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On 12th December 2018, an expert meet-ing on one health framework for action on emerging zoonotic infections was held in Amman, Jordan. The meeting, orga-nized by the World Health Organization Regional Office for Eastern Mediterrane-an [WHO EMRO], reviewed the frame-work in the light of improving efficient and coordinated multisectoral "one health" approach among human health, animal and environment sectors to pre-vent, detect and respond to emerging zoonotic infection

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Objective: Mesenchymal stem cells [MSC] from various sources have the potentials to positively affect regenerative medicine.Furthermore, pre-conditioning strategies with different agents could improve the efficacy of cell therapy. This study compares the effects of an anti-inflammatory and antioxidant agent, melatonin, on protection of bone marrow-derived MSCs [BMSCs] and adipose tissue-derived MSCs [ADSCs]

Materials and Methods: In this experimental study, rat BMSCs and ADSCs were isolated and expanded. Pre-conditioning was performed with 5 ìM melatonin for 24 hours. Cell proliferation and viability were detected by MTT assay. Expression of BAX, BCL2, melatonin receptors and osteocalcin genes were evaluated by reverse transcriptase-polymerase chain reaction [RT-PCR]. Also, apoptosis was detected with tunnel assay. Osteogenic differentiation was analyzed using alizarin red staining

Results: No significant increase was found in cell viability between BMSCs and ADSCs after melatonin preconditioning. Following melatonin preconditioning, BAX expression was significantly down-regulated in both ADSCs and BMSCs [P<0.05], with the difference being more significant in ADSCs compared to BMSCs. BCL2 expression was increased significantly in both cell types after preconditioning. Metalothionine 1 and Metalothionine 2 were both upregulated significantly in the two cell types [P<0.05]. Melatonin increased osteogenesis capability through increasing osteocalcin expression. However, expression of osteocalcin in BMSCs before and after preconditioning was higher than that in ADSCs. On the other hand, melatonin expression in ADSCs was in higher levels than in BMSCs. Melatonin also improved alizarin red concentration significantly in both BMSCs and ADSCs [P<0.05]. Alizarin red staining severity increased significantly in ADSCs after preconditioning compared to BMSCs [P<0.05]

Conclusion: Here we have shown that the effects of preconditioning on melatonin expression in ADSCs are higher than those in BMSCs. These findings could be used in adoption of a proper preconditioning protocol based on the sources of MSCs in specific clinical applications, especially in bone regeneration

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Objective: Human amniotic membrane [HAM] is used as a supporter for limbal stem cell [LSC] expansion and corneal surgery. The aim of study is to use HAM extracts from healthy donors to enhance proliferation of LSCs in vitro and in vivo

Materials and Methods: In this interventional experimental study, the effective and cytotoxic doses of the amniotic membrane extract eye drops [AMEED] was assessed by adding different concentrations of AMEED [0-2.0 mg/ml] to LSC cultures for 14 days. Subsequently, the expression levels of ATP-binding cassette sub-family G member 2 [ABCG2, a putative stem cell marker], cytokeratin 3 [K3, corneal maker], K12 and K19 [corneal-conjunctival cell makers] were assessed by real-time polymerase chain reaction [PCR]. In the second step, the corneal epithelium of 10 rabbits was mechanically removed, and the right eye of each rabbit was treated with 1 mg/ml AMEED [every 2 hours [group 1] or every 6 hours [group 2]]. The left eyes only received an antibiotic. The corneal healing process, conjunctival infection, degree of eyelid oedema, degree of photophobia, and discharge scores were evaluated during daily assessments. Finally, corneal tissues were biopsied for pathologic evidences

Results: In comparison to the positive control [10% foetal bovine serum [FBS]], 0.1-1 mg/ml AMEED induced LSC proliferation, upregulated ABCG2, and downregulated K3. There were no remarkable differences in the expression levels of K12 and K19 [P>0.05]. Interestingly, in the rabbits treated with AMEED, the epithelium healing duration decreased from 4 days in the control group to 3 days in the two AMEED groups, with lower mean degrees of eyelid oedema, chemosis, and infection compared to the control group. No pathologic abnormalities were observed in either of the AMEED groups

