The quality of life after trans oral video-assisted thyroidectomy and cervical thyroidectomy: a systematic review and meta-analysis.

Trans oral video-assisted thyroidectomy (TOVAT) is increasingly performed for cosmetic reasons. The quality of life after thyroidectomy is important for decision-making. This is the first meta-analysis to compare the quality of life among conventional transcervical thyroidectomies. This meta-analysis aimed to assess the same in the current literature. The authors systematically searched PubMed, Google Scholar, and EBSCO for relevant articles from the first published to December 4, 2022. The keywords endoscopic transoral via vestibular thyroidectomy, transcervical thyroidectomy, conventional thyroidectomy, scarless thyroidectomy, and quality of life were used. Out of the 482 studies retrieved, 27 full texts were reviewed, and only six fulfilled the inclusion and exclusion criteria. Patients with transoral thyroidectomy showed better quality of life that their counterparts who underwent transcervical thyroidectomy at 4-6 weeks following surgery, odd ratio, 2.26, 95% CI, 2.02-2.5, P-value <0.001. Substantial heterogeneity was observed, I2 for heterogeneity, 100%. The quality of life was better among patients who underwent the trans oral video-assisted thyroidectomy (TOVAT) compared to their counterparts with the conventional cervical approach (surgical questionnaire). All the components of the SF-36 quality of life questionnaire were better among TOVAT compared to the conventional approach except for social and general health components, which were equal between the two arms. Further multi-center studies with larger samples and controlling for pain and the surgical curve are needed.

Periodontitis treatment (surgical and nonsurgical) effects on glycemic control: A review and meta-analysis.

Background: Periodontitis is the sixth most prevalent chronic disease. Literature suggests a relationship between diabetes and periodontitis and when coexist may aggravate each other deleterious consequences. Therefore, we aimed to assess the effects of periodontitis treatment on glycemic control. Materials and Methods: A systematic literature search was conducted in PubMed, Cochrane Library, and the first 100 articles in Google Scholar from January 2011 to October 2021. The terms periodontitis, periodontal treatment, diabetes mellitus, nonsurgical treatment, glycated hemoglobin (HbA1c) were used, with the Protean "AND" and "OR." The titles, abstracts, and references of the included studies were screened. Any discrepancy was solved by an agreement between researchers. Out of 1059 studies retrieved, 320 stands after the removal of duplication, from them, 31 full texts were screened and only 11 studies were included in the final meta-analysis. Results: In the present meta-analysis, 11 studies (1469 patients included) were pooled, and the overall effect showed that periodontitis treatment improved the HbA1c, odd ratio, -0.024, 95% confidence interval, -0.42-.06, P value, 0.009, Chi-square, 52.99. However, substantial heterogeneity was observed, P value, < 0.001, I2 for heterogeneity 81%. Conclusion: Periodontitis treatment improved the HbA1c among patients with diabetes and poor glycemic control. Screening of this common disease is important in diabetes holistic care.

Résumé Contexte: La parodontite est la sixième maladie chronique la plus répandue. La littérature suggère une relation entre le diabète et la parodontite et lorsqu'ils coexistent peuvent aggraver les uns les autres des conséquences délétères. Par conséquent, nous avons cherché à évaluer les effets du traitement de la parodontite sur le contrôle glycémique. Matériels et méthodes: Une recherche documentaire systématique a été menée dans PubMed, Cochrane Library et les 100 premières articles dans Google Scholar de janvier 2011 à octobre 2021. Les termes parodontite, traitement parodontal, diabète sucré, non chirurgical traitement, l'hémoglobine glyquée (HbA1c) a été utilisée. Avec le protéiforme " ET " et " OU ". Les titres, résumés et références des documents inclus études ont été passées au crible. Toute divergence a été résolue par un accord entre les chercheurs. Sur 1059 études récupérées, 320 stands après la suppression des doublons, parmi eux, 31 textes intégraux ont été passés au crible et seules 11 études ont été incluses dans la méta-analyse finale. Résultats: Dans le présente méta-analyse, 11 études (1469 patients inclus) ont été regroupées et l'effet global a montré que le traitement de la parodontite améliorait l'HbA1c, rapport des cotes, −0,024, intervalle de confiance à 95 %, −0,42−0,06, valeur P, 0,009, Chi-carré, 52,99. Cependant, une grande hétérogénéité a été observé, valeur P, < 0,001, I2 pour l'hétérogénéité 81%. Conclusion: Le traitement de la parodontite a amélioré l'HbA1c chez les patients diabétiques et un mauvais contrôle glycémique. Le dépistage de cette maladie courante est important dans les soins holistiques du diabète. Mots-clés: Diabète sucré, contrôle glycémique, parodontite.

