J A Z M E D P L U S | 1

Medica

INAUGURAL ISSUE

FEBRUARY 2013 G.

February 2013 G.

4/1434 HIJRI

QUARTERLY EDITIONS

Jazmed

Plus

THE QUALITY AND ACADEMIC ACCREDITATION UNIT

A NEWSLETTER FROM THE FACULTY OF MEDICINE JAZAN UNIVERSITY KSA

President’s Message

Prof. Muhammad bin Ali Al Hayaza --------------------------------------------03

Dean’s Message

Dr. Hussein Muhamed Ageely ---------------------------------------------------03

Vice Dean’s Message

Dr. Mohammed Abdul Raheem Akeel------------------------------------------03

Editor’s Message

Prof. Qayyum Husain--------------------------------------------------------------04

Opinions

Members Faculty of Medicine----------------------------------------------------04

01. Medicine in the future

Prof. Mahmoud Ihab Mahmoud--------------------------------------------------05

02. Quality in Medical Education- A Quest

Dr. Mohammed Abdul Raheem Akeel------------------------------------------06

03. Professional Codes in Medicine

Dr. Muhamed Abdul Raheem Akeel, Mubin U Khan-------------------------06

04. Scientific Collaborations

Prof. Ibrahim M. Elhassan---------------------------------------------------------07

05. What Patients Need to Know

Dr. Almonther Hershan------------------------------------------------------------07

06. 21st century physician

Dr. Muhamed Nasir Shamas------------------------------------------------------08

07. Snake Venom- Valuable tool in Medicine

Prof. Mohamed Naguib Omar----------------------------------------------------09

08. Super nutrients for weight Loss

Dr. Prakash Bruhanmath----------------------------------------------------------10

09. Core Research Laboratory of Medical Research Centre

Dr. Rashad Alsanousi. Dr. Siddig Ibrahim--------------------------------------11

ISSN NO: AF

10 Our past is the key to our future

Dr. Abeer Abdel khalik--------------------------------------------------------11

11. How to study during Medical College Years

Dr. K.A.Zacharias---------------------------------------------------------------12

12. Continuous Professional Development – levels

Dr. Abu Obaida Yassin--------------------------------------------------------13

13. Hospital Acquired Infections- Are you Serious

Dr. Mubarack Sani TP---------------------------------------------------------14

14. Virtual Dissection

Dr. Shweta Choudhary--------------------------------------------------------14

15. Telomeres- Question of Life and Death

Dr.Thanaa Ebrahim Muhamed-----------------------------------------------15

16. Mapping Molecular Switches

Dr. Gowher Nabi----------------------------------------------------------------16

17. Journey from Jazan

Abdel Rehman Abdallah Alfifi -----------------------------------------------16

18. Contamination of Currency notes

Dr. Jeldi Hemachandran-------------------------------------------------------17

19. Medical Students-Stress and Sleep Deprivation

Dr. Tabassum Khan, Tahani Abdullah, Wafa Ahmad-------------------17

20. Social accountability in medical education

Dr. Muhammed Al Hassan-----------------------------------------------------18

21. Announcements

Media and Publication Committee------------------------------------------19

22. Media and Upcoming Events

Media and Publication committee------------------------------------------20

CONTENTS

J A Z M E D P L U S | 2

Faculty of Medicine, Jazan University will be a center of excellence in

medical education and effective partner for health promotion in

Jazan region.

Committed to implement the Islamic values, social accountability

principles and quality standards for graduating physicians competent

in responding to health needs and challenges, orienting the scientific

research and health services for solving the community health

problems and strengthening governance, management and

partnership with all stakeholders.

JAZMED PLUS

PATRON

HIS EXCELLENCY PRESIDENT JAZAN UNIVERSITY

PROF. MOHAMMED BIN ALI AL HAYAZA

CO– PATRONS

DR. HUSSEIN MUHAMED AGEELY

DR. MOHAMED ABDUL RAHEEM AKEEL

ADVISORY BOARD

DR. SAEED ALQAHTANI

DR. ALI I SWAID

PROF. IBRAHIM BANI

PROF. MAHMOUD IHAB

PROF. IBRAHIM EL HASSAN

PROF. SARAH RIFAI

EDITORIAL BOARD

PROF. QAYYUM HUSAIN

DR. MUHAMED NASIR SHAMAS

MUBEEN U KHAN

ADDRESS FOR

CORRESPONDENCE

DEVELOPMENT AND QUALITY UNIT

NEAR KING FAISAL SPORTS

CITY

FACULTY OF MEDICINE

JAZAN UNIVERSITY JAZAN KSA

POSTAL CODE 45041

POST BOX 114

jazmedplus@jazanu.edu.sa

J A Z M E D P L U S | 3

Since the establishment of the faculty of Medicine in this region, we are in continuous pursuit of attaining

higher standards in Medical education and felicitations go to the whole staff for working day and night to achieve

these targets. The Newsletter JAZMED PLUS will also help enormously to the cause and will provide a new

window of opportunities to the students and faculty members alike. I wish and hope that the NEWSLETTER

improves and sets the bar higher and higher in the future. Accept my good wishes for this innovative project.

Dr. Hussein Mohammed Ageely

We all took up one idea, thought over it, dreamt it and let it to occupy our days and nights and here we are

with the reality of achieving success in the form of JAZMED PLUS .May Allah be with us. I congratulate all on

publication of the very first edition of the newsletter JAZMED PLUS. It is worth mentioning that every step which

we take to achieve our goals and fulfill our mission is applaudable. I appreciate the hard work and visionary

approach of the staff involved in such an innovative work which is of greater benefit to the cause of Jazan

University and medicine as a whole. I ensure my continuous support for such activities and appeal all faculty

members to participate in activities meant for the upliftment of the college and improvement in the quality of

Medical education. Wishing you luck in your effort. Dr. Mohamed Abdul Raheem Akeel

Modern medicine and medical education demands progressive transformation and capitalization of these

developments. I consider first edition of the newsletter JAZMED PLUS as a positive step towards future and

towards achievement of our goals. I wish you success in this endeavor and hope that it will bring the faculty on the kingdom and world map in near future.

Dr. Saeed Alqahtani

One of the core duties of faculty members is to carry out research. Research is important for professional

and academic development. The added value of research is that it contributes to the main role of faculty members,

which is teaching. We look forward enthusiastically to continue to grow, and diversify our research studies

towards better serving our patients and the community at large in Jazan region and the Kingdom of Saudi Arabia.

Appreciations and thanks for Vice-Deanship for Quality and Development in its JAZMED PLUS

NEWSLETTER initiative which will be a forum of sharing news and ideas at the Faculty of Medicine. This is a

milestone for the faculty and staff collaboration in various divisions and departments. All the best

Prof. Ibrahim Bani

It’s my pleasure to introduce our first issue of the Faculty Magazine. This will be the window to show the

ongoing progress for the activities of the teaching staff, the talents of the students and the achievements within the

Faculty in the areas of education, research and community service. It is an influential tool of communication and

interaction between the different parties that contributes to scientific excellence. I hope this presents the corner

stone for establishing a larger world for exchange of ideas and thoughts in the field of medicine.

Prof. Sarah El-Reffaey

The first edition of the newsletter comes as a wonderful milestone in the path of the progress on which the

faculty of medicine is moving because of the enormous support and dedication of its hardworking staff members.

Accept my appreciation for this profitable endeavor and I hope that the community is equally and immensely

benefitted in future. Wishing you good luck for the future.

Dr. Ali I Swaid

It gives me immense pleasure that the Newsletter JAZMED PLUS is being issued from the faculty of

medicine. It is an important step and direction for the accomplishment of our strategies to maintain academic

excellence, attract and further development of academic staff to maintain the continuity of its leadership, keep up

with specialized research centers in the corresponding world-class universities, and construction and development

of training programs for the rehabilitation of individuals and institutions and improve their skills. I am pleased to

convey my support for such projects and my good wishes to all the faculty members on this occasion.

His Excellency Prof. Muhamed Bin Ali Al Hayaza

J A Z M E D P L U S | 4

Here comes the first issue of our JAZMED PLUS Newsletter since the inception of College of Medicine. The newsletter

will provide information about the outgoing and incoming activities in fields of Medical Sciences in Jazan University. Various popular articles have

been included in this issue and these articles will be useful for the faculty members, students and common people of the society. As the editor-in-chief

of the newsletter, I would like to express my sincere thanks to you all. Without the support, dedication, and commitment from you, the first newsletter

of this college would not have become possible. Our Patron, HIS EXCELLENCY PRESIDENT JAZAN UNIVERSITY, PROFESSOR

MOHAMMED BIN ALI AL HAYAZA and Dean, DR. HUSSEIN MUHAMED AGEELY deserve my deep thanks and appreciation for their

leadership and coordination. I would like to thank co-patron Dr. Mohamed Abdel Raheem Akeel, members of advisory & editorial board for their

hard work and contribution on the news related to Medical Science and Education. I must also express special thanks to those who made contributions

to this issue inspite of their busy schedules. Special thanks go to our members who are willing to serve for the development of Medical Science in this

University. Here, I strongly encourage our readers to join this Newsletter at your earliest convenience to share your accomplishments, contribute to

and benefit from this publication.