Conclusion: AMEED increases LSCs proliferation ex vivo and accelerates corneal epithelium healing in vivo without any adverse effects. It could be used as a supplement for LSC expansion in cell therapy

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Objective: The ability to generate lung alveolar epithelial type II [ATII] cells from pluripotent stem cells [PSCs] enables the study of lung development, regenerative medicine, and modeling of lung diseases. The establishment of defined, scalable differentiation methods is a step toward this goal. This study intends to investigate the competency of small molecule induced mouse embryonic stem cell-derived definitive endoderm [mESC-DE] cells towards ATII cells

Materials and Methods: In this experimental study, we designed a two-step differentiation protocol. mESC line Royan B20 [RB20] was induced to differentiate into DE [6 days] and then into ATII cells [9 days] by using an adherent culture method. To induce differentiation, we treated the mESCs for 6 days in serum-free differentiation [SFD] media and induced them with 200 nM small molecule inducer of definitive endoderm 2 [IDE2]. For days 7-15 [9 days] of induction, we treated the resultant DE cells with new differentiation media comprised of 100 ng/ml fibroblast growth factor [FGF2] [group F], 0.5 micro g/ml hydrocortisone [group H], and A549 conditioned medium [A549 CM] [group CM] in SFD media. Seven different combinations of factors were tested to assess the efficiencies of these factors to promote differentiation. The expressions of DE- and ATII-specific markers were investigated during each differentiation step

Results: Although both F and H [alone and in combination] promoted differentiation through ATII-like cells, the highest percentage of surfactant protein C [SP-C] expressing cells [37%] were produced in DE-like cells treated by F+H+CM. Ultrastructural analyses also confirmed the presence of lamellar bodies [LB] in the ATII-like cells

Conclusion: These results suggest that hydrocortisone can be a promoting factor in alveolar fate differentiation of IDE2- induced mESC-DE cells. These cells have potential for drug screening and cell-replacement therapies

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Objective: Type 1 diabetes is caused by destruction of beta cells of pancreas. Vildagliptin [VG], a dipeptidyl peptidase IV [DPP IV] inhibitor, is an anti-diabetic drug, which increases beta cell mass. In the present study, the effects of VG on generation of insulin-producing cells [IPCs] from adipose-derived mesenchymal stem cells [ASCs] is investigated

Materials and Methods: In this experimental study, ASCs were isolated and after characterization were exposed to differentiation media with or without VG. The presence of IPCs was confirmed by morphological analysis and gene expression [Pdx-1, Glut-2 and Insulin]. Newport Green staining was used to determine insulin-positive cells. Insulin secretion under different concentrations of glucose was measured using radioimmunoassay method

Results: In the presence of VG the morphology of differentiated cells was similar to the pancreatic islet cells. Expression of Pdx-1, Glut-2 and Insulin genes in VG-treated cells was significantly higher than the cells exposed to induction media only. Insulin release from VG-treated ASCs showed a nearly 3.6 fold [P<0.05] increase when exposed to a highglucose medium in comparison to untreated ASCs. The percentage of insulin-positive cells in the VG-treated cells was approximately 2.9-fold higher than the untreated ASCs

Conclusion: The present study has demonstrated that VG elevates differentiation of ASCs into IPCs. Improvement of this protocol may be used in cell therapy in diabetic patients

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Objective: Using mesenchymal stem cells [MSCs] is regarded as a new therapeutic approach for improving fibrotic diseases.The aim of this study to evaluate the feasibility and safety of systemic infusion of autologous adipose tissue-derived MSCs [AD-MSCs] in peritoneal dialysis [PD] patients with expected peritoneal fibrosis

Materials and Methods: This study was a prospective, open-label, non-randomized, placebo-free, phase I clinical trial. Case group consisted of nine eligible renal failure patients with more than two years of history of being on PD. Autologous AD-MSCs were obtained through lipoaspiration and expanded under good manufacturing practice conditions. Patients received 1.2 +/- 0.1×106 cell/kg of AD-MSCs via cubital vein and then were followed for six months at time points of baseline, and then 3 weeks, 6 weeks, 12 weeks, 16 weeks and 24 weeks after infusion. Clinical, biochemical and peritoneal equilibration test [PET] were performed to assess the safety and probable change in peritoneal solute transport parameters

