Table of Contents

Editorials

The impact of transanal total mesorectal excision on functional outcomes: A future standard?

Isam Juma1*, Mahmood Al Masri1, Mirza Saeed1, Eric Rullier2

Pages: 1-4

Case Reports

Metastatic colorectal carcinoma: Response to panitumumab

Nandan Shanbhag1

Pages: 5-8
  • Abstract
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  • A 69-year-old British gentleman with a good performance status, who runs a charity for animals (important), presented to the Gastroenterology outpatient department at the Bahrain Specialist Hospital (June 2016) with complaints of vague abdominal discomfort, bloating sensation, tiredness, and a recent change in the bowel habits. Endoscopy revealed a rectosigmoid colon mass, and the biopsy confirmed an invasive adenocarcinoma. The elderly man received six cycles of combination chemotherapy with oxaliplatin and capecitabine (until January 2017); however, the disease progressed, and he had liver metastases. A total mesenteric excision along with metastasectomy of the liver lesions was performed (February 2017); and a follow-up positron emission tomography–computed tomography (PET-CT) image showed a progressive disease with multiple lesions in both lobes of the liver as well as local recurrence. He was depressed and wanted to know further options; and so, was started on injection panitumumab 6 mg/kg administered every 21 days. After four doses of the therapy, PET-CT showed complete resolution of the local recurrence and partial resolution of the liver lesions. The patient, then resumed his activities with a good performance status and the therapy with panitumumab will be continued until either, disease progression or severe side effects are observed. The case illustrates the effectiveness of panitumumab in metastatic colorectal carcinoma, which has progressed on standard chemotherapy regimen.

    Keywords: Metastatic colorectal cancer (mCRC), response rate therapy, biotherapy, epithelial growth factor receptor, panitumumab.

Original Articles

A study of sexual dysfunction among Bahraini women

Khawla Saad Ahmed Mandoos1*, Elham Atalla1, Amaal Al Thawadi1, Hana Ahmed Alfayez2

Pages: 9-13
  • Abstract
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  • Background and objectives: Sexual dysfunction is one of the most common but considerably less explored female sexual problems in the Arabian world. This study provides insights into the prevalence of this problem in Bahraini women. To explore the prevalence and various aspects of the female sexual dysfunctions (FSD) in Bahraini women.
    Methods: This is a cross-sectional study which involved the collection of FSD data. The subjects were selected, in equal numbers, from four health centers in the Kingdom of Bahrain. Female Sexual Function Index (FSFI) was used in this study.
    Results: This study established that FSD is highly prevalent in Bahraini women (55.8%) and is associated with various features and characteristics. Many demographic and health risk factors of FSD were identified, including wife’s and husband’s age, female’s education and employment status, duration of the marriage and the number of children, as well as the presence of chronic illnesses such as diabetes mellitus and hypertension. In addition, it has been demonstrated that the awareness of the availability of sexual healthcare services was poor amongst women attending the healthcare centers, with 73% of women indicating they had no prior knowledge of such a facility.
    Conclusion: Prevalence of FSD in Bahrain is high, and more attention should be directed toward this problem. Most women, however, seem to be unconcerned with their FSDs. Most subjects in this study were unaware of the existence of sexual healthcare facilities. A planned follow-up study is warranted to further understanding of FSD in Bahraini women.

    Keywords: Female sexual dysfunction, Female Sexual Function Index

Prevalence and factors associated with nocturnal enuresis among children attending primary care in Bahrain

Muna Ahmed Awn1*, Nooralhoudh Ali1, Hessa Al Saqer1, Duaa Al Laith1, Adel Al Sayyad1

