Introduction: In the wake of fast paced life and cut throat competitions, students are under high academic pressure. Neuroendocrine system plays a vital role not only in supporting normal physiological function but also during stress. It influences the endocrine and reproductive system to help in adaptation and maintains homeostasis in response to stressors. Material and Methods: Study was done on 100 female college students (50 medical and 50 non-medicals). Based on the questionnaires each participant was evaluated for level of stress and variations in menstrual patterns like length, duration, dysmenorrhoea, premenstrual tension etc. Result: Significant association was observed between the level of stress and presence of premenstrual symptoms (P = 0.002). Higher stress was associated with passage of clots (P = 0.01), painful periods (P = 0.012) and the presence of premenstrual symptoms (P = 0.002). Higher number of medicos suffered from premenstrual symptoms compared to non-medical students (60%, 40%, P = 0.046). Conclusion: A strong association was observed between stress and premenstrual symptoms. There is no difference in medical and non-medical students either in the stress level perceived or in any of the menstrual complaints except for premenstrual tension (P = 0.046) which may be as 62% of medical students perceived above average or higher level of stress compared to 50% non-medicos.

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Background: Alopecia areata (AA) is one type of hair loss that typically causes patches of baldness. In some cases, total baldness develops. There are no adequate studies concerning AA on the Taif area residents, KSA. Aim: The present study conducted for the first time prevalence, causes and treatment of AA in Al-Taif area, KSA. Materials and Methods: A questionnaire employed to determine the prevalence of AA in patients attending dermatology clinics in Al-Taif area. The doctors questioned about the number of patients attend dermatology clinics and suffering from AA. Doctors also were asked about types, causes of AA and the treatment/responsiveness. The data collected and analysed statistically. Results: The obtained results showed a noticeable prevalence of AA in Al-Taif area; 6.750% in males and 6.375% in females. Localized AA was the most common (88.75%) as well as the most responsive to the treatment. The emergence of disease was mostly related to the immune system (85%). The Doctors preferred topical corticosteroids or minoxidil plus systemic vitamins and minerals treatment more than others due to its effectiveness (90%, 40% responsiveness in localized and diffused respectively). Conclusion: We concluded that, the incidence of AA disease in Al-Taif area, exceeded expectations and the autoimmune condition is the most predominance reason for its occurrence. The most effective treatment was topical corticosteroids plus systemic vitamins and minerals. Recommendations: We recommend a vitamin-rich diet as well as an increased emphasis on the use of topical rubefacient herbs in addition to the above mentioned treatments of AA.

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Background: Poor access and utilisation of antenatal services contribute to high Maternal Mortality Rate (MMR) along with other socioeconomic factors. Objectives: To evaluates the utiliation of ante natal care (ANC) services and it's determinants among full term pregnant women and recently delivered women. Materials and Methods: A cross sectional study was conducted among 380 full-term ante natal women and recently delivered women (RDW) admitted in obstetric ward of a tertiary care hospital of Kolkata between February 2014 to July. 2014 using a predesigned pretested schedule. Results: About 47.11% of the study population were between the age of 20-30 years; 68.95% were Hindu; 55.53% belonged to nuclear family; 60.53% were from rural area; 53.42% were multipara; 89.47% were literate; 63.95% were homemakers; 28.95% belonged to class III. Cent percent registered for ANC); 91.05% took three ANC visits; 65.26% registered during the first trimester; weight and blood pressure was measured in 99.74% and 98.95% respectively; 99.2% had an abdominal examination; 100% received Tetanus Toxoid (TTTT); 43.96% consumed 100 Iron Folic Acid (IFA) tablets; 97.63% had blood test for Haemoglobin and blood typing; 92.11% had blood test for VDRL; 100% had an urine examination for albumin. All of the subjects was advised about diet and immunisation; 97.89% for rest/sleep; 82.89% for physical activity; 27.89% for personal cleanliness; 27.37% for family planning; 49.21% for breastfeeding and newborn care and 66.05% for warning signs. When comparison between women who went for at least four ANC visits and who did not significant difference was observed in terms of age, educational level, socio-economic status (SES), timing of registration and parity. Conclusion: At this stage of pregnancy, women are usually more receptive to their advices. This opportunity may be utilised today for the sake of a better maternal health tomorrow.

