Benha Medical Journal (Benha Med J)

Oral gabapentin premedication for post-tonsillectomy nausea, vomiting, and recovery Ibrahim M. Abdel Moety, Dina H.A El Barbari, Mohammed M.A Esmael Benha Medical Journal 2018 35(3):265-269 Background Gabapentin is a second-generation anticonvulsant that is successful in the management of chronic neuropathic pain. It was not previously known to be useful in acute perioperative conditions, but recently it has been used for acute perioperative conditions. However, evidence-based medicine suggests that perioperative administration is useful for postoperative analgesia, preoperative anxiolysis, attenuation of the hemodynamic response to laryngoscopy and intubation, and preventing chronic postsurgical pain, postoperative nausea and vomiting (PONV), and delirium. This article reviews the clinical trial data to describe the efficacy and safety of gabapentin for perioperative anesthetic management. Aim The aim of the study was to evaluate and update the effect of preoperative gabapentin on the incidence of postoperative vomiting and on analgesic requirements after adenotonsillectomy in pediatrics. Materials and methods This randomized, double-blind study was designed to explore the possible effects of oral gabapentin as a premedication on the incidence and severity of PONV and on the early recovery profile of pediatric patients undergoing adenotonsillectomy under sevoflurane anesthesia. Results The incidence of PONV in the gabapentin group was significantly lower than in the gabapentin group. However, the numbers of rescue ondansetron doses and the PONV severity score were comparable in the two groups. Conclusion The use of gabapentin as premedication in pediatric patients undergoing adenotonsillectomies under sevoflurane anesthesia reduces the incidence of PONV and emergence agitation in the early postoperative period. However, gabapentin did not reduce pain and analgesic consumption after surgery.

Left ventricular untwist in patients with diastolic dysfunction: speckle tracking imaging study Mahmoud A Soliman, Mahmoud K Ahmed, Morad B Mena, Mohamed S.S Montaser Benha Medical Journal 2018 35(3):270-276 Background There is no single noninvasive index that can directly assess diastolic function. Untwist contributes to diastolic suction and early filling. Speckle tracking imaging (STI) can be used to study the relation between diastolic indices and untwist in patients with diastolic dysfunction. Patients and methods A total of 75 patients with diastolic dysfunction and 25 normal volunteers were selected for this study. According to mitral flow pattern, the patients were classified into group I (abnormal relaxation), group II (pseudonormalized), and group III (stiffness pattern). Using STI, the basal and apical short-axis views were imaged. Stored data were processed to get apical and basal rotation, systolic twist, peak systolic twist ratio, diastolic untwist ratio, and time to peak twist and untwist ratio. Results Peak untwisting ratio was significantly higher in Group I Patients that decreased to be normalized and even decreased with progression of diastolic dysfunction from Group II to Group III. There was a highly significant positive and negative correlation with end-diastolic volume and end-systolic volume, respectively. Time to peak untwist ratio nonsignificantly increased from group I to III, with nonsignificant correlation between untwist ratio and peak E, A, and E/A ratio. Conclusion Patients with relaxation abnormality have a higher untwist ratio, which decreases gradually with progression from relaxation to stiffness pattern. It may appear as a compensatory mechanism to ensure early filling with relaxation abnormality.

The role of dynamic contrast-enhanced MRI analysis of perfusion changes in hepatocellular carcinoma Ahmed M Elzeneini, Mohamed I Yousef, Medhat M Refaat Benha Medical Journal 2018 35(3):277-281 Background Dynamic contrast-enhanced (DCE)-MRI functional imaging is primarily focused on quantitative evaluation of tumoral perfusion and permeability, thus enabling an insight into the pathophysiology of tissue and serving as early noninvasive biologic markers of tumorigenesis. Aim The aim was to evaluate the functional role of DCE-MRI analysis of perfusion changes in hepatocellular carcinoma (HCC). Patients and methods A total of 43 patients with liver cirrhosis having 65 HCCs all underwent 3 T multiphase DCE-MRI assessment. Maximum relative enhancement, area under curve, wash-in ratio, wash-out ratio, time to arrival, and time to peak semiquantitative measurements were analytically compared between the hepatocellular carcinogenic lesions and the adjacent lesion-free liver cirrhosis. Results Comparison of different perfusion metrics across hepatocellular carcinogenic lesions and adjacent lesion-free liver cirrhosis revealed exceling statistical significance. Diagnostic accuracies were highest when using wash-out ratio (86.2%) to detect HCC from background cirrhosis, whereas they were lowest using area under the curve (67.7%). Implementing wash-in ratio (81.9%), as a first-pass perfusion metric, surpassed its counterpart, maximum relative enhancement (73.4%), in diagnostic reliability. Regarding the timing of flow dynamics, time to arrival (84.1%) was more important than time to peak (78.1%) as a diagnostic indicator of hepatocarcinogenesis. Conclusion Multiphase DCE-MRI perfusion analyses provide quantitative hemodynamic metrics that promise potential usefulness as noninvasive biomarkers in the detection of HCC.