Together we achieve! Together we make Newsletter meaningful and memorable that we will cherish for a life time!

PROF. QAYYUM HUSAIN

EDITOR IN CHIEF, JAZMED PLUS

today were still unknown: antibiotics, , most hormone replacements and steroid therapy, effective drug therapies for cancer and psychotic illnesses, testing for genetic disorders, coronary bypass surgery,

transplanted organs, and artificial joints. These and Other successes have encouraged public enthusiasm for research and belief in the potency of modem medicine. Wishing you luck. H FDH FHFD HDF

Clinical research has changed the face of modern medicine. Fifty years ago, physicians had little ability to effectively treat or prevent any of the deadliest diseases. Most of the staples of modem medicine we enjoy

encouraged public enthusiasm for research and belief in the potency of modem medicine. Wishing you luck. RGRTGERTERTR

I would like to congratulate you on successfully completing the project of JAZMED PLUS and providing a wonderful opportunity to the students and

faculty members for improving in their respective fields. It’s all because of the dedication and hard work of the team involved and I sincerely

acknowledge the hard work shown in past 3 months. I feel proud and appreciate such role in the success and wish that you all would keep up the good

work in future too…..Dr. Abdel Rahman M. Salih ………Deptt. Of Medicine

The JAZMED PLUS EDITORIAL TEAM has proven it right through hard work and dedication and it’s an occasion to be very happy with such

performance and we all appreciate this venture. It will boost our effort to move forward in terms of designation as well as responsibilities put in us by

the people..…Dr. Siddig Ibrahim ….Medical Research Centre.

I appreciate the work and this task wouldn't have been carried through without undying endeavor and dedication. Accept our appreciation for the hard

work you have put in for a job that's so well done!

Best of future for JAZMED PLUS……..Dr. Atif Shiohaieb…..Faculty of Medicne

The diligence and dedication demonstrated by THE JAZMED PLUS has been noticed and the enthusiasm is overwhelming. It is a significant

contribution to our faculty and hope that you maintain the same effort over and over again……Prof. Mahmoud Ihab. Clinical Pharmacology

Congratulations! The hard work has finally paid off! It takes a great deal of talent, effort, and determination to achieve such a challenging goal and, it is

very inspiring to me that you all realize it. Once again, congratulations………... Dr. Abdel Rahim Mutawakil…Deptt. of Community Medicine

I want to extend my congratulations to you. This is an accomplishment. I hope JAZMED PLUS to be a vision which enhances our capabilities in

future…………. Dr. Yassin Ibrahim Eltaif……Family Medicine

All the best to the faculty for such an important event………… Abdel Rehman alfifi 2nd yr student.

Wishing success and achievements with each new edition of the newsletter JAZMED PLUS……… Dr. Muhamed el Sheikh.....Medicine.

Good wishes and all the best for future……………Dr. Mudasir Nazar … Deptt. of Physiotherapy.

Best wishes for the NEWSLETTER. I am extremely confident that future of the faculty of medicine holds promise with such initiatives. All the best to

JAZMED PLUS…… Dr. Zahoor Ahmad Deptt. of Surgery

MY best wishes on publication of the first edition … all the best………. Dr. Ahmed Taha….. Department of Medicine.

Good wishes and good luck for this effort………………. Dr. Muhamed Elhassan..Medical Education.

Editor‘s Message

J A Z M E D P L U S | 5

MEDICINE IN THE

FUTURE

A REVOLUTION and changing of

concepts are expected very soon in medicine,

likewise any other area of life. The float of

knowledge integrated from different sources

will make our life more precise and

sophisticated. It will influence medicine and

people toward personalization of medicine.

PERSONALIZED MEDICINE can deliver better information to help patients

make an individual choice about the risks and

rewards of a particular course of treatment:

which medicines will work for him or her,

which drugs may pose a danger and whether

doses may need to be adjusted. Personalized

medicine can also help profile someone's

potential risk for contracting a disease like

cancer or diabetes. It becomes like tailoring

medical treatment to individual characteristics

of each patient. It is like buying a custom-made suit versus one of the rack.

The personalized medicine will

allow diagnosis and treatment based on

genetic heterogeneity, this mandates to

understand the human genome and

consequently a Human Genome Project (HGP) has been developed.

HGP is an international project

aimed at determining the sequence of

chemical base pairs of DNA and mapping the

approximately 20,000–25,000 genes of human

genomes. This project started in October 1990

and completed in April of 2003. This scientific

research project comes into reality by

scientific coloration of scientists from USA,

United Kingdom, Japan, France, Germany and

Spain.

Researchers continue to identify

protein-coding genes and their functions; the

objective is to find disease-causing genes and

possibly use the information to develop more

specific treatments. Gene therapy and genetic

research is presently the hub of attention for

its greater role in causation of the disease. It

also may be possible to locate patterns in gene

expression, which could help physicians glean

insight into the body's emergent properties.

Using gene therapy, we may be able to close a

gene or restore the normal genetic pattern of

normal physiological life. Implementation of

personalized medicine required a general practitioner with strong genetic information.

In addition to gene therapy,

Shrokhov and Zewail succeeded to develop a

4D ultrafast electron microscopy and

diffraction for atomic-scale visualization in

space and time which characterizes the

structural dynamics in chemistry and biology.

Additionally, spectroscopy and

large-scale computations will provide

information to understand the complexity of

the disease state regarding the nature of

chemical and biological transformations.

This approach will be targeting the

patient personally in order to better understand

the development of the disease. Zewail

laboratory in Cal Tech institute in California is

exploring the 4D microscopy to understand

the molecular pathogenesis of disease.

Understanding this mechanism will change the

strategy of treatment.

We know, the current therapy of

diabetes is based on replacement therapy,

either directly by insulin injections or

indirectly using insulin secretagauges e.g.

sulfonylureas. Under 4D microscopy, they

may find that this patient has a normal

synthesis of insulin but lacking magnesium

ions which facilitate exocytosis of the vesicle

carrying the insulin. Hence, the treatment of

the patient will depend on providing

magnesium ions not the replacement therapy.

If Zewail succeeds in this project, he will be a

winner for a next Noble prize soon.

REGENERATIVE MEDICINE is also

another era which will provide hope for

diseases represented by loss of cells, e.g.

Parkinsonism, Alzheimer, diabetes etc. Gluing

the stem cells (pre-differentiated or

differentiated) into lesions will replace the

damaged cells. This technique could be easy

and straight forward, yet it has to pass by a lot

of legislations and ethical approvals. In my

opinion it may be too early to predict its

therapeutic efficiency. As the new growing

cells may be losing the differentiation

overtime and retain the proliferation criteria.

This shift of the balance will lead to

uncontrolled proliferation and eventually

development of cancer.

As you can see, role of surgery is

shrinking and medicine is dominating. Surgery

and surgical procedures are slowly and

steadily taking a backseat and replaced by

newer medical modalities and innovative

methods of treatment. It is now a process that

has been appreciated and welcomed world

over. This phenomenon started in 1960th,

when cancer management becomes an internal

medicine category and not a surgical one.

Every year a great emphasis is imposed on

role of medical treatments for better

improvement by the researchers.

We need to ask ourselves TWO questions;

First question: when do we expect to have

this revolution?

The answer is very soon and all

research institutes are working very hard to

change the layout of medicine.

Here is the second question “Are we ready

for this era, worldwide?

We need medical doctors capable to

cope with the new information and applying it.

We need a physician who is a genetic

specialist, physicist, molecular biologist and a

human being with a caring heart.

***

Prof. Mahmoud Ihab Mahmoud

Professor of Clinical Pharmacology

Faculty of Medicine Jazan University

J A Z M E D P L U S | 6

QUALITY IN MEDICAL

EDUCATION- A QUEST

Ensuring quality in education and

provision of the same is now considered as

the fundamental requirement of all medical

schools around the world. The method to

evaluate the provision of quality in medical

education institutions is adapted from

industrial quality management models and

models of accreditation.

To attain Accreditation, institutions

should provide a spectrum of activities,

including ambulatory teaching, hospital

teaching, problem-based learning, self-

directed learning, student-centered learning,

team-based learning, and communication

skills training, and, if these activities are

provided in the curriculum, along with other

requirements that are duly fulfilled,

accreditation is most of the times granted.

There has also been a quest and

discussion about various approaches taken up

in the process of quality education and

accreditation and various models have been

suggested overtime. Some of them are:

THE TRANFORMATIONAL

MODEL

It is a learning-oriented approach to

quality and this model stresses upon

“enhancing participants”, “adding value” to

their capability, and “empowering” them

ultimately.

ENGAGEMENT THEORY MODEL The engagement theory of

quality, which a d v i s e student, faculty

(academics), and administrative involvement

in teaching and learning; approves and

considers student learning as the pivotal and

primary goal of providing medical education,

highlights the role that academics,

administrators and students play, and

equally important is that it offers a valid

template for assessing quality.

