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Open Journal of Stomatology 2016年第1期6卷 28-35页

作者： Ebtissam M. al-Madi Manar alJamie shaikha al-dukhail Zakariya Mohammed Neamat Hassan Abubakr College of Dentistry Princess Nourah bint Abdulrahman University Riyadh Kingdom of Saudi Arabia College of Dentistry King Saud University Riyadh Kingdom of Saudi Arabia Faculty of Science Northern Border University Arar Kingdom of Saudi Arabia

The aim of the present study was to assess the dietary habits and oral hygiene practice of dental students in a new dental school. A self-administered structured closed-ended questionnaire on demographic characteristics, medical history, oral hygiene and dietary habits was distributed to dental students. Results showed that One third of students indicated that they don’t consume low pH beverages (soft drinks) at all, while 48.9% drink a soft drink or two a day. Students took varying amount of time to consume their drinks. The majority of participants consumed citric juices, fruits and/or pickles at least once a day. 91.3% of students use either soft (41.8%) or medium (49.5%) toothbrush. Only a fifth (16.9%) of the students brush their teeth after drinking soft drinks and 58.2% brush their teeth after vomiting. In conclusion, young adults need to be aware about their dietary habits & oral hygiene, and also a proper dental health program needs to be applied.

关键词： Dietary Habits Oral Hygiene Practice Low pH Soft Drinks

Superior rectus/levator complex in acquired anophthalmic socket repaired with spheric implant—a computed tomography scan and topographic study

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International Journal of Ophthalmology(English edition) 2024年第8期17卷 1483-1488页

作者： shaikha al Eid Hamad M alSulaiman Sahar M Elkhamary Osama al Sheikh alicia Ferrero-Galindo Rajiv Kandekhar Silvana A Schellini Oculoplastic Division King Khaled Eye Specialist HospitalRiyadh 11462Saudi Arabia Radiology Division King Khaled Eye Specialist HospitalRiyadh 11462Saudi Arabia Department of Diagnostic Radiology Mansoura Faculty of MedicineMansoura 35511Egypt University Hospital Rio Hortega Valladolid 47012Spain Research Department King Khaled Eye Specialist HospitalRiyadh 11462Saudi Arabia Ophthalmology Department Medical SchoolState University of Sao PauloBotucatu 18618-687Brazil

AIM:To determine whether the levator palpebrae superioris(LPS)/superior rectus(SR)muscle complex,can influence the position of the upper lid and fornix in acquired anophthalmic ***:This comparative non-randomized and non-interventional study included retrospective data of 21 patients with unilateral acquired anophthalmic sockets repaired with spheric ***-resolution computed tomography(CT)measurements of the LPM/SR muscle complex and clinical topographic position of the upper lid,superior and inferior fornix depth in primary gaze position were *** data were presented as frequency and percentage proportions and quantitative variables comparing the socket measurements with the normal contralateral orbit was statistically analyzed using non-parametric tests considering Palmic orbits had a significantly shorter LPS length(P=0.01)and significantly thicker SR(P=0.02)than the normal *** was present in anophthalmic sockets but not in normal orbits(P=0.002),while levator function was normal in both(P>0.05,all comparisons).The superior fornix depth was similar in the anophthalmic socket and the contralateral normal orbit(P=0.192)as well the inferior fornix depth(P=0.351).CONCLUSION:Acquired anophthalmic sockets repaired with spheric implants have shorter LPS,thicker SR,and more lagophthalmos than normal *** relationship of the LPS and SR with other orbital structures,associated with passive or active forces acting in the final position of the lids and external ocular prosthesis should be further investigated.

关键词： anophthalmic socket spheric implant levator palpebrae superioris superior rectus lagophthalmos fornix depth

Diet in Renal Diseases: An Art of Science

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Open Journal of Nephrology 2024年第3期14卷 361-374页

作者： Kamel El-Reshaid shaikha al-Bader Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Nephrology Jaber Hospital Ministry of Health Kuwait City Kuwait

Purpose of Review: Chronic kidney disease (CKD) is associated with a limited ability to excrete fluids, electrolytes, uremic toxins and other end-products of catabolism. Studies on adverse renal outcomes with dietary patterns are limited. Methods: Comprehensive search in PubMed of papers published until June 2024 describing prospective cohort studies on renal nutritional therapy (RNT) with at least 3 years of follow up. Results: RNT should include adequate yet limited amounts of calories, fluids, protein, lipids, sodium, potassium, and phosphorus. RNT is an adjuvant to specific drug-therapy in 1) certain complications viz. fluid overload, anemia and renal osteodystrophy, and 2) specific kidney diseases viz. glomerulopathies, tubulopathies, polycystic kidney disease, calcium oxalates urolithiasis and cystinuria, as well as 3) types of renal failure viz acute and chronic and its treatment viz. hemodialysis, peritoneal and transplantation. Conclusion: RNT is patient-specific and should be systematically planned to delay the progression of CKD as well as to prevent and treat its complications.