Noninvasive predictors of hepatic fibrosis in patients with chronic hepatitis C virus in comparison with liver biopsy Ayman N Menessy, Nancy A Ahmed, Nagwa I Abdallah, Salah S Arif Benha Medical Journal 2018 35(3):282-286 Background Liver fibrosis is the main predictor of the progression of chronic hepatitis C, and its assessment by liver biopsy can help plan therapy. However, biopsy is an invasive procedure with occasional complications and poor patient acceptance. Aim The aim of this work was to compare noninvasive and invasive methods for evaluation of fibrosis in patients with chronic hepatitis C. Patients and methods This cross-sectional study was carried out at the Liver Unit of Mansoura University Hospital and Mansoura Health Insurance Hospital. The study was conducted on 100 patients with chronic active hepatitis. Biochemical and virological studies were performed in addition to abdominal ultrasonography and liver biopsy in all patients. Moreover, analyses of serum fibronectin (FN), AST-to-platelet ratio index (APRI), and alanine aminotransferase/aspartate aminotransferase (AST/ALT) ratio were performed. Results We found that FN has the highest sensitivity and specificity, and the independent variables related to fibrosis were FN, APRI, and AST/ALT ratio. Conclusion The biochemical tests including APRI, AST/ALT ratio, and particularly FN could be valuable noninvasive predictors for assessment of liver fibrosis in patients with chronic hepatitis C infection.

Orbitozygomatic approach results of 16 spheno-orbital hyperostotic meningiomas (en plaque) Ashraf El Badry, Azza Abdel Azeez, Ahmed Abdel Khalik Benha Medical Journal 2018 35(3):287-296 Objective This study aimed to evaluate the results of the orbitozygomatic approaches of intraosseous meningiomas that causes hyperostoses involving the greater wing of the sphenoid and orbital bones with a small soft tissue component. Patients and methods We carried out a prospective and retrospective study of 16 patients with meningiomas en plaque who underwent surgical procedures by the orbitozygomatic approach in the period between 1999 and 2014 at the Neurological Surgery Department, Mansoura University Hospital of Egypt. Results The mean age of the patients was 49.6 years, whereas the most common complaint was proptosis accounting for 81.25% of cases. The second most common complaint was visual impairment accounting for 56.25% of cases. The orbitozygomatic approach was used for all the cases and drilling of the greater wing of the sphenoid, lateral orbital wall, orbital, and optic canal roof was performed. The small soft tissue component of the meningiomas was in the anterior and middle cranial fossa involving hyperostoses in all surrounding bones in all cases, whereas four cases showed intraorbital soft tissue meningioma. The results after surgery indicated an improvement of proptosis in 75% of cases, with less improvement in visual impairment observed in 56.25% of cases. Complications included third nerve palsy in 87.25% (14) of cases, and improved only in five cases. The extent of tumor surgical resection was subtotal in 75% (12) of cases. These tumors progressed in eight cases and only two patients underwent a second surgical intervention; others were referred to radiotherapy. Conclusion Despite good surgical exposure in this approach, the radical excision of the tumors may be extremely difficult as the tumor in these areas showed involvement of very delicate structures (because of late medical consultation), which made the dissection impossible, but using this approach we can achieve good results including proptosis and visual impairment.

Intrathecal nalbuphine as an adjuvant to bupivacaine in spinal anesthesia for lower-limb surgeries: intraoperative and postoperative effects Saad I Saad, Ehab E Afifi, El-Sayed M Abd El-Azim, Walid H.I Moftah Benha Medical Journal 2018 35(3):297-306 Background Many opioids are added to intrathecal local anesthetics to provide longer duration of analgesia; however, we have to choose an additive with the longest analgesic time and least intraoperative and postoperative side effects. In this study, nalbuphine was compared with fentanyl and pethidine as additives to hyperbaric bupivacaine used in spinal anesthesia for lower-limb surgeries. Patients and methods A total of 100 patients of both sexes, American Society of Anesthesiologists I and American Society of Anesthesiologists II, scheduled for lower-limb surgeries under spinal anesthesia were assigned randomly into four groups: group B received intrathecal injection of 0.5% hyperbaric bupivacaine (3+1 ml sterile water; n=25); group N received intrathecal injection of 0.5% hyperbaric bupivacaine (3+1 ml nalbuphine 500 μg; n=25); group F received intrathecal injection of 0.5% hyperbaric bupivacaine (3+1 ml fentanyl 25 μg; n=25); and group P received intrathecal injection of 0.5% hyperbaric bupivacaine (3+1 ml pethidine 10 mg; n=25). We recorded the onset of sensory and motor blocks, peak sensory and motor block times, sensory block levels and two-segment regression time using the pin-prick method, motor block level using the modified Bromage scale, and any intraoperative or postoperative complications. Results The mean onset of sensory block significantly decreased in groups N, F, and P compared with group B, whereas the peak sensory time did not significantly change in all the four groups. In contrast, the mean onset of the motor block in all four groups was nonsignificantly different, whereas the mean time for peak motor block was significantly short in both the N group (nalbuphine and bupivacaine) and the P (pethidine and bupivacaine) group compared with the B (bupivacaine alone) and F (fentanyl and bupivacaine) groups. There was significant prolongation in both two-segment regression time and the first analgesic request time in groups N, F, and P (all narcotics and bupivacaine) compared with group B (bupivacaine alone). Conclusion Nalbuphine, fentanyl, and pethidine as adjuvants to spinal anesthesia prolong the duration for first-rescue analgesia with minimal hemodynamic and respiratory complications; however, nalbuphine at a dose of 0.5 mg has the best quality of spinal block when added to intrathecal 0.5% heavy bupivacaine in patients undergoing lower-limb surgeries.

