Objectives: Risk of malignancy index (RMI) is a mathematical formula using a combination of diagnostic modulations to predict whether an adnexal mass is benign or malignant. The aim of this study was to evaluate the diagnostic performance of RMI in differentiating benign and malignant ovarian tumors, in comparison with histopathology, the gold standard and to identify the patients with likely ovarian cancer for a referral to a specialist gynecological oncologist, for proper surgical staging and treatment. Materials and Methods: The descriptive study was done on 102 patients referred to a tertiary care center for 12 months from June 2006 to May 2007. RMI is the product of menopausal score, ultrasound score, and absolute value of serum CA-125 levels. RMI score was calculated and compared with histopathology, the gold standard. Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated for individual parameters and for RMI to assess malignancy. Chi-square test, Cohen's Kappa, and receiver operator characteristic (ROC) analysis was carried out. ROC curve was drawn to conclude on the cutoff value of RMI. Results: Analyzing the diagnostic performance of RMI, we found that RMI performed better than individual parameters in differentiating benign and malignant ovarian tumors at the cutoff score of 200. The present study gives 195 as best cutoff point for RMI to differentiate benign and malignant ovarian neoplasms. Conclusion: RMI can be used by the general gynecologists at the periphery for referral of suspected ovarian tumors to oncology centers, thus improving the survival and prognosis of women undergoing surgery for ovarian tumors.

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Background: Healthcare leadership by its very nature is essentially humanistic, and this is as critical and integral as is the leader's attention to high-quality clinical care and technical excellence. Humanistic care to employees is a requisite in organizations that wish their employees to provide humanistic care to patients. Aims: Project aimed to assess and compare perceptions of healthcare employees about humanistic care practiced by department heads in three different hospitals in Eastern Province: One Ministry of Health Hospital, Teaching Hospital - Khobar, and one private hospital. Settings and Design: Study design was cross-sectional paper-based survey done in three hospitals in Eastern Province. Materials and Methods: Target population was physicians, paramedics (nurses, therapists, technicians, and other ancillary personnel involved in medical care) who directly report to department heads. Data collection sheet was designed to assess the degree of humanistic care and Likert scale of five was used. Statistical Analysis: Data were statistically analyzed using SPSS (20). Three hospitals were compared for humanistic care offered to employees. Kruskal-Wallis test was conducted to assess significant differences of employees "perceptions between three hospitals." Statistical significance at P < 0.05 was used. Results and Conclusions: Almost all humanistic care dimensions were perceived higher in the governmental hospitals in comparison to private hospital and the difference was statistically significant (P < 0.05). Joint Commission International (JCI) Accreditation played a significant role in improving humanistic care dimensions: Interpersonal relations (124.0), respect for employees (128.0), employees involvement (126.0), employee empowerment and delegation of tasks (127.9), employee care (124.9), and work environment (130.1 ) . The difference was statistically significant (P < 0.05). JCI Accreditation improved humanistic care.

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Background: Although there are a diversity of methods proposed for cleaning complete dentures, there is still no consensus in the literature about which method is most effective for removing biofilm from acrylic resin denture base surfaces. Although chlorhexidine is mostly used, benzoic acid has emerged as an effective method of denture cleansing. This study aimed to examine the efficacy of denture soaks by benzoic acid against the colonization of Candida albicans compared to zordyl (chlorhexidine gluconate 0.2%). Materials and Methods: This is a randomized controlled trial conducted in Al-Azhar University, Assiut Branch, Faculty of Dentistry, in Egypt during a 4-month period. One hundred edentulous patients with complete dentures were assigned into two equal groups, group (1): Fifty patients given instructions to use benzoic acid for immersion of their dentures and they were given the prepared solution for free to be used, while group (2): Fifty patients used zordyl (chlorhexidine gluconate 0.2%) for denture immersion. The dentures were examined four times; before delivery of instructions, 1, 2, and 4 months after initial session of instructions. Results: It was found that household benzoic acid has inhibition effect against C. albicans. The differences in means of C. albicans counts between two groups were nonsignificant before the application of denture soaks, but they begin to be significant after 1 month of the application. The mean differences of C. albicans counts continue to be significant in the 2 ^nd and 4 ^th months of follow-up. Conclusion: This study showed that using benzoic acid for denture soak has an inhibition effects against the colonization of C. albicans on the surfaces of dentures more than using zordyl (chlorhexidine gluconate 0.2%).

