Background: The cultural norms of the Kingdom of Saudi Arabia do not encourage men to choose nursing as a career. Understanding male nursing students' experiences of their clinical exposure to the nursing profession throughout their internship might increase their retention. This study explored the experiences of final-year male nursing students as they transitioned to the role of registered nurse. Methods: A qualitative descriptive research design with an inductive content-analysis approach was used. The experiences of 22 final-year male nursing students from three public hospitals in a major city of Saudi Arabia were explored. The data were collected using focus-group interviews and documentary analysis in March 2015 and May 2015. Results: Content analysis revealed three major themes: the societal and cultural image of male nurses, male students' engagement in nursing practice, and restructuring the internship programmes' policies to suit male students' needs. Conclusion: The findings reveal issues that mainly stem from negative social views of nursing as a male profession. Considering the students' social and cultural needs during their internship programme will facilitate their transition into the role of registered nurse and their retention in the nursing profession.

Objective:To evaluate the in vitro cytotoxic activity of the fractionated extract as well as isolated compounds of Arum palaestinum Boiss. (A. palaestinum) (black calla lily), and to identify the volatile components which may be responsible for the potential antitumor activity. Methods: A. palaestinum was collected from its natural habitats and subjected to phytochemical analysis for separation of pure compounds. In vitro cytotoxic activity was investigated against four human carcinoma cell lines Hep2, HeLa, HepG2 and MCF7 for the fractionated extract and isolated compounds. While, the diethyl ether fraction was subjected to GC–MS analysis as it exhibited the most potent cytotoxic effect to evaluate the active constituents responsible for the cytotoxic activities.
Results:Four flavonoid compounds were isolated (luteolin, chrysoeriol, isoorientin, isovitexin) from the diethyl ether and ethyl acetate. The extracts and the pure isolated compounds showed a significant high antiproliferative activity against all investigated cell lines. The GC–MS analysis revealed the separation and identification of 15 compounds representing 95.01%of the extract and belonging to different groups of chemical compounds.
Conclusions:The present study is considered to be the first report on the cytotoxic activities carried out on different selected fractions and pure compounds of A. palaestinum to provide evidences for its strong antitumor activities. In addition, chrysoeriol and isovitexin compounds were isolated for the first time from the studied taxa.

Purpose: The purpose of this study was to evaluate the efficiency of multiple abdominal fat indices as measured via ultrasonography for predicting the presence and severity of carotid artery atherosclerosis and to compare the predictive capacity of ultrasonographic measurements to that of anthropometric measurements. Methods: A total of 92 patients were included in this study. All participants underwent clinical and laboratory assessments, and anthropometric measurements were obtained. Ultrasound examinations were performed to measure the values of all abdominal fat indices and the intimamedia thickness, as well as to detect the presence of atherosclerotic plaques. Univariate and multivariate logistic regression analyses were performed. Results: In the multivariate analysis, significant associations were detected between carotid artery atherosclerosis and posterior right perinephric fat thickness (PRPFT) (hazard ratio [HR], 15.23; P<0.001), preperitoneal fat thickness (PPFT) (HR, 4.31; P=0.003), visceral adipose tissue volume (VAT) (HR, 7.61; P<0.001), visceral fat thickness (VFT) (HR, 8.84; P<0.001), the ratio of VFT to subcutaneous fat thickness (VFT/SCFT) (HR, 9.39; P<0.001), and waist-to-height ratio (WHtR) (HR, 2.65; P=0.046). In the multivariate analysis, significant associations were also detected between carotid artery plaque and PRPFT (HR, 7.09; P<0.001), the abdominal wall fat index (AFI) (HR, 3.58; P=0.010), and VFT/SCFT (HR, 4.17; P=0.006). Conclusion Many abdominal fat indices as measured by ultrasound were found to be strong predictors of carotid artery atherosclerosis, including PRPFT, VFT/SCFT, VFT, VAT, PPFT, and WHtR. Moreover, PRPFT, VFT/SCFT, and AFI were identified as strong predictors of the presence of carotid artery plaque.