关键词： Calories Diet Disease Electrolytes Fluid Kidney Lipids Nutrition Protein Vitamins

The Role of AI in Cyber Security: Safeguarding Digital Identity

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Journal of Information Security 2024年第2期15卷 245-278页

作者： Mohammad Binhammad shaikha alqaydi Azzam Othman Laila Hatim Abuljadayel Department of Computer Science British University Dubai Dubai The United Arab Emirates Department of Cybersecurity Dar Al Hekma University Jeddah Saudi Arabia

This article signals the use of Artificial Intelligence (AI) in information security where its merits, downsides as well as unanticipated negative outcomes are noted. It considers AI based models that can strengthen or undermine infrastructural functions and organize the networks. In addition, the essay delves into AI’s role in Cyber security software development and the need for AI-resilient strategies that could anticipate and thwart AI-created vulnerabilities. The document also touched on the socioeconomic ramifications of the emergence of AI in Cyber security as well. Looking into AI and security literature, the report outlines benefits including made threat detection precision, extended security ops efficiency, and preventive security tasks. At the same time, it emphasizes the positive side of AI, but it also shows potential limitations such as data bias, lack of interpretability, ethical concerns, and security flaws. The work similarly focuses on the characterized of misuse and sophisticated cyberattacks. The research suggests ways to diminish AI-generating maleficence which comprise ethical AI development, robust safety measures and constant audits and updates. With regard to the AI application in Cyber security, there are both pros and cons in terms of socio-economic issues, for example, job displacement, economic growth and the change in the required workforce skills.

关键词： Artificial Intelligence Cyber Attack Cyber Security Real-Time Mitigation Social Media Security AI-Driven Threat Intelligence

Pediatric and adult liver transplantation in Bahrain: The experiences in a country with no available liver transplant facilities

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World Journal of Transplantation 2024年第1期14卷 96-111页

作者： Hasan M Isa Fatema A alkharsi Jawad K Khamis Sawsan A Hasan Zainab A Naser Zainab N Mohamed Afaf M Mohamed shaikha A altamimi Department of Pediatrics Salmaniya Medical ComplexManama 26671Bahrain Department of Pediatrics Arabian Gulf UniversityManama 26671Bahrain Department of Medicine Salmaniya Medical ComplexManama 26671Bahrain Public Health Directorate Ministry of HealthManama 26671Bahrain The Overseas Office Supreme Committee for Treatment AbroadMinistry of HealthManama 26671Bahrain

BACKGROUND Liver transplantation(LT)is a life-saving procedure for patients with end-stage liver disease and has become the standard and most effective treatment method for these *** are many indications for LT that vary between countries and *** outcome of LT depends on the available facilities and surgical expertise,as well as the types of liver graft donors *** To assess the clinical characteristics of patients from Bahrain who underwent LT overseas,and analyze factors affecting their *** In this retrospective cohort study,we reviewed the medical records and overseas committee registry information of all pediatric and adult patients who were sent overseas to undergo LT by the Pediatric and Medical Departments of Salmaniya Medical Complex and Bahrain Defence Force Hospital via the Overseas Treatment Office,Ministry of Health,Kingdom of Bahrain,between 1997 and *** data,LT indication,donor-recipient relationship,overseas LT center,graft type,post-LT medications,and LT complications,were *** measured included the overall and 5-year LT survival ***’s exact,Pearsonχ2,and Mann-Whitney U tests were used to compare the pediatric and the adults’group in terms of clinical characteristics,donor-recipient relationship,medication,complications,and *** analysis was estimated via the Kaplan-Meier’s *** and multivariate analyses were used to detect predictors of *** Of the 208 eligible patients,170(81.7%)were sent overseas to undergo LT while 38(18.3%)remained on the waiting *** the 170 patients,167(80.3%)underwent LT and were included in the *** majority of the patients were Bahraini(91.0%),and most were males(57.5%).One-hundred-and-twenty(71.8%)were adults and 47(28.3%)were *** median age at transplant was 50.0[interquartile range(IQR):14.9–58.4]*** main indication for pediatric LT was biliary atresia(31.9%),while that of adult LT was