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Background: Postictal psychosis (PIP) represents 25% of the psychoses seen in epileptic patients. There is a paucity of Indian studies on PIP. Aim: To study the clinical correlates and treatment response of patients with PIP. Materials and Methods: Consecutive patients with PIP, diagnosed according to criteria of Logsdail and Toone (1988), admitted to two tertiary care teaching hospitals were included in the study with their informed consent. After recording detailed history, examination and investigation patients were treated and followed-up. Results: The study included clinical details of 28 patients (24 male and 4 female) with PIP. Psychoses were usually precipitated by a run of seizures. The seizures were partial complex in 15 and generalised tonic clonic in 13 patients. Follow-up details were available in all cases for periods ranging from 3 months to 2 years. The length of psychosis varied from one to 79 days (mean 20.5 days), although ten patients had recovered within 1 week. All patients were confused at onset of psychosis. The episodes were characterised by pleomorphic psychotic phenomena, dominated by marked and varied mood changes and low incidence of schizophreniform phenomenology. Electroencephalogram (EEG) examination of the patients showed abnormalities in 26 patients, while two had normal EEG. Computed Tomography (CT) scan showed abnormality three patients. All patients received antiepileptic drugs. In addition 17 were treated with antipsychotics, two with antipsychotics plus antidepressants, while two received antipsychotics and ECT. Majority of the patients responded well to therapy though psychoses recurred in two. Two patients developed a chronic psychosis after the first post-ictal episode and continued to show residual symptoms for more than 2-3 months. Conclusion: Post-ictal psychoses are short lasting disorders of good prognosis.

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Introduction: The palate has also been of interest in orthodontic literature because palatal dimensions often need to be altered during orthodontic or orthognathic surgical treatment. Aim: This present study was conducted to assess the palatal dimensions of a Yemeni adults sample aged (18-26) years. Study and Design: Cross-sectional comparative study. Materials and Methods: The investigation involved clinical examination of (1285) subjects of whom only (287) were selected (141 females, 146 males) to fulfill the criteria for the study sample. Study models were constructed and evaluated to measure palatal width and length using the modified sliding caliper gauge and a Paltometer to measure the palatal depth. Statistical Analysis: Data were analyzed by using SPSS version 13. Descriptive analyses were conducted to determine the mean, standard deviation (SD) and coefficient of variation (CV) of the study variables. Independent sample t-test was applied to test the level of significance between the mean for female and male for all palatal dimensions. Results: The mean (SD) of palatal width and depth in male was 41.7 (2.8) and 21.2 (1.5) while in female was 39.1 (2.3) and 20.7 (1.4) respectively. On other hand, the length of the palate seems to be larger in female 30.4 (2.04), when compared with that of male 29.01 (2.01), and these differences are considered statistically significant at P < 0.05 significant level. Conclusion: Based on study results, the palatal morphology of Yemeni population is averaged in size and confirms the accepted view that male have greater palatal size than female only in the transverse and vertical dimensions.

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Objectives: This study was performed to observe the type and level of fluoride compounds existent in 'over-the-counter' (OTC) adult toothpastes available in the open market of Saudi Arabia and to compare them with local and international guidelines. Materials and Methods: More than 100 hyper stores, shops and pharmacies of Dammam and Al Khobar cities were selected randomly and searched for the availability of fluoride containing adult toothpastes. Only toothpastes in which fluoride was present as an active ingredient were included and name of the compound of fluoride and its concentration stated on the packaging of the toothpaste were noted. Results: There were 59 different commercial brands of OTC toothpastes in which sodium fluoride was found in 59.3% of the toothpaste brands (35 of 59), 32.2% of the brands (19 of 59) had sodium monofluorophosphate, 3.3% toothpaste brands (2 of 59) had a combination of sodium fluoride and sodium monofluorophoshpate as an active ingredient, and 5% of the brands (3 of 59) mentioned the fluoride concentration in parts per million (ppm) but did not indicate the type of compound of fluoride present in them. Fluoride concentration found in toothpastes ranged between 1,000-1,470 ppm. Conclusions: Types of fluoride compounds found in toothpastes were consistent with internationally published guidelines. However, majority of toothpastes had 1,450 ppm fluoride which was consistent with Gulf Cooperation Council (GCC) and European guidelines but exceeded the normal range set by United States Food and Drug Administration (US-FDA) and American Dental Association (ADA). Care should be taken when these toothpastes are being used to prevent possible side-effects of fluoride over-exposure.