THE UNIVERSITY OF LEARNING

MODEL This type of approach to higher

education, is pedagogic, and gives a

suggestion that in teaching, research, or

community involvement, the core and

fundamental process is one of learning (at

different levels); this model also advises that

quality in a university context is based mainly

on the quality of learning.

THE RESPONSIVE UNIVERSITY

MODEL It is based on the theory that quality

of relationships with the public and quality of

the outcomes is vital in deciding the quality

of the university. Therefore, universities will

have to be responsive, reactive and service-

oriented to survive the competition and

thrive academically.

All the above quality models

highlight two vital issues of greater

emphasis, i.e., student learning and a

dynamic collaboration around it. All these

educational quality models in medical

education define and explain the characteristics

and different components that should be

implemented to confirm and ensure that

quality learning is taking place. However, in

order to evaluate quality assurance, we all

should develop specific performance indicators

for each of the components which include:

1. Regular evaluation reports of teaching

materials and methods

2. Assessment of student academic results for

knowledge, skill, and affective domains

3. Regular Graduate job assessment reports

4. Audit reports of teaching hospitals.

Hence to measure and assess

measure the educational quality we need to

develop an effective model that can assess the

actual quality of teaching and learning and its

impact on students in terms of patient care.

***

PROFESSIONAL CODES IN MEDICINE

Evolution of human race and its

efforts to achieve the intellectual heights has

been possible once man started following

certain rules and regulations as a guide. Now

days every profession has established a set of

ethical guidelines for optimum performance of

its manpower and best results.

As a doctor, certain professional

codes are being followed in the institutions

world over which act as a useful guide and

benchmarks for the personal, intrapersonal and

interprofessional conduct.

These codes touch all aspects of a

doctor’s life and regulate a spectrum ranging

from his behavior, interactions, skill,

emotions, knowledge, humility, composure,

spirituality, instincts, hygiene, reliability,

performance and intelligence.

The pivots of ethical codes

regulating medicos are based on trust,

kindness, gentleness, dignity, compassion,

professionalism and honesty.

The profession achieves a different

dimension of spirituality when the codes

regulate and shape him for the betterment of

the community. Avoidance of unnatural

instincts, distance from addictive substances,

tolerance and personal composure even during

internal conflicts make him the most admired

in society.

The list is unending but we need to

understand that it is high time we also devise

such codes for regulation of the conduct of

doctors, medical educationists and students for

their optimum performance and excellence as

per regional values and religious beliefs.

***

DR. MOHAMMED ABDUL RAHEEM AKEEL

Vice Dean Development and Quality

Faculty of Medicine Jazan University

DR. MOHAMMED ABDUL RAHEEM AKEEL

MUBIN U. KHAN

Vice Dean Development and Quality

Coordinator Quality and Accreditation

J A Z M E D P L U S | 7

SCIENTIFIC COLLABORATIONS

THE SAUDI-SCANDINAVIAN

COLLABORATIVE PROJECT

APRIL 2012

THE Saudi-Scandinavian collaborative

project was established following the

recommendation of Stockholm meeting which

was held on the 5th of July 2011. The

delegates from Jazan University, Helsinki and

Karloniska universities have agreed to develop

strong scientific links between Jazan

University and Scandinavian countries with

main objective of strengthening the scientific

and research capabilities at Jazan University.

This program includes collaborative research

projects and training programs (short training

and long term training programs).

Memorandum of understandings and

agreements between different partners were

also signed and many are in progress.

The first scientific activity took

place in Jazan on 11th of April 2012. A

number of distinguished professors from

Scandinavian universities (Uppsala,

Stockholm, were participated in this meeting.

Scientific presentations on the advanced

biomedical research including clinical,

genetics, chemotherapy and immunology were

presented during this meeting.

Following this meeting a number of

research projects were proposed to be

established as this part of this program. These

include the following issues: toxicology,

nutrition, tuberculosis, malaria, substance

abuse, pathology of Khat and about

cardiovascular diseases.

INTENSIVE COURSE ON DRUG

ABUSE – JANUARY 2013

In January 2013, an intensive course

of the drug abuse was conducted in Jazan. The

aim of this course

was to provide basic as well as advanced

knowledge in the fundamental aspects of

drug abuse and addiction to these compou

nds. This course was held in collaboration

with Karloniska Institute, Sweden.

Professors/ FRED NYBERG, BJORN

HELLMAN, WALTER KEGO & JAN KEHR

from Sweden participated as faculties in this

course. 40 individuals from the teaching staff

of Jazan University were benefitted and

trained in this course

PREPARATORY COURSE FOR

POSTGRADUATE STUDIES IN

MEDICAL AND MOLECULAR

BIOSCIENCES (2013- 2015)

The Preparatory Course for

Postgraduate Studies in Medical and

Molecular Biosciences, 2013-2015, is targeted

to actual or potential postgraduate students of

the Jazan University, the Kingdom of Saudi

Arabia.

The Preparatory Course invites

applications from eligible students from the

Jazan University desiring to explore

possibilities for advanced research training

and postgraduate studies at the University of

Helsinki, Stockholm University, or one of

their collaborating universities.

The goals of the course are:

1. To provide each student with necessary

skills for starting postgraduate studies in

Northern Europe, 2. To provide each student

with information on the scientific, cultural,

and environmental issues associated with

performing PhD studies in Finland and in

Sweden, and 3. To facilitate contacts between

the students and leaders of selected research

groups (potential supervisors of the PhD

studies) at the University of Helsinki and

Stockholm University, and their collaborating

universities. By the end of this course a

number of students from Jazan University will

be selected for post graduate studies in

Scandinavian countries

***

WHAT PATIENTS NEED TO KNOW

Patients' rights vary in different countries and in

different jurisdictions, often depending upon

prevailing cultural and social norms. Different

models of the patient-physician relationship which

can also represent the citizen-state relationship have

been developed, and these have informed the

particular rights to which patients are entitled.

Being a physician puts you in a position where you

have to know exactly all the responsibilities toward

yourself, patients, employees and community.

This article will briefly discuss the issue of

patient’s rights in term of what patients need to

know? Or what patients have the right to know and

be aware of.

According to WHO policy, patient has the right

of sufficient and proper medical care regardless of

race, gender, age and nationality. So, indeed all

patients must be treated equally and properly.

Briefly, at the time of seeking treatment he/she

should know the identity of medical care providers

including physician, nurse and any involved

personnel. Furthermore, confidentiality and privacy

are a must. All health providers have to explain and

discuss all details about examination, procedure,

investigations and treatment plan as well as the

diagnoses and prognosis of his/her illness.

Every patient has a right to referral if his doctor is

unwilling to continue treatment, and has an

important equal right to management and

emergency care despite being from low

socioeconomic strata and having lesser ability to

support his present illness.

The Universal Declaration of Human Rights has

been instrumental in enshrining the notion of human

dignity in international law, providing a legal and

moral ground for improved standards of care on the

basis of our basic responsibilities towards each

other as members of the “human family”, and

giving important guidance on critical social, legal

and ethical issues.

But there remains a great deal of work to be

done to clarify the relationship between human

rights and right to health, including patient rights.

***

PROF. IBRAHIM M. ELHASSAN

Dept. of Microbiology,

Faculty of Medicine Jazan University

DR. ALMONTHIR A. HERSHAN

Assistant Professor, Molecular Medicine

Faculty of Medicine Jazan University

J A Z M E D P L U S | 8

21ST CENTURY PHYSICIAN

Nowadays in addition to gaining a

professional degree a doctor has to have a

broader vision and insight into a spectrum of

issues concerning his professional life directly

and indirectly.

Their professionalism and skill is

deemed to be incomplete if they are not aware of

the intricacies of medical law, policies,

legislations, health care system prevalent in the

region, ethical and bioethical concerns and above

all -the humanitarian issues associated with the

patient care.

MEDICAL LAW

In order to practice effective approach,

a physician should have an idea of basic aspects

of law and the regional legal system. Medical

law has greater

implications for

patient care and

treatment. Among

the physicians in

practice there is

great variability in

knowledge of law

and ethics. The

study going on in

this field has proven beyond doubt that how a

doctor thinks about risk of malpractice lawsuits

affects directly his ability to react to it, creating

serious ethical consequences.

Nowadays risk management is an issue and

a compulsory field that concerns most

physicians, hence improving ones knowledge of

medical law profoundly helps them understand

and estimate risks, as negates certain doubts

prevalent that have adverse effects for patient

care.

Thus, law and ethics are closely and

inevitably intertwined in the practice of medicine

and one needs to have a clear knowledge of both

for achieving the ultimate goals of personal

development and patient care.

HEALTH CARE DELIVERY

SYSTEM

As today’s physician is on the move to

satisfy his personal requirements and global

demand, he has to have knowledge of

institutional aspects of health care delivery

system of that region. A Doctor should know

how hospitals and other medical institutions

function and the mechanism with which different

health care providers and administrators work

together. These relationships include physicians’

interactions with nurses, respiratory therapists,

physical therapists, occupational therapists,

nurses’ aides, and members of hospital

administration in the areas of finance and risk

management. Good physician-role-models also

play a vital part in this system.

CLINICAL ETHICS

Bioethics and its clinical aspects are

essential for the well-being of both patients and

physicians. The integration of bioethics into

clinical medicine through the practice of “clinical

ethics” is a major part of many bioethicists’ jobs.

