Nutritional Attributes as Predictors of Coronary Heart Disease

Background: Diet is an important modifiable risk factor for coronary heart disease (CHD). However, the influence of some groups of food intake on CHD has shown inconsistent findings. Objectives: This study aimed to identify the relation of the dietary habits, Vitamin D, serum lipids, and anthropometric measures of the participants with CHD. Methods: A retrospective case-control study was conducted at Al-Remal Clinic, Gaza City. The study included 50 cases of symptomatic CHD and 50 controls, chosen by convenience sampling method. Data were collected by direct methods that included measurement of serum levels of lipids and Vitamin D, and indirect methods using a structured interview questionnaire. Results: The mean of servings per day of fruits and vegetables was lower in CHD patients than controls (P = 0.004, and P = 0.001, respectively). Vitamin D deficiency prevailed in CHD patients (odds ratio, 3.78;95% confidence interval, 1.65 - 8.65). The mean serum level of triglycerides was higher among cases (P = 0.02), while the mean of high-density lipoprotein cholesterol was lower in CHD patients (P = 0.001). Waist circumference (mean) was higher among cases (P = 0.01). Conclusion: Traditional risk factors including unhealthy diet, and Vitamin D deficiency could be associated with the development of CHD.

Low-grade chondrosarcoma of the larynx: A case report

BACKGROUND Chondrosarcomas of the larynx are malignant tumours that most commonly originate from the hyaline cartilage.Chondrosarcoma of the larynx,the most common type of low-grade tumour,accounts for 1%of all laryngeal neoplasms.CASE SUMMARY We present the case of a 60-year-old female patient who developed progressive hoarseness and shortness of breath over a 2-mo period.The patient had undergone resection of a laryngeal tumour 14 years before the aforementioned symptoms occurred,and histopathological analysis indicated that it was a chondroma.During the assessment of the patient,a submucosal,oval-shaped tumour was detected that was predominantly located on the left side of the larynx and was approximately 6 cm in size.The decision to perform left partial vertical laryngectomy was made.A pathohistological diagnosis of low-grade chondrosarcoma was made.Considering the results of pathohistological analysis and the positive margins of the resection,a total laryngectomy was performed.During the 12-mo follow-up,no local relapse or regional or distant metastases was detected.CONCLUSION Chondrosarcoma of the larynx must be considered in the differential diagnosis of laryngeal submucosal tumours.It is crucial to carefully sample of tumour tissue,differentiate chondroma and chondrosarcoma,and consider the possibility of malignant changes from chondroma to chondrosarcoma.

Topical Application of Ascorbic Acid Solution as an Adjunctive Method of Periodontal Therapy among Wet Snuff Users after Prosthodontics Therapy

Background: During several years, ascorbic acid (vitamin C) played a significant role in the health of periodontal tissues. The goals of prosthodontics management are to restore the missing teeth, provide the loss of teeth functions, and establish acceptable dental esthetics, and there are some evidences revealing the passive effects of snuff on the results of prosthodontics and periodontal treatment, so the present study is performed to evaluate the outcomes of topical application of ascorbic acid solution as an adjunctive method of periodontal therapy among wet sniff users after prosthodontics therapy. Methods: The clinical situation was evaluated in 150 moderate periodontitis patients after conventional periodontal and prosthodontics therapy. They were selected from outpatient clinics, college of dentistry, King Khalid University, and from some hospitals Ministry of Health in Tabuk, Jazan and Aseer regions. The study was conducted from September 2020 to December 2020. The time of post-treatment assessment was one year. The study was included 50 patients who don’t use wet snuff as a group I (GI) (control group), 50 patients wet snuff users as group II (GII), and 50 patients wet snuff users were treated with topical application of ascorbic acid solution as group III (GIII). The participants were aged over 20 years, with a mean age of 35 years. The duration of using wet snuff was at least one year. Plaque index (PLI), gingival index (GI), clinical attachment loss (CAL) were recorded at baseline (first visit), then after 4 weeks (second visit) and after 6 weeks (third visit) of conventional periodontal therapy and topical application of ascorbic acid solution. Statistical analysis was done using ANOVA test and paired t-test. Results: According to statistical analysis, there was the inclination of decrease in the mean and standard deviation of plaque index (PLI) from 2.8 ± 1.4 to 2.5 ± 0.51, and 2.7 ± 0.33 in group II, and decrease from 2.7 ± 0.34 to 2.5 ± 0.23 and 2.6 ± 0.65 in group III. Similarly in the gingival index (GI), there was a decrease in the mean and standard deviation from 2.8 ± 0.52 to 2.3 ± 0.62 and 2.5 ± 0.51 in group II and a decrease from 2.5 ± 0.8 to 2.3 ± 0.58 and 2.4 ± 0.47 in group III. Moreover, there was a decrease in the mean and standard deviation of clinical attachment loss (CAL) from 4.5 ± 0.26 to 3.9 ± 0.83 and 4.2 ± 0.83 in group II and from 4.2 ± 0.31 to 3.8 ± 0.46 and 3.8 ± 0.31 in group III;less than group I without significance differences (p > 0. 05) in all study groups at baseline and after 4 weeks, and 6 weeks of follow up except CAL. Conclusion: The results of our study displayed that periodontal parameters vary among wet snuff users after topical application of ascorbic acid solution as an adjunctive method of periodontal therapy