Results: No serious adverse events and no catheter-related complications were found in the participants. 14 minor reported adverse events were self-limited or subsided after supportive treatment. One patient developed an episode of peritonitis and another patient experienced exit site infection, which did not appear to be related to the procedure. A significant decrease in the rate of solute transport across peritoneal membrane was detected by PET [D/P cr=0.77 vs. 0.73, P=0.02]

Conclusion: This study, for the first time, showed the feasibility and safety of AD-MSCs in PD patients and the potentials for positive changes in solute transport. Further studies with larger samples, longer follow-up, and randomized blind control groups to elucidate the most effective route, frequency and dose of MSCs administration, are necessary [Registration Number: IRCT2015052415841N2]

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Objective: Cardiovascular progenitor cells [CPCs] are introduced as one of the promising cell sources for preclinical studies and regenerative medicine. One of the earliest type of CPCs is cardiogenic mesoderm cells [CMCs], which have the capability to generate all types of cardiac lineage derivatives. In order to benefit from CMCs, development of an efficient culture strategy is required. We aim to explore an optimized culture condition that uses human embryonic stem cell [hESC]-derived CMCs

Materials and Methods: In this experimental study, hESCs were expanded and induced toward cardiac lineage in a suspension culture. Mesoderm posterior 1-positive [MESP1+] CMCs were subjected to four different culture conditions: i. Suspension culture of CMC spheroids, ii. Adherent culture of CMC spheroids, iii. Adherent culture of single CMCs using gelatin, and iv. Adherent culture of single CMCs using Matrigel

Results: Although, we observed no substantial changes in the percentage of MESP1+ cells in different culture conditions, there were significantly higher viability and total cell numbers in CMCs cultured on Matrigel [condition iv] compared to the other groups. CMCs cultivated on Matrigel maintained their progenitor cell signature, which included the tendency for cardiogenic differentiation

Conclusion: These results showed the efficacy of an adherent culture on Matrigel for hESC-derived CMCs, which would facilitate their use for future applications

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Introduction: In terms of frequency, colorectal cancer is the 3rd cancer in Lebanon with 1093 incidences registered in 2015. However, to this date not a single screening campaign has been organized in the country. Fecal immunochemical test [FIT] is a technique being more and more advised in screening. This being said, we found it useful to organize a screening campaign using FIT in order to determine the prevalence of colorectal cancer in a population of 3000 healthy Lebanese in order to extract useful data

Material and Methods: Healthy Lebanese adults of average risk of developing colorectal cancer between 45 and 80 years old. Procedure: 3000 sampling tubes were distributed. Numerous presentations were done to explain the screening modalities and its importance. In order to preserve the sample quality, patients were asked to return the tubes within 3 days of doing the test. Once the hemoglobin quantification has been done at the medical genetics unit [UGM] of Saint-Joseph University, patients with stool hemoglobin of more than 80ng/ml were contacted and answered few questions then were asked to undergo a colonoscopy. Follow-up is still ongoing as well as sampling kits distribution

Results o Out of the 3000 distributed tests, 705 were returned [23.5 percent]. 528 were presented with enough data to be studied and out of them 459 answered the inclusion criteria. The cohort median for age was 56 years old [45-80]. Sex ratio F/M 2.3, among them 4 percent had personal cancer history, 14 percent had familial history of colorectal cancer and 20 percent underwent colonoscopies at least once in their life. Out of the 459 patients, 278 [60.5 percent] showed 0 ng/ml, 137 [29.8 percent] showed 1 to 79 ng/ml, 3 [0.6 percent] showed 80 to 99 ng/ml meaning they are at intermediate risk, 33 [7.1 percent] showed 100 to 800 ng/ml considered as a positive value and finally 8 [1.7 percent] showed over range values. Among the 44 positive patients we contacted 41, directly or by their referent physician. Out of the 8 [18 percent] colonoscopies results received so far, 5 had hemorrhoids causing false positive results. One had ulcerative ileitis. For the remaining 2, tubular adenomas of low grade were discovered, while for one of them a carcinoma was discovered

Conclusion: While it was hard for us to quantify people for whom a free FIT was proposed, the low restitution rate among those who accepted to undergo the test shows the urgent necessity of establishing sensitization and screening campaigns. This takes a particular dimension knowing that some patients with positive FIT refused further investigations