This usually is managed in at least two ways,

first by educating physicians-in-training, and

second, by conducting clinical ethics

consultations, which have both an educational

role and are designed to assist with a particular

ethical problem in a clinical setting. In this

setting, the bioethicist provides services that

assist specific patients and their families, as well

as health care providers. By modeling good

clinical ethics practice, bioethicists can teach

physicians ways to better perform these

functions.

HEALTH POLICIES

Legislation and regional policy and its

knowhow for a practicing doctor is an important

part of delivering good health care in the modern

era. The very relevant topics in health policy, of

which physicians should be aware, include: state

and federal regulation of health care financing;

public health and health promotion efforts;

legislative action on end-of-life decisions and

pain control; pharmaceutical regulation; and the

effect of emerging genetic testing and other

biotechnology on the society.

MEDICAL HUMANITIES

We all are humans first and in the process of

attaining requires therapeutic skill over the years

we tend to forget and trivialize the issue of

sensitivities and sentiments associated with a

patient and his disease. Experience of the

humanities is a key pillar of patient care policy

nowadays. Whenever a physician reads poetry or

fiction that explains and explores aspects of

human suffering, it provides him with exposure

to the human experience of health care that may

usually be lost in the daily activities of

technological medicine. The humanities thus add

to the richness of physicians’ experiences.

Specialist training workshops are regularly

conducted to enhance the humanitarian feeling of

the medical student and revive the concept of

divinity associated with this profession..

CONFLICT-OF-INTEREST

Privatization is the most happening

phenomenon in medicine and patient care in the

developing world. With medicine becoming ever

more dependent on the private sector in health

care. A physician’s ability to think critically

about ethical issues and take a measured action in

response is considered a key element of

physicians’ day to day activities. As research

physicians increasingly have a direct financial

interest in the outcome of their research,

bioethicists can provide sensitivity to the public

perceptions that may emerge from such financial

relationships.

Thus a physician in practice is the

pivot and a sacred character in any society as he

needs to perform to the utmost satisfaction of his

people. From the routine skillful and emotional

handling involved patient care to the critical

decisions on emerging medical and financial

issues, a doctor has to rise above the rest to

achieve the goals of professional excellence and

quality care.

DR. MUHAMED NASIR SHAMAS

Assistant Professor Medicine

Supervisor Clinical Research Unit

Faculty of Medicine, Jazan University KSA

J A Z M E D P L U S | 9

SNAKE VENOM

Valuable Tool in Medicine

For most of the people, just

mentioning snakes or reptiles brings a sense

of primitive fear. By the end of this article

you will discover that the snakes that you

have come to fear, and often kill, could one

day save your life or someone's life that you

love.

Snake Bite Information - World Health

Organization Data:

There is a global mortality of 50-100,000

hospital deaths/year. Significant chronic

disability in survivors due to tissue necrosis

which may be severe necessitating

amputation.

Purpose of snake venoms?

1. Incapacitation of the prey.

2. Digestion of the prey.

3. Deterrent to the predators.

But not all snake bites are toxic. 50% of

snake bites are dry bites without venom

injection.

VENOMOUS SPECIES OF SNAKES

1. Elapidae فصيلة الحرشوفيات e.g. cobra and

horned snakes. Present in Middle Eastern

countries including Saudi deserts. Their

toxins are neurotoxins

2. Viperidae االفعويات e.g. Russell vipers

is present in Saudi Arabia.

3. Hydrophidae فصيلة حيات الماء present in coast

waters.

4. Crotalidae افاعي الحفرة e.g. rattle snake

5. Colubridae وتنتشر في القارة االفريقية الحنشيات

What’s in Snake Venom?

It is modified saliva.

Mostly comprised of proteins.

Enzymes determine its toxicity.

Therapeutic Value of Snake Venoms

In the old days, rattle snake venom was

administered by mouth and as lotions to

humans with leprosy. It was thought that the

toxin that made the snakes wounds heal when

it shed would also help humans. This was

unsuccessful.

Snake Venoms as Antitumor Drugs

In December of 2000, a purified protein

from the venom of copperhead snakes was

tested in mice to treat different types of

cancers; breast cancer; ovarian cancer, and

even brain cancer.

Possible Antitumor Mechanism

1. Histo pathological examination of tumors

showed tissue necrosis. The venoms

displayed potent cytotoxic and

apoptogenic effect.

2. The protein also acts to immobilize the

cell and inhibits its movement, thus

decreasing its ability to spread to other

areas of the body.

3. The tumors could not generate the blood

vessels required for continual growth.

4. Although this cancer treatment is still in

an experimental phase, it shows much

promise to prolong the lives of people

afflicted with this disease.

Snake Venoms and Management of

Thrombosis

• Snake venom has also been found to

contain anticoagulants that are able to

dissolve blood clots that cause strokes

and heart attacks.

• Two drugs that have been made from

snake venom are Aggrastat, given to heart

attack victims, and Ancrod, being tested

for stroke victims.

Aggrastat is a disintegrin isolated from the

venom of Echis carinatus (African Saw-scaled

Viper). It inhibits platelet GPIIb/IIIa receptor.

Integrelin

Synthetic cyclic peptide designed after the

lys-gly-asp sequence found in a protein

purified from venom of southern rattle snake.

Lysine (K) is substituted for arginine (R) thus

creating a KGD peptide sequence mimicking

the RGD sequence recognized by the receptor.

Ancrod is an enzyme derivative from snake

venom Agkistrodon rhodostoma (Malayan Pit

Viper): Ancrod digests Aα chain of Fibrinogen

producing a molecule with increased

susceptibility to lysis by Plasmin leading to

hypofibrinogenemia.

Clinical trials have found that ancrod

treatment improved outcomes after stroke and

had a favorable benefit - risk profile for

patients. Further studies of ancrod are

going on.

Snake Venoms are Potential Cures for Many

Diseases

1. The enzymes in cobra venom have been

shown to hold the key for curing Parkinson's

disease and Alzheimer's disease.

2. Some viper venoms have shown promise to

cure osteoporosis.

3. The venom of some snakes, like the red-

necked spitting cobra, has been shown to

provide treatment for leukemia and other

cancers.

In short, even the most dreaded species as

snakes are of great utility provide cure for many

human sufferings and diseases.

Prof. Mohammad Naguib Omar

Head of Department

Clinical Biochemistry

Faculty of Medicine Jazan University

J A Z M E D P L U S | 10

SUPER NUTRIENTS FOR

WEIGHT LOSS

Obesity is a leading preventable cause of

death worldwide, with increasing prevalence in

adults and children. Authorities worldwide view

it as one of the most serious public health

problems of the 21st century. Obesity is

stigmatized in much of the modern world and

hence after due research multiple effective

measures have been suggested to avoid it and

treat this menace which is a root cause of many

lethal diseases.

Some of the nutrients found to be effective in

weght loss are mentioned under

1. Monounsaturated fats:

Replacing carbohydrates in diet with

monounsaturated fats will help in slimming down

by shuttling fat away from your midsection.

Where to get it: Avocados, Macadamia nuts,

and olive oil are great sources of

monounsaturated fats. They also come packaged

with great nutrients such as antioxidants (in olive

oil), fibre (in avocado), and B-vitamins (in

macadamia nuts).

2. EGCG:

EGCG or Epigallocatechin gallate is an

antioxidant found in green tea (and put in most

weight-loss supplements available today). EGCG

can increase thermogenesis or heat production

through extra calorie burning and the use of

stored fat as energy. Some research also shows

that EGCG can stop the growth of new fat cells.

Where to get it: The greatest weight loss effects

of EGCG are seen when combined with caffeine,

as it naturally occurs in green tea.

3. Raspberry ketones:

Raspberry ketones are an antioxidant found in

raspberries that preliminary research shows have

some interesting fat loss effects. Raspberry

ketones can increase the production of the

muscle-energizing, fat-burning hormone

adiponectin as well as directly increasing the

burning of stored fat.

Where to get it: Concentrated raspberry ketone

supplement (they are inexpensive and available

at more health food stores). Keep an eye out for

more about raspberry ketones and weight loss as

new research gets published.

4. Docosahexaenoic acid (DHA): Docosahexaenoic acid or DHA is one of the two

omega-3 fats found in oily fish like salmon.

DHA can stop growth of young fat cells and

actually causes them to die, says research

published in the Journal of Nutrition.

Where to get it: To get more DHA in diet, take

more oily fish or just take a fish oil supplement.

Vegetarians pick up an algae-based DHA

supplement to reap the same benefits.

5. Acetic acid: ‘

Vinegar, a dilute form of acetic acid, has potent

glucose-lowering effects. One study in Italy

found that when participants added just more

than one tablespoon of vinegar to their meal (as

salad dressing) they experienced a 30 % decrease

in their post-meal blood sugar levels. Controlling

blood sugar remains an essential component to

weight loss and maintaining a lean body.

Where to get it: Adding vinegar to salads should

be standard protocol, but if you can manage to

find chocolate balsamic vinegar, it makes an

excellent addition to a protein-packed chocolate

smoothie.