BACKGROUND: Many oral presentations of osteoporosis-a bone metabolic disease-were recorded. Thus, we aimed to assess panoramic radiomorphometric indices with bone mineral density (BMD) values among Saudi postmenopausal women and its importance in the prediction of osteoporosis. METHODS: A total of 431 Saudi women were enrolled in this study. Panoramic radiographs were obtained at the time of BMD measurement. Subjects were fatherly classified into; normal BMD, osteopenia, and osteoporosis groups. Serum follicle-stimulating hormone, luteinizing hormone (LH), estradiol (E2), 25-hydroxy-vitamin D (25[OH]D) and intact-parathyroid hormone were measured. Moreover, serum creatinine, calcium, and phosphate, together with serum osteocalcin (s-OC), procollagen type I N-terminal propeptide (s-PINP) and cross-linked C-terminal telopeptide of type 1 collagen (s-CTX) were measured. Receiver-operator curve (ROC) curve analysis for use of mandibular cortical width (MCW), panoramic mandibular index (PMI), and maxillary-mandibular ratio (M/M ratio) to differentiate women with osteoporosis or osteopenia from normal subjects was calculated. Cut off values of 4.6 at T score <−1 and 4.1 at T score ≤−2.5 were used. RESULTS: Body mass index is significantly low in the osteoporotic group. There is no significant difference in serum levels of LH, E2, calcium, phosphate, and 25(OH)D between the studied groups. Moreover, s-OC, C-terminal propeptide of procollagen type I, s-PINP, s-CTX, and urinary-CTX are significantly higher in osteoporosis than normal and osteopenia groups. ROC curve analysis revealed that MCW and PMI showed significant data while M/M ratio is non-significant. CONCLUSIONS: It could be concluded that MCW as an important panoramic radiographic parameter can be used for prediction and diagnosis of osteoporosis in postmenopausal Saudi women with low BMD.
Body Mass Index ; Bone Density ; Bone Diseases, Metabolic ; Calcium ; Collagen Type I ; Creatinine ; Diagnosis ; Estradiol ; Female ; Follicle Stimulating Hormone ; Humans ; Luteinizing Hormone ; Osteocalcin ; Osteoporosis* ; Postmenopause ; Radiography, Panoramic ; ROC Curve ; Saudi Arabia

PURPOSE: We evaluated and compared the effectiveness of an enuresis alarm, desmopressin medication, and their combination in the treatment of Saudi children with primary monosymptomatic nocturnal enuresis (PMNE). MATERIALS AND METHODS: A total of 136 children with PMNE were randomly assigned to receive an enuresis alarm alone (EA group, n=45), desmopressin alone (D group, n=46), or a combination of both (EA/D group, n=45). Patients were followed weekly during treatment and for 12 weeks after treatment withdrawal. RESULTS: During treatment, wetting frequencies were significantly reduced in all groups and remained significantly lower than pretreatment values until the end of follow-up. In the D and EA/D groups, an immediate reduction in wetting frequencies was observed, whereas a longer time was required to reach a significant reduction in the EA group. The full and partial response rates were 13.3% and 37.8% in the EA group, 26.1% and 43.5% in the D group, and 40.0% and 33.3% in the EA/D group. A significant difference was observed only between the EA and EA/D groups (p=0.025). Relapse rates were higher in the D group (66.6%) than in the EA (16.6%) and EA/D (33.3%) groups. A significant difference was observed between the D and EA groups only (p=0.019). CONCLUSIONS: Desmopressin, an enuresis alarm, and combined therapy are effective in the treatment of Saudi children with PMNE. Desmopressin produced an immediate effect but relapses were common. The enuresis alarm provided gradual effects that persisted posttreatment. The combined therapy was superior to the alarm in achieving an immediate response; however, its effect was not better than that of the alarm long term.
Child* ; Combined Modality Therapy ; Deamino Arginine Vasopressin* ; Enuresis* ; Follow-Up Studies ; Humans ; Nocturnal Enuresis* ; Recurrence ; Treatment Outcome