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Introduction: Skin's exposure to UV radiation mediates formation of pyrimidine dimmers repaired by nucleotide excision repair [NER]. NER deficiencies can lead to cancer [1]. This is manifested by high incidence of melanoma and non-melanoma skin cancers in Xeroderma Pigmentosum C patients, harboring mutations in NER DNA damage recognition protein XPC [2]. However, XPC was also linked to base excision repair [BER] [3]. The phenotype of XPC cells encompasses photosensitivity and accumulation of DNA damage. Therefore, we aim to develop screening method to identify RNAi and chemical products reversing the XPC phenotype and enabling repair of UV-induced DNA damage

Methods: Screening procedure consists of transfecting or treating XPC fibroblasts or keratinocytes with either RNAi Kinome or chemical library, UV irradiation then assessment of reversal. UV irradiation is subjected to platting format and disposition variables. Therefore, evaluation of XPC cells survival following different irradiation formats by MTT will allow the choice of the optimal one. As for readout for phenotype reversal the first is cell viability. Hits from the screen should increase survival if the XPC cells are photosensitive to start with. The second readout is repair of accumulated pyrimidine dimers detected by immunocytochemistry necessitating pretreatment with denaturing agent to allow access to the damaged sites. Positive hits should allow NER restoration

Results and Conclusion: Our results identified UVB lamp as optimal source for damage induction with no disposition issues in 96 well plates. However, XPC fibroblasts were not photosensitive compared to normal ruling out the use of viability as a readout for fibroblasts but not keratinocytes. For immunocytochemistry, the pretreatment of fixed cells with 3M HCL allowed the optimal assessment of DNA damage. In addition, damage accumulation was measured at the single cell level rather than whole well fluorescence by using Cellinsight technology. The next step will be the performance of the chemical and RNAi screens. Once hits that enhance NER are identified by phenotype reversal their effects on BER will be tested. Finally, treatments in 3D skin models to mimic physiologic conditions will be carried out. Products that reduce DNA damage can decrease cancer incidence in XPC patients and possibly delay its onset in normal individuals

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Background: Pancreatic adenocarcinoma [PAC] forms 85 percent of pancreatic cancers. In Lebanon the annual mortality rate is 4.3 per 100 000 persons. Data are lacking in the Lebanese population on the treatment evolution of pancreatic adenocarcinoma. We conducted a study to compare two groups of pancreatic adenocarcinoma patients through time

Methods: We randomly assigned 70 patients from NDS-UH who were diagnosed having PAC from the beginning of the year 2000 until the end of 2017. All patients were above 18 years old at time of diagnosis, with an ECOG PS of 0 or 1. All of them had not received any prior chemotherapy or radiotherapy, and they all had a locally advanced i.e. inoperable or metastatic PAC. The 70 patients were divided into 2 groups. The first group is formed by all patients diagnosed before 2010 and the second group by all patients diagnosed after 2010. The primary endpoint is the OS rate in each group. The secondary endpoints are the PFS1, PFS2, RR and the mean OS variability in each gender with time