Pages: 14-21
  • Abstract
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  • Background and objectives: Primary nocturnal enuresis is the bedwetting tendency in children aged ≥ 5 years, who have not stayed dry during sleep, for a period of more than 6 months. Secondary nocturnal enuresis is the recurrence of bedwetting after continuous a dry period of more than 6–12 months. The primary objective of the study was to estimate the prevalence of nocturnal enuresis (NE) among children aged 5–12 years, who received primary healthcare in Bahrain. The secondary objective was to determine the prevalence of primary and secondary NE, and the factors associated with primary NE.
    Methods: This is a cross-sectional analytical study conducted in children aged 5–12 years, who attended local health centers in Bahrain in June 2015. A total of 438 children from eight local health centers were included in the study. A self-administered questionnaire was used as the assessment tool.
    Results: The overall prevalence of NE in Bahrain was 11.1%. The prevalence of primary NE and secondary NE was 82% and 18%, respectively. A significant association was established between NE and father’s education (P = 0.003), number of siblings (P = 0.045), and father’s (P = 0.033), mother’s (P < 0.001), and sibling’s (P < 0.001) history of NE.
    Conclusion: The prevalence of NE in Bahrain is similar to that observed in other studies. Further studies are required to assess the prevalence of secondary enuresis and its associated factors.

    Keywords: Prevalence, enuresis, children, primary care, Bahrain

Causes of irreversible unilateral or bilateral blindness in the eastern province Saudi population of the Kingdom of Saudi Arabia

Huda Farhan Alghamdi1*, Nadira A Albaghli2

Pages: 22-26
  • Abstract
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  • Background and objectives: To determine the causes of irreversible unilateral or bilateral blindness in the Saudi population of the eastern province of the Kingdom of Saudi Arabia.
    Methods: This observational, exploratory cross-sectional study evaluated patients with irreversible unilateral or bilateral blindness using a nonprobability sampling technique, which was conducted in a major referral hospital of the eastern province in Dammam city. Saudi patients were enrolled if they had < 0.05 (3/60 Snellen acuity) vision in the better eye after correction bilaterally, or visual field of 10–15° around fixation in the better eye. The same was done in unilaterally blind eye patients. The primary investigator excluded treatable cases of blindness, such as refractive error and cataract and corneal pathology occurring after 5 years of age, in addition to keratoconus, recent vitreous hemorrhage (< 6-month duration), and operable retinal detachment.
    Results: A convenient sample of one hundred consecutive unilaterally or bilaterally blind patients comprised the study sample. The mean age of the study sample was 54 ± 2.26 years. The male: female ratio was 4:5. The most common cause of blindness in an eye(s) was glaucoma. Seventy-eighty patients had unilateral blindness. Deep amblyopia (11) turned out to be almost the second most common cause of unilateral blindness occurring mainly in the left eye in majority of the patients (10/11).
    Conclusion: Glaucoma is the most common cause of irreversible blindness in one or both the eyes. Although underestimated (due to old corneal scarring and other causes), amblyopia is likely to be the second most common cause of blindness in an eye in the eastern province of Saudi Arabia. Deep amblyopia occurred more frequently in the left eye.

    Keywords: Unilateral blindness, bilateral blindness, irreversible blindness, glaucoma, amblyopia.

Prevalence and risk factors associated with erectile dysfunction among Bahraini men with diabetes mellitus

Amal AlGhanem1*, Ghada Al Zayani1

Pages: 27-34
  • Abstract
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  • Background and objectives: Erectile dysfunction (ED) is a common complication in diabetes mellitus, affecting ≥ 50 % of men with diabetes, worldwide. This study assessed the prevalence and risk factors associated with ED in Bahraini men with type 1 and type 2 diabetes mellitus attending the Central diabetic or the Non-communicable disease (NCD) clinic in Primary Health Centers (PHC) in Bahrain.
    Methods: Across-sectional study was conducted in men with type 1 and type 2 diabetes mellitus attending the Central diabetic or the NCD clinic in the PHCs in Bahrain, from June 2013 to September 2013. The study included 86 married diabetic participants. A modified Arabic version of the International Index of Erection Function was used in this study. Data were analyzed using SPSS 16 and P< 0.05 was considered statistically significant.
    Results: Mean age of the participants was 53.47 ± 9.57 years and the overall prevalence of ED was 74.4 %. The prevalence and severity of ED increased with age, from 55.6 % in patients < 40 years of age to 83.3 % in patients aged 60–69 years (P = 0.028). A significant relationship was found between ED and duration of diabetes, hypertension, and coronary heart disease (P < 0.05). However, no significant relation was observed between the prevalence of ED and glycemic control, body mass index, dyslipidemia, and diabetes-related complications (P > 0.05).
    Conclusion: ED is highly prevalent among Bahraini men with diabetes and increases with age and duration of diabetes.