关键词： Overseas liver transplantation End-stage liver disease Liver transplant facilities Liver donor Biliary atresia Hepatitis C

Sequential Combination Diuretic-Therapy for Massive Fluid Overload in Furosemide-Refractory Patients with Diabetic Kidney Disease

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Open Journal of Nephrology 2021年第2期11卷 265-272页

作者： Kamel El-Reshaid shaikha al-Bader Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Medicine Nephrology Unit Amiri Hospital Ministry of Health Kuwait City Kuwait

Patients with renal disease are at risk of fluid overload which escalates as the disease progresses. In the present study, we evaluated the efficacy of sequential combination diuretic-therapy (SCDT) in management of massive fluid overload in Furosemide-refractory renal patients. The added diuretics were Spironolactone 25 mg daily for 3 days, to those without risk of hyperkalemia, followed by Hydrochlorothiazide 25 mg/Metolazone 5 mg daily for 3 more days. Excluded patients were those with 1) acute renal disease, 2) echocardiographic evidence of: a) left ventricular ejection fraction alvular disease, c) ASD or VSD, d) significant pericardial disease, and 3) significant limb venous disease or on drugs likely to cause limb-oedema. To assess the extent of fluid overload;clinical examination was complemented with radiological imaging as well as echocardiographic measurement of systolic pulmonary arterial pressure (sPAP). SCDT led to significant symptomatic, clinical, and radiological improvement of fluid overload without significant side effects. The latter were limited to hyperkalemia and hyponatremia which improved with dietary compliance. Moreover, hyperkalemia improved after subsequent addition of Thiazide/Metolazone. SCDT led to significant (p al excretion of sodium and decrease in body weight and sPAP. In conclusion;SCDT is a safe and efficacious measure to control fluid overload in patients with renal diseases.

关键词： aldactone Diabetes Mellitus Echocardiography Fluid Overload Furosemide Hydrochlorothiazide Kidney Disease Metolazone Spironolactone

Transient D-Penicillamine-Induced Nephrogenic Diabetes Insipidus during Treatment of a Patient with Cystinuria —D-Penicillamine-Induced Nephrogenic Diabetes Insipidus

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Open Journal of Nephrology 2023年第4期13卷 378-384页

Background: Diabetes insipidus (DI) is a rare disorder characterized by inappropriate polyuria and hypo-osmolar urine. It is caused by inadequate production of antidiuretic hormone, in response to hypothalamic osmoreceptor-stimulation, from the pituitary gland (central DI) or resistance to its action at terminal distal convoluted tubules and collecting ducts (nephrogenic DI). Most cases of nephrogenic DI are caused by drugs, especially chronic lithium use. The Case: A 46-year-old man manifested such a disorder 8 months following d-Penicillamine (d-P) therapy for cystinuria. The drug was discontinued and the patient was managed conservatively with high fluid intake, diet low in protein and salt as well as alkalization of urine with Urolyte U to a pH > 7.5. Six weeks later, such side effect disappeared. Our patient had developed such phenomenon: a) without significant liver or renal disease to account for cumulative toxicity, and b) with a conventional dosage range of d-P. Such isolated toxicity indicates inherited a predisposition to this side effect. Conclusion: DI is a potential side effect of d-P therapy that is nephrogenic in site, transient in prognosis and an isolated phenomenon likely to reflect genetic predisposition.

关键词： Diabetes Insipidus D-Penicillamine Cystinuria Genetic Side Effect

The Beneficial Effect of Renin-Angiotensin-aldosterone System Blockade in Treatment of Hypertension, Resistant to Conventional Antihypertensives, in Patients on Maintenance Hemodialysis

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Open Journal of Nephrology 2023年第2期13卷 67-73页

作者： Kamel El-Reshaid shaikha al-Bader Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Nephrology Amiri Hospital Ministry of Health (Kuwait) Kuwait City Kuwait

