestine Refugees (UNRWA) started to integrate mental health and psychosocial support (MHPSS) into its primary health-care services in Jordan in late 2017. This baseline study aimed to assess the knowledge, attitudes, practices, and perceived barriers among UNRWA health staff regarding the implementation of the MHPSS programme.

The use of direct oral anticoagulants for extended duration thromboprophylaxis in medically ill patients: a systematic review and meta-analysis

Journal of Thrombosis and Thrombolysis - The extended use of thromboprophylaxis with direct oral anticoagulants (DOACs) for more than 30 days has been evaluated as an alternative...     

Exploring the outcome of multiple sclerosis among Saudi adult patients: A single-centered cross-sectional study at King Abdulaziz Medical City in Riyadh,Saudi Arabia

Objectives:To assess the outcome and impact of multiple sclerosis (MS) using validated Arabic versions of the Barthel index (BI) multiple sclerosis impact scale (MSIS-29), the modified Rankin scale (mRS), and the expanded disability status scale (EDSS).Methods:A cross-sectional study conducted at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia, during July-November 2017. All Saudi adult patients diagnosed with MS between 2000-2016 (269 patients) were included. Patients were contacted via phone calls and were assessed using a newly developed and validated multi-component questionnaire that included demographic data, disease course, and Arabic versions of the scales.Results:Out of 269 patients, 210 (78.2%) responded. The average patient age was 37.44±10.3 years. The majority were females (69.5%). Only, 51 (24.3%) patients reported worsening conditions. Annually, the average relapse rate was 2.28±1.91. In regard to patient outcomes, 120 (57.1%) showed no significant disability in mRS, 146 (69.5%) were ambulatory without aid in EDSS, and 185 (89.4%) were independent in BI scores. The average MSIS-29-PHYS score was 33.6±27.6 and MSIS-29-PSYCH score was 38.2±25.8. Modified Rankin scale and EDSS were significantly associated with the current use of disease-modifying therapy (DMT). Modified Rankin scale was negatively associated with delayed diagnosis. Barthel index showed significant association with medication compliance and the absence of attacks.Conclusion:Majority of patients had a favorable outcome that was linked with the use of DMT, compliance, early diagnosis, and absence of attacks.

Multiple sclerosis (MS) is a neurological disease that is singularly characterized by multifocal areas of demyelination in the central nervous system (CNS). Though its precise etiology is unclear, the pathogenesis of the disease is believed to be immune-mediated myelin destruction and, eventually, axon disruption, which is the main cause behind the progressive disability.1 Multiple sclerosis is the most common neurological autoimmune disorder in the world, with an estimated number of 2.3 million until 2013. The increase from 2.1 million in 2008 to 2.3 million in 2013 has raised not only epidemiologists’ interest and alarm but also neurologists’.2 As of Kingdom of Saudi Arabia, it was estimated that 40/100,000 is the prevalence of multiple sclerosis in 2008.3 When it comes to gender, women are generally more affected than men, estimated by a study carried out in Kingdom of Saudi Arabia.4 Affected person’s average age of onset is 30 years.The outcome and prognosis of MS do not only vary depending on a plethora of factors but are also unpredictable in nature. It is well-recognized in the literature that MS can cause disability with varying degrees, and this can have an impact on patients’ quality of life (QoL) and daily activities.5 However, the outcome is not thoroughly studied, especially in Kingdom of Saudi Arabia. To predict MS patient outcomes, conventional and physician-based validated scales are usually used, one of which is the EDSS. It mainly assesses the degree of disability and monitors the diseases’ progression but with several limitations which are documented, such as its insensitivity to change over a spectrum of 2-3 years.6 Therefore, in this study, we additionally considered other vital scores and scales that not only assess disability via the EDSS, but also the mRS. Moreover, health-related quality of life (HRQoL) is evaluated by the MSIS-29 and the BI. Such measures will help us to have a more objective and reliable endpoint regarding the patients’ outcome and survival.In this study, we hypothesised that the outcome in regard to disability and HRQoL would differ depending on the variables we took into consideration when assessing MS. Thus, the aim was to evaluate the outcome of this neurological disease that we call MS.     

The beneficial roles of Lupineus luteus and lifestyle changes in management of metabolic syndrome: A case study

Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors including obesity, hypertension, dyslipidemia and hyperuricemia. Here, we report a 43-year-old man with obesity, hypertension, hypercholesterolemia, hyperuricemia and mild liver dysfunctions. Lupid (Lupineus luteus) and therapeutic lifestyle change (TLC) were suggested as therapeutic intervention for the present case for 6 months. The body weight, body mass index (BMI), blood pressure, total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), triacylglycerol (TAG), uric acid (UA) and alanine transaminase (ALT) were markedly decreased by 26.85%, 26.95%, 13%, 53.84%, 57.84%, 36.14%, 47.58% and 61.62% respectively, compared to those at baselines. However, high density lipoprotein cholesterol (HDL-C) value was markedly increased by 30.77%. The present results concluded that administration of lupin with TLC is good intervention for prevention and treatment of MetS.     

Successful treatment of relapsing autoimmune thrombotic thrombocytopenic purpura with rituximab

Thrombotic thrombocytopenic purpura (TTP) is a rare but life‐threatening condition characterized by thrombotic microangiopathy. The standard treatment for TTP is plasmapheresis. For refractory or relapsing cases, various immunosuppressive agents have been tried, and among them rituximab has shown promising results. TTP is rarer in the pediatric age group and the use of rituximab in children with TTP is limited. Reported herein is the successful treatment of relapsing autoimmune TTP with rituximab in a 12‐year‐old girl.     

Social Impact of Dialysis on Children and Their Families

Objectives

To evaluate the social consequences of dialysis on children and their parents.

Methods

From January through June 2012 short structured interviews with parents or caregivers of children on peritoneal dialysis (PD) or hemodialysis (HD) who were followed up at King Abdulaziz University Hospital, King Faisal Specialty Hospital and Research Center, or the Kidney Center at King Fahad Hospital were conducted. Data were analyzed using the Statistical Package for the Social Sciences.

Results

Thirty six children (22 boys and 16 girls) and their families were included. The mean (SD) age of the children was 11.5?±?6.87 y, and the mean (SD) duration of dialysis was 28?±?11.32 mo. Only one third of the families had the opportunity to choose the modality of dialysis. Both modalities of dialysis had a negative effect on fathers’ jobs in over 50 % of the cases. Similarly, both modalities of treatment had a considerable impact on the quality of care provided by the mothers to other family members. There was no difference between the two modalities on the frequency of admissions.

Conclusions

Both PD and HD had a negative impact on fathers’ jobs and on the level of care provided by mothers to the rest of the family.     

Reference values for ultrasonograpy of peripheral nerves

Introduction: High‐resolution ultrasonography (HRU) is a novel method that provides morphological information about peripheral nerves. We aimed to determine reference values for nerve cross‐sectional area (CSA) on HRU. Methods: One hundred healthy volunteers had HRU of median, radial, ulnar, fibular, tibial, sural, and superficial fibular nerves at defined sites. The CSA was measured and the effects of age, gender, and body mass index (BMI) were evaluated. Results: CSA values in healthy subjects are described. CSA is larger in lower limb motor nerves than in sensory nerves at similar sites, and the CSA tends to be symmetrical. The strongest effect on CSA was for age, although gender and BMI had some effects. Conclusions: This study provides normative values for HRU, and it suggests that further research with age‐ and gender‐specific distributions must be a key priority in the development of HRU for use as a diagnostic test for peripheral nerve diseases. Muscle Nerve 53 : 538–544, 2016