6. Protein:

Protein from lean sources like beef, poultry, fish,

dairy, or soy are weight loss rock stars. The

amino acids that make up protein cause your

body to release the fat-burning and energy-

stabilizing hormone glucagon. The process of

digesting protein also stimulates your body to

release the satiety hormone CCK. This one-two

punch combined with the fact that it takes your

body more energy to digest and breakdown

protein compared to carbohydrates or fat makes

it a must-have at every meal throughout your

day.

Where to get it: The possibilities are endless,

but lean proteins like Greek yogurt, cottage

cheese, and organic grilled chicken strips are

especially convenient.

7. Caffeine:

Caffeine is one of the most potent weight loss

compounds available to you each and every day.

Caffeine blocks the breakdown of a compound

call camp, which is responsible for mobilizing

stored fats so they can be burned as energy.

Where to get it: If looking for a bigger fat-

burning boost, then make sure to choose black

tea over green tea or light roast coffee over dark

roast for a larger dose of caffeine.

8. Fibre: Fibre is often touted to be a great

nutrient for weight loss because it slows down

digestion, allowing for sustained energy and

stable blood sugar. However fibre can also

optimize hormones released during digestion that

are responsible for feelings of hunger and satiety.

Where to get it: Try to get your fibre in its raw

form instead of from foods that have been overly

processed.

Now with the proven benefits of the food items

mentioned we all need to contribute to the bigger

cause of reducing and minimising the burden of

obesity and hence avoiding all the morbid

manifestations of lifestyle diseases in the modern

era.

Lets add these superfoods to our daily

consumable lists and improve our family

health

Dr. Prakash Bruhan Math

Assistant Professor

Dept. of Clinical Pharmacology

Faculty of Medicine Jazan University

J A Z M E D P L U S | 11

CORE RESEARCH

LABORATORY OF MEDICAL

RESEARCH CENTRE

Medical Research Centre aimed to

establish centralized facility for the usage by all

the academicians and researchers from Jazan

University and the province as well. Core

facilities represent increasingly important

operational and strategic components of

institutions’ research bodies, especially in

bimolecular science and engineering disciplines.

With this realization, many research institutions

are placing more attention on effectively

managing core facilities within the research

body. Our management objective is to meet your

questions, challenges, and opportunities. This

objective is intended to assist in guiding core

facility management in the context of a portfolio

of facilities and within all the colleges in Jazan

University.

CENTRALIZED RESEARCH CORE

FACILITY:

The MRC Centralized Research Core Facility

was established in 2010. The facility is supported

by the top management of Jazan University. This

facility is the only one of its kind in the province

and was established to significantly enhance the

competitiveness of biomedical researchers at

Jazan University and the whole Province. The

facility provides research and training support to

Jazan University academicians and researchers

and to the Jazan province biomedical research

community. It is equipped with instrumentation

for biomedical, pharmaceutical, and

biotechnological research. Technical staff

members manage the laboratory and are available

to assist in the operation of the instruments and

to analyze samples (Research or Diagnosis) on a

fee/or free-for-service basis. In addition, the

center will organize instructional seminars and

training workshops in collaboration with the

instrument manufacturers. Topics will include

Basic PCR, Real-Time Quantitative PCR and

RT-PCR, ELISA techniques, Microbiological

techniques, Automated coagulation system, Light

and Confocal Microscopy attached with Digital

Imaging System, Animal Cell Culture, Gel

electrophoresis, ICP-MS, ICP-MAS,

Atomic absorption, HPLC and GC-

MS. Reservations for instrument usage and

services are highly recommended.

***

OUR PAST IS THE

KEY TO OUR FUTURE

The faculty of medicine in Jazan

University is pursuing the mission of raising

student achievements, abilities and talents

through promotion of historical, cultural and

social accountability and promotion of the

vision to be Center of Excellence in history

of medicine and medical arts in Jazan region

and kingdom as a whole.

The National Commission for

Academic Assessment and Accreditation

(NCAAA), which we are striving to comply

with its standards nowadays has emphasized

and stressed the importance of both

innovations and stressed the importance of

different types of graduates abilities

regarding skills in team work,

communication, problem solving and

critical thinking.

Faculty of medicine at Jazan

University is changing its strategic

directions to become socially accountable

educational institution and history is an

essential component of our society.

Over the last sixty years, many

physicians have made great claims for the

potential of exploring history of medicine.

In addition, studying history of medicine

inspires us, socializes, connects with the

traditions, enhances our history taking

skills, provides cultural reference points,

raises overall social consciousness and

expands our horizons. Mighty outcome,

indeed.

So, we are challenging our self and

introducing unusual and innovated self-

learning strategies using interesting

extracurricular materials and student’s

activities to cover all domains of skills

needed for our graduate attributes.

Our Objectives:

1- Stress on the Arab root of medicine.

2- Explore history of medicine in

different eras and cultures especially

in KSA and Jazan area.

3- Establishment of innovative methods

of student’s self- learning, leadership,

teamwork, critical thinking,

communication, presentation and

behavioral skills and humanities by

working in the museum journey.

4- Preserve in the Faculty of Medicine,

Jazan University our rich history.

5- Establish history of medicine as an

elective module within the program.

***

DR. RASHAD ALSANOUSI DR. SIDDIG IBRAHIM

Medical Research Centre

Jazan university

DR. ABEER ABDEL KHALIK

Assistant Professor

Medical Education Jazan University

J A Z M E D P L U S | 12

HOW TO STUDY DURING MEDICAL COLLEGE

YEARS

Dr. K A Zacharias

Associate Professor

Department of Obstetrics & Gynecology

Faculty of Medicine

Jazan University

There is a constant, common complaint from

all medical students: “Doctor, we don’t have

enough time to study! There is TOO MUCH

material to cover during this Module! Please

advise me! I don’t want to fail! I want to do well

in this module, I want high marks”!

There is no easy answer to this. All your teachers

have been medical students and gone through the

same problems! Success in Medical College in

NOT solely a function of baseline intelligence: it

is a matter of KNOWING HOW TO STUDY

PROPERLY. All it requires is genuine

dedication and a real desire to pursue medicine as

a career. So I thought that the following tips may

come in useful for all our students:

Prepare your own notes as you study a

lecture or a topic from a text book: When

you take notes, you are studying actively. Taking

notes as you are studying forces you to be more

attentive, because you are not only reading, but

you are also deciding which parts of what you

are reading are more important.

Preparing notes will help you to review

the topic in less time: For one lecture, you

spend two hours during the weekday to read it

and make your own notes, thirty minutes to

review it, and less than thirty minutes each

subsequent time you spend revising it. The end

result is that a high percentage of material is

retained and very little time is needed to review it

later.

Other benefits of making notes: Since you

have a short weekend before the examination to

cover all the topics in revision. By preparing

notes, you can narrow down twenty lectures and

ten textbook chapters to about 25-35 pages of

notes.

Always ask yourself why when you are

reading your lecture notes/ textbooks. This

benefits as it makes sure that you really

understand the material, as opposed to just

memorizing it and helps you answer examination

questions, since the material is often asked

indirectly. An example is the following:

“Kallman syndrome causes hypogonadotropic

hypogonadism”.

Why? “Because the lack of KAL 1 protein makes

it so that the neurons that produce GnRH don’t

migrate to the hypothalamus”.

Do not go to sleep unless you have

covered the day’s lecture/ other teaching

and finished preparing your own notes. It is not a

matter of how much time you spend; it is a

matter of finishing taking notes.

Develop your own method of writing

notes: there is no right or wrong way. It can be

in Point form (good for recall classes like

microbiology and pharmacology). Diagrams

(good for classes like Physiology and

biochemistry pathways, reactions). Combination

of line written facts and diagrams (good for

classes like pathology) Writing your own

questions and answering those (good for most

classes).

Use your own notes, don’t use borrowed or

photocopied notes: because you have made them

yourself by actively studying and the style of

writing will be unique to your method of thinking

and analyzing the material.

If you do not know or understand

something, do not ask someone else, do not

skip that section, do not get frustrated, and do not

give up! LOOK IT UP YOURSELF! When you

spend the time looking it up in a textbook or

online, you will be surprised how well you can

recall it later! This is true self-directed learning:

you are actively studying.

Mnemonics and word associations help us

remember things: you can use them for almost

any subject. I think most of our students are

experts at this anyway! Examples:

a. “The Zebra Bit My Cookie”- branches of the

facial nerve: Temporal, Zygomatic, Buccal,

Manidbular, and Cervical.

b. “Alpha-Feto Protein goes DOWN in

DOWN’S syndrome”.

If your examination is on Saturday, do

active studies with note-taking during the

weekdays, don’t go to sleep till you have covered

that day’s material, and use the week end:

Thursday and Friday to review and revise the

material. Remember to have a nice, long

refreshing sleep.

Make a study group with some friends: it

might improve your learning process. It usually

makes studying more fun; you can compare

notes, and gives you a reason to finish the

portions before you meet up during the study

session.

Do not skip classes- it is better to attend ALL

your classes, since you can understand the text

book/ lecture notes better if you have physically

attended the lecture session.