The cross talk between chronotype, depression symptomatology, and glycaemic control among sudanese patients with diabetes mellitus: A case-control study.

Aim of the Study: There is an increasing awareness about chronotype and depression among patients with diabetes mellitus as commonly ignored serious association. We aimed to investigate the same among patients with type 2 diabetes mellitus and their relation to glycaemic control. Subjects' and Methods: This case-control study conducted at two diabetes centers in Omdurman, Sudan during the period from April 2019 to September 2019. Ninety-two patient with type 2 diabetes and 94 controls signed a written informed consent then interviewed using a structured questionnaire based on the morningness-eveningness scale and the 12-item general health questionnaire; A blood sample was taken for the glycated haemoglobin to assess glycaemic control. The Statistical Package for Social Silences was used for Data analysis. Results: They were 92 patients with diabetes (58.7% women) and 94 healthy control subjects (52.1% women); matched for ages (57.03 ± 8.59 for diabetic patients and 58.46 ± 10.58 years for control subjects) and sex. Morning chronotype was reported in 95.3% vs. 47.5% and intermediate chronotype was evident in 52.4% vs. 4.3% in controls and patients respectively, P < 0.05. Depression symptomatology was found in 76.1% of patients with diabetes vs. 40.4% of control subjects, P < 0.05. No association was shown between depression symptomatology, chronotype, age, sex, and HbA1c, P > 0.05. Conclusion: Sudanese patients with diabetes were more likely intermediate, less morning chronotype, and more depressed compared to their counterparts. No association was found between depression symptomatology and other patient's characters. Larger studies investigating the risk behind depression, chrono-nutrition, and social jetlag among patients with diabetes are needed.

Effects of Smokeless Tobacco Samples from Tabuk Saudi Arabia on Nitric Oxide Production: A Potential Risk for Cancer and Cardiovascular Diseases.

BACKGROUND: Smokeless tobacco (SLT) is traditionally used in Middle East countries. The several toxic constituents with potential carcinogenicity make it a serious human health risk. Literature regarding their effects on cardiac and cancer disease is lacking in Saudi Arabia. OBJECTIVE: This study was conducted to investigate the adverse effect of 11 different samples of widely used SLT varieties from the Tabuk region - Saudi Arabia, on Nitric Oxide (NO) level and their potential risk on cardiovascular health, etiology and/or progression of cancers. METHODS: Samples were collected from Tabuk, KSA and analyzed by the GC-MS technique. Nitric oxide inhibition was performed using J774.2 macrophages by the Griess method. The retrieved crystallized structure of human inducible nitric oxide synthase (iNOS) from Brookhaven Protein Data Bank Repository PDB I.D: 3E7G with 2.20Å resolution was further prepared by structure using the MOE.2019 tool. The compounds abstracted from 11 different Shammah varieties were sketched by the MOE-Builder tool. Minimization for both receptor and compounds was performed via AMBER99 and MMFF99X force field implemented in MOE. RESULTS: Nine samples (4 - 11) showed a potent suppressive effect on NO production with IC50 values ranging between (16.9-20.4 µg/mL), respectively. The samples (1 & 2) exhibited a moderate level of inhibition with IC50 ranging between 33.2 and 57.4 µg/mL, respectively. Interestingly, sample 4 consisting of compounds (13-15, 19-26, 28) that mostly belongs to the group fatty acid ester and phthalic acid ester showed the most potent suppressive effect. Molecular docking results revealed that the current local SLT constituents presented noticeable potency in different extract samples. CONCLUSION: Variable suppressive effects on NO were detected in the current SLT samples, where sample 4 was the most potent among all. The extract of the latter exhibited molecular interaction with the first shell amino acid residues of Inducible nitric oxide synthase (iNOS), which may anchor the plasticity and selectivity of the compounds present in it. The samples (4 -11) showed a potent inhibitory effect on the NO, where compound 26 (Phthalic acid ester) is common, and its adequate concentration may account for augmented biological activity. These results may effectively highlight their adverse effects on cardiovascular health and etiology and/or progression of cancer and may help in strengthening the social and governmental efforts in minimizing the use of these substances.

Dates fruits effects on blood glucose among patients with diabetes mellitus: A review and meta-analysis.