The Safety and Efficacy of Combination Therapy of Dapagliflozin and Metformin in Patient with Type 2 Diabetes Mellitus: A Review Study

Background: Sodium glucose co-transporter 2 (SGLT2) inhibitors are a new class that approved by FDA for patient with type 2 DM. Dapagliflozin alone or in combination therapy with metformin provided effective glycemic control and HbA1c reduction, with minimal hypoglycemia and hypotension adverse effects. Objective: To evaluate the safety and efficacy of the combination therapy of dapagliflozin and metformin in type 2 diabetes mellitus patients. Methods: Research was conducted through MEDLINE and Embase databases in search of randomized controlled studies including dapagliflozin, sodium glucose co-transporter 2, metformin, and efficacy. Results: Forty seven articles were spotted, 3 randomized controlled studies were involved in this review. Dapagliflozin and metformin combination was found beneficial in HbA1c reduction equal to 20.7% - 31.5% from the baseline compared to patients on metformin alone. 40.6% of patients on combination therapy achieved the ADA recommended reduction in HbA1c to less than 7%. Moreover fasting plasma glucose level was reduced by 23.4 mg/dl from the baseline in the combination therapy compared to 5.9 mg/dl in metformin group. Body weight reduction was statistically significant (P Conclusion: The combination therapy of dapagliflozin and metformin found to be safe and effective in type 2 diabetes mellitus management with minimal adverse effects.

Barrett食管在普通人群中的发生率:一项内镜检查研究

Background &Aims: Barrett’s esophagus (BE) is associated with esophageal adenocarcinoma, the incidence of which has been increasing dramatically. The prevalence of BE in the general population is uncertain because upper endoscopy is required for diagnosis. This study aimed to determine the prevalence of BE and possible associated risk factors in an adult Swedish population. Methods: A random sample (n = 3000) of the adult population (n = 21,610) in 2 municipalities was surveyed using a validated gastrointestinal symptom questionnaire (response rate, 74%); a random subsample (n = 1000; mean age, 53.5 years; 51%female) underwent upper endoscopy. Endoscopic signs suggestive of columnar-lined esophagus (CLE) were defined as mucosal tongues or an upward shift of the squamocolumnar junction. BE was diagnosed when specialized intestinal metaplasia was detected histologically in suspected CLE. Results: BE was present in 16 subjects (1.6%; 95%confidence interval, 0.8-2.4): 5 with a long segment and 11 with a short segment. Overall, 40%reported reflux symptoms and 15.5%showed esophagitis; 103 (10%) had suspected CLE, and 12 (1.2%) had a visible segment ≥2 cm. The prevalence of BE in those with reflux symptoms was 2.3%and in those without reflux symptoms was 1.2%(P = .18). In those with esophag-itis, the prevalence was 2.6%; in those without, the prevalence was 1.4%(P = .32). Alcohol (P = .04) and smoking (P = .047) were independent risk factors for BE. Conclusions: BE was found in 1.6%of the general Swedish population. Alcohol and smoking were significant risk factors.

Middle East respiratory syndrome:what to be concerned more in preparedness?

The recent problem on Middle East respiratory syndrome is a very interesting new infection emerging from the Gulf area. For practitioners in intensive care medicine, knowledge update on this new emerging infection is needed. Preparation for diagnostic tool and antiviral drug to cope with possible outbreak is suggested. In addition, the consideration of ecological factors of this new disease is important. The consideration of not only ecological but also humanistic background can be useful to manage the new disease, Middle East respiratory syndrome as well. Finally, how to improve medical service for underserved population is a big issue. The local health department must play an important role.