Be a tutor yourself: if you can teach your

colleagues or juniors the advantages are:

You will become thorough with the topic before

you try teaching it. You will review all your

notes automatically before trying to teach

it.You will revise your earlier year’s topics

when you try to teach students of junior years.

Take time to relax in between by

developing some hobby or extracurricular

activity that engages your mind and body during

your spare time. For example, participate in

sports, cultural activities, or read a good non-

medical book! These help you to keep your mind

and body sharp and optimized!

Finally, during your clinical rotations

Above all, be regular and punctual in your

hospital teaching sessions, and try to make the

most use of the clinical material available during

the hospital rounds, OPDs, and operating room

attachments provided for you.

Welcome to the wonderful field of medicine, I

am sure you will go effortlessly thorough

medical college and achieve your desired goals.

Wishing you all the very best and good luck in

your future as a doctor!

J A Z M E D P L U S | 13

Continuing Professional Development (CPD)

Institutional & Individual

Levels

What is CPD?

Broadly speaking, Continuing Professional

Development (CPD) is any activity engaged in

by qualified professionals through which they

continue to develop professionally. CPD

obligations are common to most professions.

Many professions define CPD as a structured

approach to learning to help ensure competence

to practice, taking in knowledge, skills and

practical experience. CPD can involve any

relevant learning activity, whether formal and structured or informal and self-directed.

The term CPD is also defined as the process of

lifelong uninterrupted learning and self-

improvement for individuals and teams, which

enable medical professionals to expand and

fulfill their potential in maintaining a high

medical standard and an ever improving quality

of care that meets the need of patients.

.

The importance of CPD

Competent professionals, and the

Professional Institutions that represent them,

should already understand the importance of

CPD – even if they do not currently label it as

such. CPD implies a long-term approach of

lifelong learning and possession of the attitudes

and capacities to be flexible, adaptable, creative and amenable to change.

It has benefits for both individuals and

organizations and is therefore needed for every

professional whether in the developing or

developed world. One of the most important

reasons given for CPD is that it allows doctors

time to discover and fulfill learning needs,

increase job satisfaction and improve self-

esteem. This is perhaps more important for a

practitioner in a developing country, who is

constantly faced with the ruinous effects of

bureaucratic problems and the insurmountable

hurdles of scarce resources. Planned CPD

activities in these settings should help to

prevent professional isolation and burnout while boosting the individual’s morale.

CPD Framework

Review - Analysis and Appraisal:

Individuals/Institutes review their

professional experiences in a structured way.

This appraisal enables them to identify their

interests and competences. Analysis of future

needs takes account of current, future, job and

career requirements. The analysis identifies the

priority areas for their CPD development which

is recorded as their profile of needs.

Planning:

Individuals/Institutes identify the most

appropriate learning and development activities

to meet their profile of needs, informed by any

advice from their organization(s) or mentor,

taking into account the opportunities available

as well as any preferences and constraints. They

set targets which are of high priority, practical,

achievable and challenging. The profile is

recorded as the personal development plan

which specifies objectives, responsibilities,

resource requirements, time-scale and indicators of successful achievement.

Development Activities:

To meet their development needs and achieve

their targets, Individuals/Institutes choose from

the wide range of formal and informal activities

available to them. Although most activities will

be planned, individuals are encouraged to

recognize and take advantage of opportunities

which arise from day-to-day work experiences,

unexpected challenges and professional

contacts. Successful development usually

requires that learning activities are matched by practical applications.

An important outcome of development

activities is the detailed record, kept by the

individual, of the activities undertaken. The

record shows intended objectives, what

activities have actually occurred and with what

consequences. The development process is

given adequate time to include personal

reflection.

Assessing Achievements:

To gain full benefit from their developmental

activities, Individuals/Institutes need to ensure

that the results are assessed in some way. This

is done against their development plan and

measured in terms of new and improved levels

of competence. Individuals provide evidence of

their achievements and the development

activities which lead to them. A constructive

and thoughtful record of assessed achievement

provides an excellent opportunity for review by

employers, organizations and professional

bodies. It is also useful in employment and career development.

Individual & Institutional Levels

Depend on the following

Changes are problem driven.

Problem defined by individual/institution.

Motivation intrinsic/extrinsic.

Available resources.

Compete with other demand on time and

resources.

Individual/institutional judge result.

Dr. Abu Obaida Yassin

CPD Coordinator Faculty of Medicine

Jazan University

J A Z M E D P L U S | 14

HOSPITAL ACQUIRED

INFECTIONS

Are you Serious?

Dr. Mubarack Sani TP

Associate Professor, Community Medicine.

Jazan University

"First, do no harm." This principle is

well-known to physicians as part of the

Hippocratic Oath. It is true that science and

technology greatly helped us, the ‘Modern

Medicine’ to address the mal-functioning of the

human body. Modern hospitals are the

specialized centers were all such ‘corrective

activities’ are taking place. Normally we expect a

visit or admission to a hospital will bring about

health by correcting all the medical problems. It

may not be true for at-least some of the

unfortunate patients admitted in the hospital but

the visit or admission to the hospital happened to

be a free ticket for another deadly disease, sufferings and death.

About 5-10% of patients admitted to

hospitals in the United States develop a hospital

acquired infection (HAI). The Centers for

Disease Control and Prevention (CDC) estimate

that more than two million patients develop

hospital-acquired infections in the United States

each year. About 90,000 of these patients die as a

result of their infections. If that is the situations

in American hospitals what will be the situation

in other countries and the kingdom.

Hospital-acquired infections usually

are related to a procedure or treatment used to

diagnose or treat the patient's illness or injury.

HAI can be caused by bacteria, viruses, fungi, or

parasites, contaminated hospital equipment,

health care workers, or other patients. Depending

on the causal agents involved, an infection may

start in any part of the body. A localized

infection is limited to a specific part of the body

and has local symptoms. For example, if a

surgical wound in the abdomen becomes

infected, the area of the wound becomes red, hot,

and painful. A generalized infection is one that

enters the bloodstream and causes general

systemic symptoms such as fever, chills, low

blood pressure, or mental confusion etc.

Hospital-acquired infections may

develop from surgical procedures, catheters

placed in the urinary tract or blood vessels,

ventilators or from material from the nose or

mouth that is inhaled into the lungs. The most

common types of hospital-acquired infections are

urinary tract infections (UTIs), pneumonia, and

surgical wound infections.

Hospital-acquired infections are

serious illnesses that cause death in about 1% of

cases. Rapid diagnosis and identification of the

responsible microorganism is necessary, so

treatment can be started as soon as possible.

About 25% of these infections can be prevented

by healthcare workers taking proper precautions

when caring for patients.

Once the infection is identified, the

patient is treated with antibiotics sensitive to the

organism. The most unfortunate issue is that

most of the hospital acquired bacteria are

becoming more and more resistant to the

standard antibiotic treatments. When this

happens, a different, more powerful antibiotic

must be used.

Two strong antibiotics that have been

effective against resistant bacteria are

vancomycin and imipenem, although some

bacteria are developing resistance to these

antibiotics as well.

“The most unfortunate issue is that

most of the hospital acquired bacteria

are becoming more and more resistant

to the standard antibiotic treatments “

Hospital Acquired Infections have a

significant impact on the length of hospital stay

and medical care cost. Extra costs of HAI

resulted not only from prolongation of hospital

stay, but also other tangible and intangible

medical costs. Infection control for preventing

nosocomial infections may play an important role

in reducing medical costs, hospital stay, and mortality in hospitalized patients.

So the question is that, how much

importance you are giving to apply Infection

control policies and procedures in your day to

day practice and how much care you are taking

to apply the professional responsibility of "

First, do no harm." Principle.

VIRTUAL DISSECTION

For nearly a century, the dissection of

human cadavers has been a dreaded rite of

passage for budding doctors. But over the last

two decades, the field has lost prominence at

medical schools-due to a general sense that

dissection is an antiquated chore in a high-tech world.

GOING VIRTUAL

Most anatomy lessons are incorporated into

other courses and taught with computer programs

and prosections. Some medical schools have

begun to incorporate virtual dissections into their

curriculums. One aid is the Visible Human, a

computer program developed at the University of

Colorado. The program features anatomical

images taken from a cadaver — an executed

murderer from Texas that was frozen, then sliced

into 1,871 1-millimeter cross-sections. Starting

this fall at more than two dozen medical schools,

students will be able to click away layers of tissue or entire organs from a 3-D image.

Chinese researchers recently cut a body into

0.1-millimeter slices. Such advances will allow

finer resolution in computer models. The aim is

to combine that imagery with virtual-reality

technology that would allow students to feel the

weight, texture and elasticity of body parts without a whiff of formaldehyde.

For all the technological advances,

anatomists wince at the notion that a computer

simulation or video lessons could one day

replace a real body. Computers, they say, cannot

recreate the experience of unveiling a heart, of

witnessing firsthand all the anatomical variations

in people, of seeing how the parts of the body form the whole of a human being.

To eliminate the dissection requirement two

years ago has reverberated through medical

schools worldwide. Anatomists say they feel

increasing pressure from administrators to condense dissection.