Background: Hypertension (HTN) is present in up to 90% of end stage kidney disease (ESRD) patients irrespective of the etiology of their kidney disease. Moreover, it is an important modifiable risk factor for progression to ESRD and its overall cardiovascular morbidity and mortality. Objective: to evaluate, prospectively, the role of Renin-Angiotensin-aldosterone System blockade (RAAS) in HTN, resistant to 3 conventional antihypertensives, in patients on maintenance hemodialysis (MHD). Patients and methods: A total of 52 such patients were treated with Ramipril and 5 with Losartan after intolerable cough/shortness of breath following Ramipril-use. None of the patients had fluid depletion, renal artery stenosis and primary endocrinopathy. The study group was compared to a matched control group of MHD patients with normal blood pressure following 3 drugs-combination therapies. Results: all patients, with resistant HTN, had significant activation of RAAS system prior to treatment compared to inactive one in the control group. In those with resistant HTN, control of HTN, was established within 2 weeks of therapy and was associated with suppression of the RAAS. Such therapy was associated with minor side effects. Conclusion: Our study has shown that RAAS blockade is safe and effective in controlling such resistant HTN in MHD patients.

关键词： ACEI aldosterone Angiotensin ARB Hemodialysis Hypertension Renin Resistant Hypertension

A Problem-Solving in a Case of Medullary Nephrocalcinosis

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Open Journal of Nephrology 2022年第2期12卷 214-221页

Medullary Nephrocalcinosis (MNC) is defined as calcium deposition in tubular basement membrane and interstitium of the kidney medulla. It is 20 times more common than cortical one. In this case report, we present a 12-year-boy who presented with persistent nocturnal enuresis for 8 years. Physical examination and routine tests were normal except for microscopic hematuria. Renal ultrasound showed extensive MNC. Twenty-four-hour urine collection revealed normal mineral metabolic screen with low urinary excretion of calcium, phosphorous, magnesium and uric acid yet high for oxalates. Hence, and based on the above-mentioned data, certain metabolic disorders were ruled out: 1) hyperparathyroidism, 2) excessive intake of vitamin D, 3) hypercalcemia, 4) hypercalciuria, 5) hyperuricemia, 6) hyperuricosuria, 7) hypocitraturia, 8) cystinuria, 9) lysinuria and 10) distal renal tubular acidosis were ruled out. Subsequently, urine testing showed high concentration of glycolate with low glycerate and 4-hydroxy-2-oxoglutarates establishing diagnosis of type 1 primary hyperoxaluria (PH I). Further confirmatory tests included: 1) kidney biopsy which showed typical crystals deposition, 2) liver biopsy that confirmed deficiency of the liver-specific peroxisomal enzyme alanine: glyoxylate aminotransferase (AGXT), and 3) full gene analysis that confirmed gene mutation. In conclusion, our case report provides practical algorithm for establishing diagnosis in MNC which is not renal-limited and its prognosis depends upon the underlying etiology.

关键词： Hypercalcemia Hypercalciuria Medullary Nephrocalcinosis Mutation Primary Hyperoxaluria

Reversible Chronic Interstitial Nephritis Induced by Tacrolimus —Tacrolimus Chronic Interstitial Nephritis

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Open Journal of Nephrology 2023年第1期13卷 1-5页

Calcineurin inhibitors (CNI) are potent immunosuppressive agents in prophylaxis against graft rejection and autoimmune diseases including primary glomerulopathies. Previous research showed reversible;acute afferent arteriolar vasculopathy and irreversible chronic interstitial fibrosis associated with CNI nephrotoxicity. In this case report we describe a patient, with minimal change disease, that had developed chronic and progressive renal disease while receiving therapeutic dose of Tacrolimus. His serum creatinine had reached 537 umol/L and his nephrotic state worsened. Kidney biopsy showed chronic interstitial nephritis. Tacrolimus was discontinued and he was treated with 1 mg/kg prednisone in addition to Mycophenolate mofetil (MMF) 1 g twice daily. By the 2nd month;serum creatinine returned to normal and by the 3rd month serum albumin too. After 1 month of therapy;the dose of Prednisone was tapered down gradually till 5 mg daily by the end of 3rd month. Moreover, the dose of MMF was reduced to 500 mg X2 by the end of 3rd month. After 2 years of follow up;he remained stable and without relapse of NS or renal failure. In conclusion, reversible renal disease, due to chronic interstitial nephritis can be induced by CNI which is amenable to treatment with Prednisone and MMF.

关键词： Calcineurin Inhibitors Mycophenolate Mofetil Tacrolimus Interstitial Nephritis Minimal Change Disease Nephrotic Syndrome