BACKGROUND & OBJECTIVE: Dates fruit is known for its great nutritional value and two to three servings of dates fruit/day are beneficial for patients with diabetes. However, some may advice against this cheap and widely available fruit consumption. Besides, 12% of the population Worldwide are either suffering or are at risk of developing diabetes, but no previous meta-analysis has assessed this important issue. Thus, the study aimed to investigate the effects of date's fruit on glycemia among patients with diabetes. METHODS: A systematic literature search was conducted in PubMed, Medline, EBSCO, Cochrane, and Google Scholar databases for trials published in English from the first published article up to December 2020. The following keywords were used: "dates fruit and glycemic control", "dates fruit and blood glucose", "dates fruit and HbA1c " without limitations regarding the date of publication. RESULTS: Out of the 942 references identified, only 10 cohorts from five full texts were included, a reduction of Fasting plasma glucose (FPG), odd ratio, -24.79, 95% CI=-34.75, -14.83 P =0.002. I2 for heterogeneity=79%, P <0.00001 and postprandial plasma glucose (PPPG), odd ratio -28.19, 95% CI=-60.66-4.29, P =<0.0001. I2 for heterogeneity=92%, P=0.09) was observed. While the effect on HbA1c was neutral, odd ratio, -.20, 95% CI=-.46 -.06, P=0.13. I2 for heterogeneity=0. %, P=0.55. CONCLUSION: Dates fruit was beneficial regarding glycemic control among patients with diabetes, physician may not need to restrict its use among patients with diabetes. The small number of the included studies and the heterogeneity observed in PPPG and FPG sub-analysis limited the current results. Further trials assessing the glycemic indices of various types of dates fruit are needed.

The relationship between coffee intake, obstructive sleep apnea risk, and type 2 diabetes glycemic control, in Tabuk City, The Kingdom of Saudi Arabia: a case-control study.

OBJECTIVES: The study aimed to assess the relationship between coffee intake, obstructive sleep apnea risk (OSA), and glycemic control among patients with diabetes mellitus. RESULTS: There were 110 patients with diabetes and 96 healthy control subjects (matched for age and sex) attending a diabetes center زinTabuk, Saudi Arabia during the period from June 2018-October 2019. Stop-Bang questionnaire was used to assess OSA risk, and Epworth Sleepiness Scale to investigate daytime sleepiness. OSA risk and daytime sleepiness were higher among patients with diabetes compared to controls (4.34 ± 1.61 vs. 2.86 ± 1.24, and 8.31 ± 4.40 vs. 6.39 ± 3.70 respectively, P < 0.5), while coffee consumption was not (4.64 ± 3.95 vs. 3.45 ± 3.06, P > 0.05). Women with diabetes were younger with short duration since the diagnosis of diabetes and consumed less coffee compared to men, P < 0.5. A negative correlation was found between coffee consumption and the duration of diabetes, while no correlation was found between coffee intake, the glycated hemoglobin, OSA risk, sex, and daytime sleepiness. Daytime sleepiness and OSA risk were commoners among patients with diabetes, they were not correlated with coffee consumption which was negatively correlated with the duration since diabetes diagnosis. Further larger multi-center studies investigating coffee intake among patients newly diagnosed with diabetes are recommended.

An evaluation of adherence to anti-diabetic medications among type 2 diabetic patients in a Sudanese outpatient clinic.

INTRODUCTION: Adherence to anti-diabetic medication is a known cornerstone in the management of type 2 diabetic patients. We sought to assess the factors associated with adherence to medication s among type 2 diabetic patients being followed up in a Sudanese outpatient clinic. METHODS: This cross-sectional study conducted among 102 patients with type 2 diabetes attending an outpatient clinic in Omdurman, Sudan during the period from June to December 2017. Participants were interviewed using a structured questionnaire to collect demographic data, number, and type of medications, polypharmacy, medications side effects, financial problems and education regarding drug used. The study of participants' adherence to anti-diabetic medications was assessed using a validated questionnaire asking the patients about the percent and self-rating of adherence (Excellent, very good, good, fair and poor). The Statistical Package for Social Sciences (SPSS) was used to compare the adherent patients and their counterparts. A P-value < 0.05 was considered significant. RESULTS: The study results summarized the following: participants (70.6% women), their mean age was (59.62±9.91) years and nearly 60.8% were housewives, their glycated hemoglobin (mean± SD) was about 10.16±3.14, 37.3%, it implies that the patients were non-adherent to medications. In addition, other groups of patients with medication but non-adherence were younger ones (55.94±9.94 vs. 61.81±9.36, P=0.04) and had shown inadequate glycemic control (11.33±3.05vs. 9.47±3.04, P=0.04), however, this group of patients has reported more drug-related side effects (57.8% vs. 28.1%) because they were taking more drugs compared to their counterparts( F=4.115, P=0.047). The present study found no statistically significant differences in the following factors such as sex, occupation, education level, financial problems and insulin use. CONCLUSION: In conclusion, the study revealed that adherence to anti-diabetic medications was sub-optimal among Sudanese type 2 diabetic patients and was associated with higher glycated hemoglobin seen among younger age groups. Besides the above, overdosing of medications and their side effects were evident.