Now in present scenario virtual dissection is

need of today and possibly necessity of tomorrow………….

DR. SHWETA CHAUDHARY

Lecturer, Department Of Anatomy Faculty of Medicine Jazan University

J A Z M E D P L U S | 15

TELOMERES – QUESTION OF LIFE AND DEATH

A curious student and a new researcher is

always very interested in asking about

TELOMERES AND TELOMERASES? What

do they do? How do they get there? And why

should anybody care about their role.

Let us start by answering what are

telomeres?

• Telomeres are simply repetitive noncoding

DNA sequence present at the ends of

chromosomes.

What are the exact functions of telomeres?

They act as a genetic clock.

Protective cap

Loss of telomere end protection leads to

genome instability

Telomeres protect chromosomal ends and

prevent shortening of vital genes after

replication (cell division)

Telomere length serves as an intrinsic

biological clock that regulates life span of the

cell.

The longer the telomere, the more the times of

cell division.

The problem with DNA replication is that the

replication of linear DNA would result in the loss

of genetic material at the ends, without a

mechanism to add DNA directly to the ends.

Telomeres are synthesized by telomerase

enzyme

Telomerase is a ribonucleoprotein enzyme

complex (a cellular reverse transcriptase).

It stabilizes telomere length by adding

hexameric (TTGGGG) repeats onto the

telomeric ends of the chromosomes, thus

compensating for the shortening occurs after

cell division.

Telomerase Activity

High telomerase activity exists in rapidly

dividing cells such as epidermal skin cells,

follicular hair cells, and cancer cells.

Inactive in most cells: somatic cells and

differentiated cells.

TELOMERES AND AGEING

It is believed that shortened telomeres in

mitotic (dividing) cells may be responsible for

some of the changes associated with normal

aging. but are not sure how big a role this

plays in the aging process. Each type of cells

has a limited numbers of cell division. When

cells reach this limit they undergo

morphological and biochemical changes that

eventually lead to arrest of cell proliferation a

processes called cell senescence. Most normal

human cells are mortal because they can

divide only a finite number of times. In most

somatic tissues, telomerase is expressed at

very low levels or not at all -- as cells divide,

telomeres shorten progressively. With this

telomere shortening following phenomena

occur:

Cell morphology changes

Gene expression changes

cells stop division

cellular senescence occurs

AGEING occurs

Think of it like this…

For the cell, having a long telomere can be

compared to having a full tank of gas in your

automobile; having a short telomere is like

running on empty.

What is next?

As, scientists have determined that there is a

direct connection between telomere length

and aging.

What will be their next step?

Experimental work

Scientists are uncertain that similar results

will be found in humans. Another concern

about using telomerase as a potential anti-

aging drug in humans is that it might

support the UNCONTROLLED

REPLICATION OF CELLS and thus

leading to cancers.

Telomeres and Telomerase

in Cancer Development

Cancer cells are characterized by

uncontrollable growth and immortality.

Cancer cells have a highly active telomerase

that maintains stable telomere length and

results in unlimited cell division.

Telomeres and Telomerase

in Normal vs. Immortal Cells

In normal human cells

Telomerase activity is repressed normally

Telomeres shorten with successive cell

divisions in normal cells.

In cancer cell lines

Telomerase activity maintains stable

telomere lengths.

Unlimited replicative potential is there.

Questions waiting to be answered

Knowing what we have just learned about

telomeres and telomerase, there are a

number of questions waiting to be

answered;

If telomerase makes cancer cells immortal,

could we stop growth of cancer cells by

inhibiting telomerase activity?

Could we extend lifespan by preserving or

restoring the length of telomeres with

telomerase?

If so, does that raise a risk that telomerase

also will cause cancer?

Who knows how far this could go?

Scientists are not yet sure. And let’s hope

and pray for the best.

***

Dr. Thanaa Ebrahim Mohamed

Professor Clinical Biochemistry

Faculty of Medicine Jazan University

J A Z M E D P L U S | 16

MAPPING MOLECULAR

SWITCHES

THE advent of modern technologies

and the availability of genome sequences present

in biological databases led to the development of

innovative genetic approaches which improved

individual’s understandings of functional

genomics. Though the human genome has been

sequenced, scientists are still trying to figure out

how the accomplishment can help people, i.e.,

how it can be used to treat diseases. The human

genome was mapped ten years ago, but its

function has not been completely understood yet.

Human genome draft showed that human beings

have more than 20,000 genes much less than as

expected before. However, the challenge was to

find out the elements in the genome (molecular

switches) that determine when, where, and how

genes produce proteins?

Human genes (specifically, coding

exons) constitute only about 1.5% of the genome,

whereas regulatory elements (on/off switches)

take up about 6% and these elements were

encrypted within the remaining 98% of the

genome. Without these switches, called

regulatory DNA, genes are inert. Researchers

world over have been focusing on identifying

regulatory DNA to understand how the genome

works. Recently researchers at University of

Washington have created the first detailed maps

of regulatory DNA which is located within

hundreds of different types of living cells.

Dr. John A. Stamatoyannopoulos,

associate professor of Genome Sciences and

Medicine at the University of Washington has

reported that these breakthrough studies have

provided the first extensive maps of the DNA

switches that control human genes.

This information is very important to

understand how the body makes different kinds

of cells, and how normal gene circuitry gets

disturbed under the disease conditions.

The key finding was that of the 2.89x106

regulatory DNA regions they mapped, only a

small fraction around 200,000 were active in any

given cell type. This fraction is almost totally

unique to each type of cell and becomes a sort of

molecular bar code of the cell's identity.

These researchers also developed a method for

linking regulatory DNA to the genes which it

controls. The results of these analyses show that

the regulatory 'program' of most genes is made

up of more than a dozen switches. Together,

these findings greatly expand our understanding

of how genes are controlled and how their

regulation may differ between normal and diseased cells.

Moreover, the instructions for

turning genes on/off are written in DNA switches

called regulatory DNA. These switches are

scattered throughout the non-gene regions of the

human genome, which is the major chunk of

genome. Having mapped the locations of the

regulatory DNA switches, researchers wanted to know what made them on and off.

Further research showed that these

regions contain small chains of DNA 'words' that

make up docking sites for special regulatory

proteins involved in gene control. The human

genome contains hundreds of genes that make

such proteins. Scientists determined that genes

are connected to a complex web and in this web,

regulatory DNA regions typically control one or

at most a few genes, but genes receive inputs

from large numbers of regulatory regions.

These researchers also found evidence

for a combinatorial code that helps to match

regulatory DNA with the right genes. Humans

share over 90% of their DNA with their primate cousins (chimpanzees and monkeys).

The expression analysis or activity

patterns of genes differ across species in ways

that help to explain each species distinct biology

and behavior. These findings revealed that most

DNA variants associated with specific human

diseases or clinical traits which are located in

regulatory DNA rather than in gene sequences.

***

JOURNEY FROM JAZAN

BY: ABDEL REHMAN ABDALLAH

ALFIFI

2ND YEAR STUDENT, MEDICINE

A journey of thousand miles

From the darkness to light

Begins with a resolve

To take a leap forward

Into the unknown,

Into the unseen ….

A journey of thousand miles

starts with a colorful dream

we see in the night

with eyes open and backs upright.

A journey for being a reason

to make my Ummah smile

starts with a sharing

With mentors inspiring

A journey with good friends,

A journey with better souls

A journey with pious books

starts from my heart ………..

and my heart lies in Jazan…...

Dr. GOWHER NABI

Assistant Professor Applied Medical Sciences

Jazan University

J A Z M E D P L U S | 17

Paper currency is used repeatedly in

exchange for goods and services, and this is

why the circulation of paper currency from one

individual to another potentially spreads

microorganisms. If these currencies are

c o n t a m i n a t e d by pathogenic bacteria, the rate

of infectious diseases will continue to rise.

Various microorganisms have been isolated

from money worldwide including developed

countries. Bacillus sp. and Staphylococcus

aureus have been identified as common

contaminants isolated from paper currency.

However, other organisms like, Micrococcus sp.,

Cornebacterium sp., Vibrio cholerae,

Mycobacterium tuberculosis and members of

the family Enterobacteriacea have been isolated

from currency too. Pathogenic microbes like

S. aureus, Escherichia coli, and Klebseilla,

enterobacter have been isolated from the US

coins and paper bills currencies.

A study was carried out aimed at isolating

and identifying the level of contamination of the

c urrency notes by microbial pathogens and to

identify the possible associated risk factors.

Currency notes collected from three sources

(i.e., public transport conductors, fish vendors,

and vegetable vendors) w e r e e x a m i n e d .

N otes were collected with hands covered wi th

s te r i l e p las t i c gloves an d were placed

immediately into sterile polythene bags and

labeled accordingly. The samples were

transported immediately to the laboratory for

analysis.

All notes studied were found to be

contaminated with bacteria. The culture

from the collected paper currency yielded

isolates representing eight different types of

bacterial species viz E. coli, Proteus mirabilis,

Vibrio sp., S. aureus, Pseudomonas sp.,

Salmonella sp., Bacillus sp., and Klebsiella sp.