Results: The groups of people studied in this analysis were 64.3 percent male 35.7 percent female with a mean age of 64.37 years. 58.6 percent had an ECOG-PS of 0 while the remaining 41.4 percent had an ECOG-PS of 1. 60 percent of the cancers were located in the head of the pancreas, 14.3 percent in its tail and 22.9 percent in the body. The mean size of the tumor regarding the location was 36.24 mm [body: 36.88 mm, tail: 57.4 mm, head: 30.95 mm]. The stages were divided as follow: 17.15 percent stage IIB, 24.28 percent stage III and 58.57 percent stage IV. 40 percent of the patients had metastases in the lymph nodes at diagnosis while 44.3 percent, 5.7 percent, 4.3 percent and 5.7 percent had hepatic, pulmonary, hepatic and pulmonary metastases and peritoneal carcinoses at diagnosis respectively. The mean Ca 19-9 was 16 080.8197 U/ml. Our two groups were statistically similar in terms of sex, age, ECOG PS, stages and location of the cancer in the pancreatic gland at diagnosis with identical mean WBC, LDH, Ca19-9, total and direct bilirubin and HbA1C levels at time of diagnosis. The mean glycemia level was different in the 2 groups with 132 mg/ml in the group diagnosed before 2010 versus 181.32 mg/ml in the group diagnosed after 2010 with a p value of 0.019. The mean OS was 11.5 months [95 percent CI, 7.4 to 15.5] in patients diagnosed before 2010 vs. 14.39 months [95 percent CI, 11.4 to 17.3] in patients diagnosed after 2010. The median OS was 7.3 months [95 percent CI, 4.28-10.45] in the first group vs. 12.4 months [95 percent CI, 8.15-16.64] in the second group with a p value of 0.23; p > 0.005 percent. The mean PFS1 was 10.34 months [95 percent CI, 8.05 to 12.63] after 2010 vs. 7.94 months [95 percent CI, 4.7 to 11.14] in the first group. We saw an increase of 4 months in the median PFS1 between the 2 groups with 4.27 months [95 percent CI, 3.2 to 5.2] in the first group vs. 8.23 months [95 percent CI, 5.4 to 10.9] in the second with a p value of 0.18; p > 0.005 percent. Mean PFS2 in the first group is 6.08 months [95 percent CI, 3.4 to 8.7] vs. 6.96 months [95 percent CI, 1.088 to 4.8] in the second group. Median PFS2 is 3.8 months [95 percent CI, 1.84 to 5.76] for the former group vs. 6.1 months [95 percent CI, 2.68 to 9.5] for the latter group, with a p value of 0.43; p > 0.005 percent. The response rate was higher in the group of patients diagnosed after 2010 with 37.5 percent com- pared to 20 percent in the group of patients diagnosed before 2010. When comparing the OS between genders we saw a stable OS in female patients within the 2 groups while the male groups had an increase in their OS. In the group of patients diagnosed before 2010, males had a mean OS of 10 months [95 percent CI, 5.2 to 14.8] and females had a mean OS of 14.4 months [95 percent CI, 7.1 to 21.6]. In the group of patients diagnosed after 2010, males had a mean OS of 14.1 months [95 percent CI, 9.9 to 18.2] and females a mean OS of 14.8 months [95 percent CI, 11 to 18.6]. In other terms, the MR in female remained stable with time, while it decreased in the males that were diagnosed after 2010

Conclusion: Overall, there was an absolute increase of 5.1, 3.96 and 2.3 months in the median OS, PFS1 and PFS2 respectively, between the groups of patients diagnosed before and after 2010 without any statistical significance. This lack of significance can be due to the fact that our study was based on comparing two periods of time and not different chemotherapeutic regimens as seen in all the literature

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Different cancer chemotherapeutics can work by inducing apoptosis in cancer cells. Moreover, various tumor suppressors and oncogenes play a role in regulating senescence and apoptosis [1]. Senescent cells, formed in response to chemotherapeutic drugs, facilitate protection from lymphogenesis and aid in tissue repair [2]. Yet, the accumulation and chronic persistence of these cells promote adverse effects including chemoresistance and cancer relapse [3]. This demonstrates the importance of cell fate decision, apoptosis versus senescence, in determining the efficacy of therapeutic treatment not only in tumor clearance but also its recurrence. Here we established an in vitro senescence model using SU-DHL-4 lymphoma cells [DLBCL]. Our results showed that the exposure to the chemotherapeutic drug doxorubicin induces features of cellular senescence including cell cycle arrest, regulation of the tumor suppressor p53, resistance to apoptosis, secretion of various senescence-associated factors and positive beta-galactosidase staining. In addition, those senescent cells showed resistance to the treatment with cell-permeable peptide [Bcl-2/IP3R disruptor-2 [BIRD-2]] that targets the BH4 domain of BCL-2 potentiating pro-apoptotic calcium signaling in normal lymphoma cells. This suggests a calcium-dependent mechanism by which senescent cells resist apoptosis. We also revealed using Western blot analysis that senescent cells upregulate the antiapoptotic protein BCL-2. Inhibition of this protein using the small molecule ABT-737 specifically induced apoptosis in senescent cells. Reaching the conclusion that senescent cells can be eliminated pharmacologically paves the way towards new strategies to encounter cancer relapse due to chemoresistance