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Background: Cervical cancer is the sixth on the list of the most widespread cancers in Saudi Arabia. It is a preventable disease. Identifying risk factors may suggest prevention strategies. Aims: Study aimed to determine incidence of abnormal cervical cytology for the period (2004-2013) and identify its risk factors. Settings: Study was conducted in the university hospital in Khobar. Design: Study was case- control, hospital- based. Materials and Methods: Cases were Saudis with 'abnormal Pap smear' and controls were healthy Saudis. Independent variables (socio-demographic and obstetrics and gynaecology history) were collected from patients' charts and hospital database. Incidence of abnormal cervical cytology was calculated using hospital statistics. Binary logistic regression was used to model predictors of abnormal cervical cytology. Odds ratio and 95% confidence interval (CI) were calculated. Five percent (%) level of significance was used. Stepwise logistic regression was applied to identify predictors of abnormal cervical cytology. Results: Incidence of abnormal cervical cytology in Saudi Arabia was low in comparison to other countries. Findings showed that 1.8% (129 cases during the period 2004-2013) of all women screened with Pap smear had abnormal cervical cytology and 2.5% (75 cases during the period 2004-2013) of Saudi women had abnormal Pap smear results. Risk factors associated with abnormal cervical cytology were use of intrauterine device (OR 2.851, P = 0.012) and repeated pregnancies (three or more, OR 3.116, P = 0.010). However, patients of age 30 to less than 50, patients conducted Pap smear once or more, and patients with partners using condom were protective factors. Conclusions: Early Pap smear screening should be activated for prevention of cervical cancer.

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Background and Aim: Vitamin D (VD) is well-known for its traditional but essential role in calcium homeostasis and bone metabolism. However, the evidence suggests that VD endocrine system is linked to obesity as well. In adults, an inverse relationship has been reported between adiposity and circulating VD. The purpose of present study, therefore, was to investigate the effect of VD supplementation on anthropometric indices in a population of VD deficient obese Saudi females. Materials and Methods: It was a randomised controlled trial (RCT) for which 30 vitamin D deficient obese female students were recruited from our university and divided as: 1) Vitamin D group (oral 50,000 IU cholecalciferol/week for 8 weeks and 2) Placebo group (sterile drops). Weight, height, waist and hip circumference were recorded. Body mass index (BMI) and waist-hip ratio were calculated at the beginning and in the end. Statistical Analysis: Two sample t-test, paired t-test and Pearson correlation. Results: After treatment with 50,000 IU of VD weekly for 8 weeks, a significant decrease in waist circumference was observed in VD group compared to their pre-treatment measurement (100.8 ± 8.4 vs 96.7 ± 10.4; P = 0.04), although there was no significant change in any other variables (P > 0.05). No significant differences were observed among the groups in the beginning or in the end. Serum VD levels were not significantly related to any of the anthropometric variables at baseline in both groups. Conclusions: Correction of 25 (OH) D concentrations led to significant reduction in waist circumference in VD deficient young Saudi obese female students without affecting other anthropometric indices.

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The occurrence of cervical myoma is not common, but they merit special considerations in view of their proximity to important pelvic structures, their propensity to cause complications and the technical difficulty in their removal. Herein, we report the case of a huge prolapsed cervical myoma micking cystocele in a 38-year-old woman having a history of abortive disease.