The association between hypoglycemia and hospital use, food insufficiency, and unstable housing conditions: a cross-sectional study among patients with type 2 diabetes in Sudan.

OBJECTIVES: Hypoglycemia is associated with mortality and healthcare utilization. We aimed to assess hypoglycemia risk and Hospital use among Sudanese patients with type 2 diabetes. RESULTS: One hundred and fifty-nine patients with type 2 diabetes attending a diabetes center in Omdurman, Sudan during the period from June to September 2018were approached. A structured questionnaire based on hypoglycemia risk and Hospital use, Fasting plasma glucose (FPG) and the glycated hemoglobin (HbA1c) was used to interview the patients. Participants (age 58.13 ± 9.96 years), 4.4%, 14.5%, and 81.1% were at high, moderate, and low hypoglycemia respectively, 66% reported food insufficiency, while 15.1% had unstable housing conditions. No relationship was evident between the hypoglycemia risk, gender, unstable housing conditions, food insufficiency, fasting plasma glucose,HbA1c, and the duration since the diagnosis of diabetes. A considerable number (18.9%) of Sudanese patients with diabetes were at moderate/high risk of hypoglycemia and Hospital use, including hypoglycemia risk and hospital use assessment in the holistic care of diabetes are recommended.

Breakfast skipping, late dinner intake and chronotype (eveningness-morningness) among medical students in Tabuk City, Saudi Arabia.

INTRODUCTION: There is an increasing awareness regarding meal timing and chronotype. The present study aimed to assess breakfast skipping, late dinner intake, and chronotype among Saudi medical students. METHODS: A cross-sectional study was conducted among 169 clinical phase medical students during the period from January to May 2017. A self-administered questionnaire was used to report the frequency and timing of breakfast and dinner. In addition, the previous cumulative grade average, bedtime, wake-up time, and sleep duration during working days and weekends were reported. The chronotype was calculated from mid-sleep and wakeup time during weekends and sleep dept. The student's weight and height were measured to assess the body mass index (BMI). Participants also completed a diary detailing their sleep habits for two weeks before filling out the questionnaire. The chi-square and Pearson's correlation were used for the statistical analysis. RESULTS: Out of 169 medical students (48.5% males), their age was 22.90±1.27 years, 42% were breakfast-skippers, while 49.7% were late dinner consumers. No correlation was found between the previous cumulative grades (GPA), BMI, chronotype, and time lag in wakeup and bedtime between weekdays and weekends (p>0.005). No significant statistical differences between breakfast-skippers and late dinner consumers and their counterparts regarding GPA and chronotype. CONCLUSION: Breakfast skipping and late dinner consumption were prevalent among medical students in Tabuk, Saudi Arabia, future large sample case-control studies to assess the impact of meal timing, and chronotype on academic performance are highly recommended.

Relationship of body mass index to sleep duration, and current smoking among medical students in Tabuk City, Saudi Arabia.

BACKGROUND: Being overweight is associated with cardiometabolic risk, and lifestyles including smoking and good sleep hygiene are also implicated. We aimed to assess the dietary habit, time spent on social media, and sleep duration relationship to body mass index (BMI) among medical students in Tabuk, Saudi Arabia. METHODS: A cross-sectional study was conducted among 147 clinical phase medical students in the Medical College, University of Tabuk (Saudi Arabia) from January 2018 to May 2018. A checklist questionnaire was used to measure variables such as age, sex, smoking, level of exercise, whether taking meals and snacks regularly, eating fast food, fruit and vegetable consumption, sleep duration, time spent on social media, and breakfast skipping. Data were analyzed by IBM-SPSS version 20, using one-way ANOVA and Pearson's production-moment correlation (r). A p-value of less than 0.05 was considered statistically significant. RESULTS: Participants consisted of 51% males, mean age (Mean ± SD) was 22.90±1.27 years, sleep duration was 7.50±2.17 hours, time spent on social media was 5.54±3.49 hours, body mass index was 24.8±5.19, and breakfast skipping, fast food consumption, smoking, and regular exercise were reported in 52.4%, 87.7%, 12.9%, and 36.1% respectively. A significant negative correlation was evident between BMI and sleep duration (r= -0.185, p=0.025), cigarette smokers were more likely to be obese compared to their counterparts (27.28±6.85 vs. 24.10±4.98, p=0.018). No significant statistical relationship was evident between BMI, breakfast skipping, fast food, fruit and vegetable intake, and time spent on social media. CONCLUSION: BMI was higher among smokers and those with shorter sleep duration, there was no association between BMI and other students' characteristics. Measures to smoking quitting and good sleep hygiene are recommended.