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Background:Estrogen [ER] and progesterone [PR] are important factors in prognosis and treatment of breast cancer patients. Many studies suggest that disease free survival [DFS] differs when one of these receptors is positive and the other is negative. We aim to study the impact of positivity of estrogen receptors comparing with progesterone receptors on DFS in early breast cancer

Patients and Methods: Asingle institute retrospective study was performed of 224 patients with early breast cancer, stage I, II, IIIa, between 2008 and 2010. The patients underwent mastectomy or lumpectomy and received adjuvant hormone therapy. This study has two arms: Group A [patients with ER positive, PR negative n = 127]. Group B [patients with PR positive, ER negative n = 97]. The endpoint was 3-year disease free survival in both arms

Results: The 3-year disease free survival in the group A was 75.8 percent, while it was 77.2 percent in group B [p = 0.31]

Conclusion: There is no difference between the impact of estrogen receptors positivity and progesterone receptors positivity on disease free survival in the treatment of early breast cancer

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Background: Dietary habits are established in childhood and are often maintained into adulthood [Thompson RA et al., 2005]. Early childhood is the perfect time to teach children good eating habits, especially in nurseries where they spent most of their time [Dosso JA et al., 2017]. Currently, the nutrients intake of many children does not meet the dietary guidelines [Pem D et al., 2015]. Overweight/obesity is common, and increases rapidly in early childhood. Thus, nutrition education and interventions are key to improve children's health; nursery educators being the main target [Al Mohtadi RM and Al Zboon HS, 2017]

Objective: This study aims to determine the effectiveness of a nutrition education intervention on nutrition status of children aged one to three years old and nutritional knowledge of nursery educators in private and public Lebanese nurseries

Design: 137 children were assessed at baseline. Fifty-six of them were included in the study. Pre and post surveys were conducted including a demographic questionnaire addressed to nurseries' directors and a nutritional standardized questionnaire addressed to nurseries' educators. The intervention consisted of nutrition education trainings, anthropometric measurements for children and nutrition activities program during the six-month Period

Results: Results indicated an improvement in the full intervention nursery versus the minimal intervention nurseries. The prevalence of overweight children was 44.6 Percent and 36.6Percent after intervention with an improvement of 8Percent. Post intervention, the percentage of stunted children remained the same in all nurseries; children in healthy range increased from 55.3Percent to 62.5Percent and the percentage of children in excessive range decreased by 4 Percent. The intervention made a significant impact on the nutrition knowledge [p value = 0.064], with a 6.13Percent improvement between pre and post results. Results demonstrated also a lack of conformity between the offered nutrient intakes and the recommended corresponding references. This non-compliance is due to a deficiency of recommended energy [770.05 Kcal vs. 1100 Kcal] and carbohydrates intake [101.86g vs. 130g], whereas proteins [14.0Percent] and fat [33Percent] intake appears to be consistent. The dietary patterns of children revealed a carbohydrate-based diet with very few consuming a variety of fruit and vegetables. Some changes were made in the dietary choices of the children after the intervention, with the inclusion of more fruits and vegetables and decreased intake of carbohydrate-rich food

Conclusion o Results analysis indicated a need to enhance nurseries educators' nutrition knowledge and to improve the quality and quantity of food provided to children. A typical menu and directed children activities might be a good additional approach to enhance nutrition and behavioral outcomes. Parent's involvement seems a good axis for future research

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Early childhood is the perfect time to teach the child good eating habits, especially in nurseries through their educators and the offered menu. These nurseries should therefore ensure that their menus are varied and balanced. This study aims to analyze nutritionally the menus offered to children, from one to three years old in Lebanese nurseries located in Metn. For this purpose, a survey was made including a demographic standardized questionnaire addressed to nurseries heads, with another nutritional standardized questionnaire addressed to nurseries teachers and a checklist also standardized to locate the current nutritional status of nurseries. Among fifty-three visited nurseries, a sampling of thirty menus acquired was used for this analysis and the results demonstrated the lack of conformity between the offered nutrient intakes and the recommended American corresponding reference. This non-compliance is due to an excess of 28.2Percent of recommended energy intake, 23.6Percent and 51Percent respectively of carbohydrates and proteins, whereas only fat intake appears consistent. The iron intake exceeded recommendations by 39.3Percent, while zinc exceeded by 65Percent; only vitamin A intake was 46.2Percent below the recommended intake. Nurseries educators' nutritional knowledge was found to be insufficient. Accordingly, these results indicate the need to improve the quality and quantity of food provided to children in nurseries and the necessity for nurseries educators training and education in early childhood nutrition