We found common occurrence of some bacteria

isolated from currency notes regardless of

their sources; those included E. coli, Vibrio sp.,

S. aureus, and Pseudomonas sp.; other

isolates such as, P. mirabilis and Klebsiella

sp. were found in a limited number of

colonies.

Isolation of Gram positive as well as

Gram negative bacteria from currency notes

confirmed that currency might be playing an

important role, as a vector, in the transmission

of pathogenic bacteria in the community. The

pathogenic or potentially pathogenic bacteria

found on these currency notes, namely E. coli,

S. aureus, Bacillus sp., Klebsiella sp.,

Salmonella sp., Pseudomonas sp., P. Mirabilis

and Bacillus sp. may cause a wide variety of

diseases from food poisoning, wound and skin

infections, respiratory and gastrointestinal

problems to life threatening diseases such as

meningitis and septicemia.

Considering these f i n d i n g s , i t

s e e m s that disinfection of currency in banks

by ultraviolet light, supersonic and chemi-

cals means would decrease the risk of

transmission of in fect ion . Replacement of

the traditional methods of trading with

electronic money transactions would of course

be another good solution for the problem.

u

Medical students

STRESS AND SLEEP DEPRIVATION

A wise saying is “think in the morning, act

in the noon, eat in the evening and sleep in the

night’. Sleep is considered as the best medication

but our younger generation usually

underestimates the importance of sleep in their

daily life. Studentship, Stress and Sleep

deprivation go hand in hand. It is the stress only

that keeps about 68 percent of students awake at

night as per study. Stress is found to influence

the quality of their sleep far severely than

alcohol, caffeine or late-night internet use.

About 60 percent of college students have

disturbed sleep-wake patterns and only 30

percent of them sleep at least eight hours a night,

which is a minimum requirement for a healthy

body. It is found that on week nights, 20 % of

students stay up all night at least once a month

and 35% stay up until 3 a.m. at least once a

week. 12% of poor sleepers miss class three or

more times a month or fall asleep in class.

There are also profound effects on the

immune and cardiovascular systems due to

insufficient sleep; as weight gain, anxiety, and

bipolar depression in addition to usual poor

grades, dropout and subsequent unemployment.

Of serious concern is the students' tendency to

indulge in use of alcohol and drugs to induce

sleep and hence fall into abuse.

Exam time is defined by stress, tension and

sleepless night. The biggest mistake that college

students make to cram their studies in limited

time is stay up all night. Short-term sleep

deprivation amongst students can lead to

irritability and exhaustion.

The pathophysiology is that after missing a

night's sleep; the mesolimbic pathway is strongly

stimulated, driven by a dopamine. Over a longer

period if the mesolimbic pathway is frequently

over-stimulated by sleep deprivation, there could

be permanent brain damage.

We should be helping students to understand

the importance of sleep. ”It's a chilling thought,

but that is life without sleep. Sleep is important

for the cognitive functions of the brain, and

without it, the overall ability to consolidate

memories, learn tasks, and make decisions is

impaired to a large extent. So wishing you

always a sound sleep and sweet dreams.

DR. JELDI HEMACHANDRAN

Associate Professor

Department of Physiology

Faculty of Medicine

Jazan University

DR. TABASSUM KHAN TAHANI ABDALLAH DOSHI,

WAFA AHMED HUSSAIN

Deptt of Physiology, Jazan University

CONTAMINATION OF CURRENCY NOTES

J A Z M E D P L U S | 18

Social Accountability

of Medical Schools

During the last two decades, the concept of

social development has been raised in the context

of launching the Millennium Development Goals

(MDGs). The attainment of the required level of

development necessitates social accountability,

which has been addressed in all aspects of life,

including political, social, and economic aspects.

Nevertheless, each discipline has defined social

accountability according to the goals of the

discipline.

Medical schools are not dissimilar to other

sectors that adhere to the principles of social

accountability; thus, the WHO has defined social

accountability in the medical education field as

the "obligation of the medical schools to direct

their education, research and service activities

towards addressing the priority health concerns

of the community, region, and/or nation they

have a mandate to serve. Priority health concerns

are to be jointly identified by governments,

health care organisations, health professionals

and the public".

The concept that is found in all of the

definitions from different sectors is the need to

address societies and encourage them to

contribute to the decisions that are relevant to

their lives.

Tracing this concept, it can be define as the

goal of humanity, as it has been expressed in

various religious faiths.

In Islam, for example, consulting people in

decisions that are crucial to their lives fulfils an

Islamic moral value known as Shura.

Based on the definition above, social

accountability is a broader concept than

previously anticipated, as this concept includes

the three functions of medical schools rather than

merely the education and curriculum aspects that

are emphasised in COME and CBE. As noted

previously, COME is related to social

responsibility, and CBE is related to the social

responsiveness of medical schools. Therefore,

these strategies can be considered as part of the

process of becoming socially accountable.

Social accountability should be considered a

moral obligation of schools and should assist in

fulfilling school mandates. More importantly,

social accountability should be viewed as an

opportunity to broaden the scope of health

professionals to improve the health of

communities.

It can be concluded that socially

accountable medical schools extend beyond mere

responsiveness to the urgent needs of

communities. Rather, such schools must also

consult stakeholders, including the communities

themselves, to identify priority health needs and

expectations to address these needs to obtain

short-term and long-term benefits for both the

community and the medical school.

The three basic functions of medical schools

determine the extent of their participation in

promoting the health status of communities. The

education function aims to graduate properly

prepared doctors who are able and willing to

provide care to individuals and to a community

and who understand their role in the context of

the community and their social requirements to

reduce the burden of illness and improve the

health status of community residents. Medical

schools should plan and conduct research in the

relevant areas of community health to improve

health and support the health system. Medical

schools should initiate and implement health

services that include both curative and preventive

aspects in relation to community needs.

A medical school’s adoption of social

accountability indicates that the medical school

considers community health development to be

an important issue. The role of such schools may

expand to include a follow-up of the graduates in

their profession and collaboration in preparing

good working environments and exploring

methods of adapting health systems to ensure the

optimal use of their graduates.

In consideration of the social accountability

of medical schools, there are many concepts in

common with the public accountability of the

health system. Which are observed in the context

of the following four values of the health system.

Relevance: A school's mission and

core activities in education, research

and service must be synchronous with

the health needs of the community in

which the school is located.

Quality: The quality of the activities in

which a school participates must be

viewed and determined in the context

of cultural and consumer expectations

and in accordance with the availability

of and changes in resources.

Cost-effectiveness: Activities must be

cost-effective for individuals and for

the public. Research can also address

the area of care delivery in a cost-

effective manner.

Equity: In health systems, equity

refers to the goal of making high-

quality health care available to all

people.

The most import milestone in social

accountability is the development of the Global

Consensus for Social Accountability of Medical

schools. The Consensus has been agreed upon

through a scientific process. It was finalised in a

conference that was held specifically for this

issue in October 2010.The Consensus addressed

the following ten areas:

Area 1: Anticipating the Health Needs of Society

Area 2: Partnering with the Health System and

other Stakeholders

Area 3: Adapting to the Evolving Roles of

Doctors and other Health Professionals

Area 4: Fostering Outcome-Based Education

Area 5: Creating Responsive and Responsible

Governance of Medical Schools

Area 6: Refining the Scope of Standards for

Education, Research and Service Delivery

Area 7: Supporting Continuous Quality

Improvement in Education, Research and Service

Delivery

Area 8: Establishing Mandated Mechanisms for

Accreditation

Area 9: Balancing Global Principles with

Context Specificity

Area 10: Defining the Role of Society

These ten areas lead to the definition of

the scope of the work that medical schools

require to ensure their substantial roles in the

development of health systems and, hence, the

health status of communities.

Regional and global work is needed to

adopt these ten areas and put them into real

practice for the benefit of medical schools and

the societies that they serve.

DR. MUHAMMED ALHASSAN

Medical Education Unit Faculty of Medicine, Jazan University

J A Z M E D P L U S | 19

CONTINUING PROFESSIONAL DEVELOPMENT

CPD ANNOUNCEMENT

SESSION 1434 -1435 HIJRI

FACULTY DEVELOPMENT PROGRAMME

CERTIFICATE OF HEALTH PROFESSIONALS EDUCATION

MEDICAL RESEARCH PROGRAMME

CERTIFICATE FOR REASEARCH METHODOLOGY

HUMAN RESOURCES DEVELOPMENT PROGRAMME

CERTIFICATE OF HUMAN RESOURCES DEVELOPMENT

REGISTRATION WEBSITE

http://colleges.jazanu.edu.sa/sites/en/med/Pages/default.aspx

P A G E | 20

MEDIA GALLERY

UPCOMING EVENTS 2013

MEDICAL RESEARCH DAY FEBRUARY 2012 AT ALSHWARJA COMPLEX

UNIVERSITY OF UPPSALA - SWEDEN- DRUG ADDICTION WORKSHOP JANUARY 2013

REASEARCHERS WORKSHOP – FEBRUARY 2013 FACULTY OF MEDICINE

DEVELOPMENT AND QUALITY UNIT, FACULTY OF MEDICINE–JAZAN UNIVERSITY KSA