The Outcome of Assisted Reproductive Techniques among Couples with Male Factors at Prince Khalid Bin Sultan Fertility Centre, Kingdom of Saudi Arabia.

BACKGROUND: Thirty-three percent of infertility due to paternal factors, there are an increasing proportion of couples who decide to conceive by assisted reproductive techniques (ART). The outcome prediction is pivotal for decision making. AIM: We aimed to study the pregnancy outcomes of different ART with male factors infertility. METHODS: This is retrospective cross-sectional study conducted at Tabuk, Kingdom of Saudi Arabia. One hundred fifteen patients' records reviewed using a structured checklist to collect demographic data, sperm (concentration, motility, and morphology). Female with significant infertility factor were excluded. Chi-square was used for the outcome of various ART. RESULTS: Out of 115 couples with male factors; treated by Intracytoplasmic Sperm Injection (ICSI), In Vitro Fertilization (IVF) and Intrauterine Insemination (IUI); the mean age was 35.2 ± 6.3 years for men and 29.7 ± 5.1 for females. IVF had the highest success rate overall and had a high pregnancy rate with oligospermia and asthenospermia. ICSI has a good outcome for those with azoospermia, severe oligospermia, and teratozoospermia. IUI must be tried as a first line treatment when semen concentration is more than 10 million sperm/ml. all are not significant (P > 0.05). CONCLUSION: No significant differences were reported in the pregnancy outcome between various assisted reproductive techniques, smoking, type of infertility and medication.

Risk factors associated with metabolic syndrome and cardiovascular disease among women with polycystic ovary syndrome in Tabuk, Saudi Arabia.

BACKGROUND: Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder at a reproductive age. It is associated with a high risk of metabolic syndrome (MS) and cardiovascular diseases (CVD). OBJECTIVE: To measure the prevalence of MS in women with PCOS and to assess the global cardiovascular risk (CVR) among them. METHODS: This cross-sectional study was conducted at King Khalid Hospital, Tabuk, Saudi Arabia during the period from February through December 2014. A total of 404 infertile women were randomly selected, and checked for diagnosing PCOS, MS and estimated CVD probability. Data were analyzed by IBM-SPSS version 22, using independent-samples t-test, Chi-square, and conditional logistic regression. A p-value of <0.05 was considered significant. RESULTS: MS was diagnosed in 58% and 32% of women with and without PCOS respectively (p<0.00). Results showed a statistically significant association between the two syndromes. Patients with the two syndromes showed high averages of clinical and biochemical values (p<0.00), high rate of predicted CVR, a high percentage of clustering of MS factors, and that weight-waist circumference - HDL are predictive for the occurrence of MS. CONCLUSION: PCOS is associated with the risk of development of MS, and CVD. Screening for early detection of PCOS and MS and the application of cohort studies are recommended to better explore the role of PCOS in the development of CVD and to assess the significance of interventions.

Good sleep quality is associated with better academic performance among Sudanese medical students.

BACKGROUND: There is increasing awareness about the association of sleep quality and academic achievement among university students. However, the relationship between sleep quality and academic performance has not been examined in Sudan; this study assessed the relationship between sleep quality and academic performance among Sudanese medical students. METHODS: A case-control study was conducted among 165 male and female medical students at two Sudanese universities. Excellent (A) and pass (C) academic groups were invited to respond to a self-administered questionnaire, using the Pittsburgh Sleep Quality Index (PSQI). Students also completed a diary detailing their sleep habits for 2 weeks prior to filling out the questionnaire. Various parameters of sleep quality were then compared between the two groups. RESULTS: A significant difference (p < 0.001) between the excellent and average groups was found for overall sleep quality, subjective sleep rating, bedtime later than midnight, sleep latency, and daytime dysfunction (during driving, preparing a meal, etc.). No differences were found between groups for the use of sleep medications. The mean sleeping hours was (7 ± 1.9) and (6.3 ± 1.9) for the excellent and pass groups respectively (p < 0.05). A significant difference (p < 0.001) between the excellent and average groups was found for weekday and weekend bedtime, weekend wake-up time, and weekend wake-up delay. No differences were found between groups for the weekday's wake- up time, and bedtime delay during weekends. Besides, snoring was present in 9.2 % of the excellent group versus 28 % in pass group (p < 0.005).