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Immune Thrombocytopenic Purpura (ITP) is an autoimmune disorder which is characterized by low circulating platelets with an increased susceptibility to recurrent infections. Treatment with immunosuppressive drugs may increase the risk of infections in ITP. Delayed diagnosis because of blunted host immune response and lack of outward signs and symptoms places the treating physician at a disadvantage in the management of this type of disease. Osteoarticular infection is very rare in ITP. We present a case of acute haematogenous E. coli osteomyelitis of bilateral tibia in a patient of chronic ITP on immunosuppressive drugs. With high index of suspicion and use of Magnetic Resonance Imaging (MRI) early diagnosis was made and treated successfully.

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Background: A woman's risk at birth of having ovarian cancer at some point in her lifetime is 1-1.5% and mortality due to the disease is almost 0.5%. It accounts for 3% of all cancers in females. Despite a low contributory percentage, it remains the fifth leading cause of cancer related death. This is because most ovarian cancers are detected when they have spread beyond the ovary. Bioelectric Impedance Analysis (BIA) affords an emerging opportunity to assess prognosis because of its ability to non invasively assess cell and plasma membrane structure and function by means of phase angle. Aims: To compare the Phase Angle between patients of Ovarian Cancer and their matched control with the help of BIA. Settings and Design: After taking clearance from ethical committee a total of 33 female cases of histological proven serous cyst adenocarcinoma were included from the surgery in Patient Department, Department of surgery. Equal numbers of matched controls were recruited from the friends and relatives of cases. Subjects and Methods: BIA BODY STAT QUAD SCAN 4000 was used to measure resistance (R) and reactance (Xc) by recording a voltage drop in applied current. Phase angle is the ratio of reactance to resistance and is a measure of cell vitality. Statistical Analysis Used: Unpaired t-test and One Way ANOVA were applied. Results: In control group Phase angle showed a mean ± SEM 5.073 (0.0698) while in test group it showed a mean value ± SEM 3.536 (0.0616). Mean of stage I was 3.800 (0.1154) while that of stage II was 3.620 (0.2588). Means of stage III and IV are 3.275 (0.158) and 2.90 (0.141) respectively. One Way ANOVA was applied to see any significant differences among the phase angle values of all stages. The results were statistically significant. The smaller the phase angle values higher was the Malignant Tumours (TNM) staging. Conclusions: The phase angles differed significantly from the healthy age matched control values and also among the stages. This study demonstrated that phase angle is a strong predictor of severity and prognosis of ovarian cancer and differed significantly between the groups. Further studies are required to validate its role as a screening and prognostic tool.

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The prevalence of uterine fibroids of the female genital tract varies from 20-50% in women of reproductive age. Surgical management by myomectomy is usually reserved for the non pregnant uterus. The complication rate in fibroids coexisting with pregnancy may be 10-30%, which are preferably often managed conservatively. Red degeneration of fibroid during pregnancy is common, which respond to conservative management in majority of the cases. Those not responding to conservative treatment, myomectomy may be an option. Myomectomy in pregnancy remains a controversial issue. Counselling and comprehensive peri-operative preparations are mandatory to minimise complications We present a case of a multiple symptomatic uterine fibroids diagnosed during pregnancy which was successfully managed by antenatal myomectomy.

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A 26-years-old young man came with complaints of abnormally dark skin coloring (hyperpigmentation), particularly in the back of the hands and intertriginous folds between digits, progressively spreading since last 5 years without any family history of the same. He was diagnosed with clinical diagnosis of hyper-pigmented disorder under evaluation most probably medication induced. He had no personal and family history of such skin disease or diabetes mellitus. We received a skin biopsy of 0.3 × 0.3 cm which was totally embedded for histopathology reporting. Section studied through skin reveals epidermis, dermis and subcutaneous tissue. Epidermis shows hyperkeratosis, irregular acanthosis with focal filliform down growth of epidermis. Multiple keratin horn cysts were seen in the down growth. The tips of rete ridges showed pronounced hyperpigmentation. Histopathological impression was given as Dowling-Degos disease (DDD). DDD is a rare genetic skin condition without definite cure, although its prevalence is unknown. So we report a DDD case in a young man with clinico-pathological correlation.

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