Objective:To develop HPTLC fingerprint profile of anti-inflammatory active extract fractions of Tribulus terrestris (family Zygophyllaceae).
Methods:The anti-inflammatory activity was tested for the methanol and its fractions (chloroform, ethyl acetate, n-butanol and aqueous) and chloroform extract of Tribulus terrestris (aerial parts) by injecting different groups of rats (6 each) with carrageenan in hind paw and measuring the edema volume before and 1, 2 and 3 h after carrageenan injection. Control group received saline i.p. The extracts treatment was injected i.p. in doses of 200 mg/kg 1 h before carrageenan administration. Indomethacin (30 mg/kg) was used as standard. HPTLC studies were carried out using CAMAG HPTLC system equipped with Linomat IV applicator, TLC scanner 3, Reprostar 3, CAMAG ADC 2 and WIN CATS-4 software for the active fractions of chloroform fraction of methanol extract.
Results:The methanol extract showed good antiedematous effect with percentage of inhibition more than 72%, indicating its ability to inhibit the inflammatory mediators. The methanol extract was re-dissolved in 100 mL of distilled water and fractionated with chloroform, ethyl acetate and n-butanol. The four fractions (chloroform, ethyl acetate, n-butanol and aqueous) were subjected to anti-inflammatory activity. Chloroform fraction showed good anti-inflammatory activity at dose of 200 mg/kg. Chloroform fraction was then subjected to normal phase silica gel column chromatography and eluted with petroleum ether-chloroform, chloroform-ethyl acetate mixtures of increasing polarity which produced 15 fractions (F1-F15). Only fractions F1, F2, F4, F5, F7, F9, F11 and F14 were found to be active, hence these were analyzed with HPTLC to develop their finger print profile. These fractions showed different spots with different Rf values.
Conclusions:The different chloroform fractions F1, F2, F4, F5, F7, F9, F11 and F14 revealed 4, 7, 7, 8, 9, 7, 7 and 6 major spots, respectively. The results obtained in this experiment strongly support and validate the traditional uses of this Sudanese medicinal plant.

BACKGROUND: Magnesium is one of the effective, safe local anesthetic adjuvants that can exert an analgesic effect in conditions presenting acute and chronic post-sternotomy pain. We studied the efficacy of continuous infusion of presternal magnesium sulfate with bupivacaine for pain relief following cardiac surgery. METHODS: Ninety adult patients undergoing valve replacement cardiac surgery randomly allocated into three groups. In all patients; a presternal catheter was placed for continuous infusion of either 0.125% bupivacaine and 5% magnesium sulfate (3 ml/h for 48 hours) in group 1, or 0.125% bupivacaine only in the same rate in group 2, versus conventional intravenous paracetamol and ketorolac in group 3. Rescue analgesia was iv 25 µg fentanyl. Postoperative Visual Analog Scale (VAS) and fentanyl consumption during the early two postoperative days were assessed. All patients were followed up over two months for occurrence of chronic post-sternotomy pain. RESULTS: VAS values showed high significant differences during the first 48 hours with the least pain scale in group 1 and significantly least fentanyl consumption (30.8 ± 7 µg in group 1 vs. 69 ± 18 µg in group 2, and 162 ± 3 in group 3 respectively). The incidence of chronic pain has not differed between the three groups although it was more pronounced in group 3. CONCLUSIONS: Continuous presternal bupivacaine and magnesium infusion resulted in better postoperative analgesia than both presternal bupivacaine alone or conventional analgesic groups.
Acetaminophen ; Adjuvants, Anesthesia ; Adult ; Analgesia ; Bupivacaine ; Catheters ; Chronic Pain ; Double-Blind Method ; Fentanyl ; Humans ; Incidence ; Ketorolac ; Magnesium Sulfate ; Magnesium ; Thoracic Surgery ; Visual Analog Scale