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Midline diastema is the most common esthetic problem seen as a result of space discrepancy in the anterior region of the mouth. Closure of midline diastema will give the patient a better smile, good esthetics, and social confidence. Appropriate diagnosis and planning hold the key to the successful clinical outcome. The size of the diastema decides the closure with composite resin or indirect ceramic restorations that can yield excellent treatment alternative. This case reports the closure of diastema with ceramic veneer restoration from maxillary right first premolar to maxillary left first premolar except maxillary right central incisor were all ceramic restoration was considered the tooth had undergone root canal treatment. The case also highlights the closure of the black triangle or in other words restoratively driven papilla regeneration, which is a clearly visible at the 8 ^th month follow-up.

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Background: Cardiovascular disease has become the main cause of mortality and morbidity worldwide. Aims: This study was aimed to explore the association between the prevalence of hypertension among employees population and its associated risk factors in private sectors. Settings and Design: The study was cross-sectional screening campaigns by visiting every company. Materials and Methods: The sample size was 915 male employees aged 20-64 years, who voluntarily participated in the screening program. Weight, random blood glucose, and blood pressure (BP) were collected. Statistical Analysis Used: Data were analyzed using SPSS version 20 for windows. A descriptive statistics, t-test, and simple linear regression were used between the variables. Results: Forty-four percent of the participants were prehypertensive and 34% were hypertensive. There were significant differences between participants based on glucose levels, age, and body weight in systolic BP (P < 0.001), and between participants based on their age and body weight in diastolic BP (DBP) (P < 0.001). There were statistically significant differences between groups classified by occupational status (supervisor, skilled, and unskilled jobs) in age and weight (P < 0.001), as well as DBP (P = 0.049). Exercise and smoking did not affect BP. Conclusion: The findings provided limited proof that the prevalence of prehypertension and hypertension were high in male employees in the private sector in the Eastern Province of Saudi Arabia. Age, body weight, and diabetes were risk factors of hypertension.

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Myelolipoma is benign tumors composed of mature adipose tissue and normal hematopoietic elements in variable proportions. It is commonly found in adrenal glands. Extra-adrenal myelolipomas are rare. Their presentation and location can cause them to be easily confused with a malignant tumor. It is difficult to differentiate them from malignant tumors on the clinical and radiological basis alone. Histological examination offers an additional aid in confirming the diagnosis. We report a case of retroperitoneal myelolipoma in a 70-year-old male which was clinically diagnosed as liposarcoma on account of age, location, and imaging.

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Mayer-Rokitansky-Kuster-Hauser is a rare congenital anomaly of the female genital tract that may remain undiagnosed until adolescence, early adulthood, or during marital life. It is caused by embryonic growth failure resulting in agenesis or underdevelopment of the vagina or uterus or both. Satisfactory vagina creation remains a challenge, however there is no standard treatment for creating a vagina though a variety of surgical options have been tried. We present a case of laparoscopic-assisted Davydov operation in a 25-year-old female with complete congenital vagina agenesis.

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Pulmonary hernia extending into the chest wall is a rarely seen disease, occurring mostly after trauma associated with the fracture of ribs. It can present immediately after the injury or even years later. Symptoms are usually minimal and infrequent. Patient can present to us with a soft reducible bulge on the chest, moving and altering with respiration, coughing and straining, pain dyspnea, and chest infections. The diagnosis is made clinically and radiographically. Conservative management for smaller hernias with no symptoms and surgical interventions for larger, symptomatic hernias posing threats of strangulation or incarceration is indicated. We report a case of a 40-year-old male who had suffered a blunt chest trauma and later presented to us with an acquired traumatic thoracic lung hernia.

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Objective: To determine the child dental patient accompanying person to the Paediatric Dental Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria. Materials and Methods: This cross-sectional, observational study was conducted among patients attending the Paediatric Dental Clinic of University of Benin Teaching Hospital, Nigeria, between June and November 2014. Data collected include age, gender, ethnicity, socioeconomic status of the patient, accompanying person, period of visit (school calendar period, holiday period, or school public holiday), appointment time (morning or afternoon), and type of dental treatment (emergency visit, routine dental treatment, new patient assessment, and follow-up visit). Results: Data of 385 pediatric dental visits of children aged 0.18-16 years with a mean age of 8.57 ΁ 3.99 years were recorded and analyzed. The majority of the participants were Edo State indigenes, females (56.4%), aged 6-12 years (57.1%), and of high socioeconomic status. The majority (60.8%) of the children were accompanied by their mother. Both parents were the main accompanying person of children aged 0-5 years, nonparents for the indigenous children, and fathers in emergency visits. Conclusion: Data from this study revealed mothers as the dominant child dental patient accompanying person. There existed a statistically significant difference among accompanying person, age of patient, ethnicity, and type of treatment.

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