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During infancy, children spend most of their time in child care. The aim of our study is to evaluate the nutritional knowledge level of educators and to show that nutritional education initiated in the preschool age [0 to 3 years] helps to improve children's eating habits. For this purpose, a pilot study was conducted between July 15, 2015 and October 15, 2015, covering one nursery and five educators, in which interventions have allowed educators to learn the basics of child nutrition and strategies to improve eating behaviors of children. After analyzing the results, desirable changes in eating habits of the children were noticeable, for instance an 80Percent improvement in fruit consumption and 55Percent in vegetable consumption; similarly there was a 21Percent increase in the knowledge of educators. However, despite this nutritional intervention, 80Percent of children persist to prefer sweets and treats. Thus continuous nutrition education might be the solution to this problem

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Objective: To evaluate the association between chemical exposure in salons and respiratory symptom development and evaluate pulmonary function tests [PFTs]

Design: A Cross-Sectional Prospective Study

Setting: King Abdulaziz University Hospital, Jeddah, Saudi Arabia

Method: One hundred sixty employees from 35 randomly selected salons in Jeddah from July 2017 to September 2017 were included in the study. The study consisted of two parts answering a self-administrated questionnaire and measuring PFTs

Result: One hundred sixty salon employees were included in the study, 91 [57%] reported different respiratory symptoms. Forty-four employees [28%] reported at least one respiratory symptom. However, cough, sputum, wheezing and shortness of breath were reported by only eight [5%] employees. Shortness of breath was the most common symptom reported by 71 [44%] followed by wheezing in 40 [25%]. Four main risk factors were identified: [1] having a history of respiratory disease [odds ratio [OR] 6.51]; [2] working with make-up [OR 4.3]; [3] smoking [OR 3.61]; [4] exposure to chemicals at work [OR 2.17]

Conclusion: More than half of salon employees reported respiratory symptoms in workplace. However, no significant impairment in PFTs was found. Improving the working environment and using protective devices will minimize exposure-related respiratory symptoms. Worker safety agencies and policymakers must ensure the suitability of the work environment and enforce the use of protective devices for all employees

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Background: Antenatal ultrasound [US] Estimated Fetal Weight [EFW] is an important component of antenatal care

Objective: To evaluate the accuracy and consequences of US EFW within one-week interval prior to delivery in diabetic Bahraini population

Design: A Retrospective Cohort Study. Setting: Bahrain Defence Force Hospital, Bahrain

Method: Two hundred eighty-four diabetic women deliveries were reviewed. EFW, actual birth weight, gestational diabetes and mode of delivery were documented and analyzed via stats Direct. P-value of less than 0.05 was considered significant

Result: The study population was divided into two groups. Twenty-eight [10%] yield an accurate EFW. Accurate fetal weight estimation was affected by GA, EFW and actual birth weight. Fetal gender, parity, diabetic status, maternal BMI, maternal age, mode of delivery and induction of labor was not altered by the inaccurate estimation

Conclusion: Ultrasound EFW in diabetic patient is more accurate at early gestation and for smaller fetuses

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Background: Urinary tract infection [UTI] is common in infants; it might be associated with underlying renal anomalies. Early detection and treatment are important to prevent morbidities and improve patients' outcomes

Objective: To evaluate the most common underlying organisms and the associated urological anomalies in infants with UTIs

Design: A Retrospective Study. Setting: Pediatrics Department, Salmaniya Medical Complex, Bahrain

Methods: All medical records of infants below one year of age with confirmed UTI admitted between June 2015 and June 2017 were reviewed