OBJECTIVES: To compare the flexural cyclic fatigue resistance and the length of the fractured segments (FLs) of recently introduced M-Pro rotary files with that of RaCe rotary files in curved canals and to evaluate the fracture surface by scanning electron microscopy (SEM). MATERIALS AND METHODS: Thirty-six endodontic files with the same tip size and taper (size 25, 0.06 taper) were used. The samples were classified into 2 groups (n = 18): the M-Pro group (M-Pro IMD) and the RaCe group (FKG). A custom-made simulated canal model was fabricated to evaluate the total number of cycles to failure and the FL. SEM was used to examine the fracture surfaces of the fragmented segments. The data were statistically analyzed and comparisons between the 2 groups for normally distributed numerical variables were carried out using the independent Student's t-test. A p value less than 0.05 was considered to indicate statistical significance. RESULTS: The M-Pro group showed significantly higher resistance to flexural cyclic fatigue than the RaCe group (p < 0.05), but there was no significant difference in the FLs between the 2 groups (p ≥ 0.05). CONCLUSIONS: Thermal treatment of nickel-titanium instruments can improve the flexural cyclic fatigue resistance of rotary endodontic files, and the M-Pro rotary system seems to be a promising rotary endodontic file.
Continental Population Groups ; Fatigue ; Humans ; In Vitro Techniques ; Microscopy ; Microscopy, Electron, Scanning

BACKGROUND: Loss of the dental and paradental tissues resulting from trauma, caries or from systemic diseasesconsidered as one of the most significant and frequent clinical problem to the healthcare professionals. Great attempts havebeen implemented to recreate functionally, healthy dental and paradental tissues in order to substitute dead and diseasedtissues resulting from secondary trauma of car accidents, congenital malformations of cleft lip and palate or due to acquireddiseases such as cancer and periodontal involvements.METHOD: An extensive literature search has been done on PubMed database from 2010 to 2019 about the challenges ofengineering a biomimetic tooth (BioTooth) regarding basic biology of the tooth and its supporting structures, strategies,and different techniques of obtaining biological substitutes for dental tissue engineering. RESULTS: It has been found that great challenges need to be considered before engineering biomimetic individual parts of thetooth such as enamel, dentin-pulp complex and periodontium. In addition, two approaches have been adopted to engineer aBioTooth.The first one was to engineer a BioTooth as an individual unit and the other was to engineer a BioToothwith its supporting structures. CONCLUSION Engineering of BioTooth with its supporting structures thought to be in the future will replace the traditionaland conventional treatment modalities in the field of dentistry. To accomplish this goal, different cell lines and growthfactors with a variety of scaffolds at the nano-scale level are now in use. Recent researches in this area of interest arededicated for this objective, both in vivo and in vitro. Despite progress in this field, there are still many challenges ahead andneed to be overcome, many of which related to the basic tooth biology and its supporting structures and some others related tothe sophisticated techniques isolating cells, fabricating the needed scaffolds and obtaining the signaling molecules.

BACKGROUND: Loss of the dental and paradental tissues resulting from trauma, caries or from systemic diseasesconsidered as one of the most significant and frequent clinical problem to the healthcare professionals. Great attempts havebeen implemented to recreate functionally, healthy dental and paradental tissues in order to substitute dead and diseasedtissues resulting from secondary trauma of car accidents, congenital malformations of cleft lip and palate or due to acquireddiseases such as cancer and periodontal involvements.METHOD: An extensive literature search has been done on PubMed database from 2010 to 2019 about the challenges ofengineering a biomimetic tooth (BioTooth) regarding basic biology of the tooth and its supporting structures, strategies,and different techniques of obtaining biological substitutes for dental tissue engineering. RESULTS: It has been found that great challenges need to be considered before engineering biomimetic individual parts of thetooth such as enamel, dentin-pulp complex and periodontium. In addition, two approaches have been adopted to engineer aBioTooth.The first one was to engineer a BioTooth as an individual unit and the other was to engineer a BioToothwith its supporting structures. CONCLUSION Engineering of BioTooth with its supporting structures thought to be in the future will replace the traditionaland conventional treatment modalities in the field of dentistry. To accomplish this goal, different cell lines and growthfactors with a variety of scaffolds at the nano-scale level are now in use. Recent researches in this area of interest arededicated for this objective, both in vivo and in vitro. Despite progress in this field, there are still many challenges ahead andneed to be overcome, many of which related to the basic tooth biology and its supporting structures and some others related tothe sophisticated techniques isolating cells, fabricating the needed scaffolds and obtaining the signaling molecules.