    Keywords: Diabetes mellitus, erectile dysfunction, non-communicable diseases

Nurses' errors during nursing work

Rifaie Yaseen Hameed1*, Rami Ramadan Allo2

Pages: 35-44
  • Abstract
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  • Background and objectives: Patient safety is an essential and vital component of quality nursing care. However, the nation's health care system is prone to errors, and can be detrimental to safe patient care due to basic system flaws. Studies in different parts of the world have reported nursing errors, which resulted in excess injuries and unnecessary deaths. The study aimed to assess nursing errors generally in some of daily activities through nursing work.
    Methods: A descriptive study was conducted between November 2, 2013 and January 30, 2014. It was implemented on a convenience sample of the nursing staff (94 nurses) working at three teaching hospitals in the Mosul city. A preliminary open-end question was directed to nurses (11) regarding errors and mistakes that can occur in daily nursing activities. Then a self-administered checklist was constructed for the study, which consisted of three main aspects: nursing administration (14 items), personal aspect and communication (9 items), and professional aspect (19 items). Each item had two options (no = 1; yes = 2). SPSS 11.5 was used to analyze data through descriptive statistics (frequency and percentage) and inferential statistics (chi-square), while P ≤ 0.05 was considered significant.
    Results: Majority of the nurses were in both the surgical and internal medicine wards (37.2%) and in hospital A (38.3%). Most (40.4%) of them had a tenure of 20–29 years of work. Majority of the errors were due to professional activities (84.21%) followed by management and administration aspects (64.29%) and personal aspects (77.8%).
    Conclusion: The study found that the role of nurses is functional and not professional, as it clearly lacks; job  description, proper professional relationships, sense of belonging to the profession, sense of responsibility, adherence to professional rules at work, lack of patient care, and staying away from career development. The study recommends: emphasis on nursing documentation during daily work, nursing process in caring the patient, and emphasis on sterilization and disinfection guidelines. 

    Keywords: Nurse, error, nursing, nursing work

Prevalence of molar incisor hypomineralization in seven–nine-year-old Bahraini children: an epidemiological study

Deyana Ditto1*, Taghreed Ajoor1, Manar Al-Khashram1, Tabassum Tayab1, Wafa Al Sharbati2

Pages: 45-51
  • Abstract
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  • Background and objectives: Molar incisor hypomineralization (MIH) is a common developmental disturbance of the enamel involving the permanent incisors and first molars. There is no account of data regarding the prevalence of MIH in Bahrain, till date. The aim of the study was to ascertain the prevalence of MIH in seven–nine-year-old children attending government schools in Bahrain.
    Methods: This cross-sectional descriptive survey consisted of 760 children aged seven–nine years, attending government schools located in the four governorates in Bahrain. Dental screenings were conducted and MIH was diagnosed according to the European Academy of Pediatric Dentistry, 2003 judgment criteria.
    Results: The prevalence of MIH was 17.6%, which decreased with age. The highest prevalence rate was found in Muharraq and the odds of children diagnosed with severe MIH were more in the Southern Governorate. Demarcated opacity was the most common dental defect, which affected the molars and incisors. Significantly larger numbers of maxillary first permanent molars and incisors were diagnosed with MIH.
    Conclusion: MIH was common in children’s permanent teeth, with some intra-country variation. A predilection for maxillary teeth being affected with MIH opacities was clearly revealed. There is a need for regular follow-ups with regard to the prevalence of MIH.

    Keywords: Molar incisor hypomineralization, demarcated opacities, developmental dental defects, enamel defects, prevalence, proportion.