Results: One hundred twenty-five infants with UTI were included in the study, 85 [68%] were males. Median age was 29 days [range 2 to 329]. Fever, 74 [59.2%], and neonatal jaundice, 46 [33.6%], were the most common clinical presentation. The most common pathogens were Escherichia coli in 69 [55.2%] followed by Klebsiella pneumonia in 44 [35.2%] patients. Extended-spectrum beta-lactamase organisms were found in 44 [35.2%] patients. Recurrent UTI were documented in 15 [12%] patients. Eighty-three [66.4%] patients had renal ultrasound; 29 [23.2%] had urological anomalies. Hydronephrosis was found in 19 [15.2%] patients; 11 [8.8%] had bilateral hydronephrosis and seven [5.6%] had unilateral hydronephrosis. Vesicoureteric reflux [VUR] was seen in 15 [12%] patients; 10 [8%] had bilateral VUR

Conclusions: Escherichia coli remain the most common causative organism for UTIs in infants. Approximately one-third of infants with UTIs had urological anomalies

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Background: C-reactive protein [CRP] and erythrocyte sedimentation rate [ESR] are frequently used to aid the diagnosis of postoperative peri-prosthetic infections [PPIs] following total knee arthroplasty [TKA]. The role of using these inflammatory markers preoperatively to predict the risk of postoperative PPIs in patients undergoing TKAs has not been well documented to date

Objective: To evaluate the role and cost-effectiveness of preoperative markers; ESR and CRP in predicting postoperative PPIs in patients undergoing elective primary TKA

Design: A Prospective Study

Setting: Department of Orthopedic Surgery, Salmaniya Medical Complex, Kingdom of Bahrain

Method: All patients who underwent primary or simultaneous bilateral TKA from 1 September 2014 to 31 December 2016 were included in the study. Patients who had uncontrolled diabetes, previous surgery or septic arthritis on the same knee, or lost for follow-up were excluded. Inflammatory markers were documented 1-2 days preoperatively. Patients were followed up over a period of 12 months postoperatively. All necessary data were collected prospectively and documented. The data were analyzed using SPSS 20

Result: One hundred thirty-nine patients were included in this study. One hundred and forty-two primary TKAs were performed during the study period, three patients underwent simultaneous bilateral TKA. Eighty-seven [62.59%] patients were females and 52 [37.41%] were males. The mean age was 64 years. Ninety-five [68.34%] patients had one or more preoperative comorbidities. High preoperative levels of CRP and/or ESR were found in thirty-seven [26.62%] patients. Two [1.44%] patients developed postoperative infection and were treated successfully. No other complications were recorded

Conclusion: In our study, we found no significant link between elevated preoperative inflammatory markers and the presence of PPI. Therefore, we do not support the routine use of preoperative inflammatory markers

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Objective: To evaluate the lifestyle of students at the University of Bahrain and to determine the prevalence of diseases and behavioral risk factors

Design: A Cross-Sectional Study

Setting: University of Bahrain, Bahrain

Method: Nine hundred sixty-six students enrolled in the academic year 2011/2012 from all educational levels seeking bachelor degree at the University of Bahrain were included in the study

Result: Two hundred and thirty-eight [24.6%] males and 728 [75.4%] females were included in the study. The participants' age ranged between 18 and 21 years. Five hundred and twenty-four [54.2%] students had normal weight, 192 [19.9%] were overweight and 133 [13.8%] were obese. Eight hundred two [83%] presented with normal waist/hip ratio [WHR]. Eighty-three [34.9%] males and 81 [11.1%] females presented with central obesity. Seven [0.7%] students had high blood sugar level. Nine [3.8%] males presented with systolic blood pressure [SBP] >140 mmHg and 5 [0.7%] females presented with SBP >140 mmHg. Three hundred twenty-six [44.8%] females had anemia compared to 78 [32.8%] males. Four [1.7%] males were diabetic compared to 7 [1%] females. Five hundred and fifty-four [57.3%] students reported physical activity for thirty or more minutes/day. One hundred six [44.5%] males and 36 [4.9%] females were smokers. Two hundred twenty-nine [31.5%] females have checked their blood sugar level during the past 12 months and only 47 [19.7%] males did

Conclusion: The study emphasizes the importance of providing periodic measurements of diabetes as well as the importance of early detection of diseases and health risks. In addition, the importance of participating in regular physical activities as a prevention measure from diseases associated with a sedentary lifestyle