Effect of Nigella sativa oil on Schistosoma mansoni immature worms in experimentally infected mice Azza S Al Hamshary, Ibrahim M Nagati, Maysa A Eraky, Eman A Abou-Ouf, Asmaa A Kholy, Ghada H Omar Benha Medical Journal 2018 35(3):307-311 Background Nigella sativa oil is one of the promising drugs of a plant origin that have an antischistosomal effect. Aim The aim of the present work was to explore the role of N. sativa oil either alone or in combination with praziquantel on immature worms of Schistosoma mansoni. Materials and methods N. sativa oil capsules dissolved in corn oil were administered to S. mansoni-infected mice aiming to study the therapeutic and prophylactic effects. The study included six groups of mice: (a) noninfected and nontreated, (b) infected and nontreated, (c) prophylactic N. sativa oil group, (d) praziquantel group, (e) therapeutic N. sativa oil group, and (d) combined group. All mice were killed 4 weeks after infection and treatment. The antischistosomal effect of N. sativa oil was assessed by worm burden, histopathology, and scanning electron microscopy. Results Therapeutic N. sativa oil group showed the highest significant decrease in the mean number of immature worm burden (R% was 57%) when given after infection followed by the combined group (R%=55.67%), whereas prophylactic N. sativa oil group showed nonsignificant decrease (R%=37%). The least changes were observed in praziquantel group (R%=0%). Conclusion N. sativa oil has a potent effect on immature S. mansoni which could be helpful for potentiating praziquantel effect and thus reducing development of resistance.

Diagnostic accuracy of lectin-reactive α-fetoprotein (AFP-L3) in the diagnosis of hepatitis C virus-related hepatocellular carcinoma Atef Ahmed Ali Ibrahim, Roshdy Mohamed Khalaf Allah, Amr M El Hammady, Rizk Sayad Rizk Sarhan, Medhat A Khalil, Marwa Mohiy Eldin Abdel Rahman Benha Medical Journal 2018 35(3):312-316 Background Hepatocellular carcinoma (HCC) is one of the most malignant neoplasms. It has a very poor prognosis because the diagnosis is very late. Therefore, early detection is important in the management of this neoplasm. α-fetoprotein (AFP)-L3 has been recommended as a marker for early-stage HCC in many countries all over the world. Aim The aim was to evaluate the potential clinical value of lens culinaris agglutinin-reactive AFP-L3 against total AFP in the diagnosis of hepatitis C virus-related HCC and to evaluate its role in disease diagnosis. Materials and methods This study included 40 patients who were diagnosed as hepatocellular carcinoma (diagnosis was based on the BCLC staging classification), 20 patients with chronic liver disease, and 20 healthy subjects as a control group. Results Results showed that there was a significant positive correlation between each of serum AFP and AFP-L3 and each of tumor size and tumor number among patients with HCC. The median value of both serum AFP-L3 and AFP-L3/AFP ratio was significantly higher in patients with HCC group when compared with patients with chronic liver disease and normal control individuals. Receiver operator characteristic curves were constructed for serum AFP, AFP-L3, and AFP-L3/AFP ratio as predictors of HCC. Serum AFP-L3 had the largest area under the curve. The best cut-off point for AFP as predictor of HCC was 128 ng/ml [sensitivity 75%, specificity 100%, positive predictive value (PPV) 100%, negative predictive value (NPV) 66.7%, and efficacy 83.3%]. The best cut-off point for AFP-L3 as predictor of HCC was 23 ng/ml (sensitivity 97.5%, specificity 100%, PPV 100%, NPV 95.2%, and efficacy 98.3%). The best cut-off point for AFP-L3/AFP ratio was 16% (sensitivity 97.5%, specificity 100%, PPV 100%, NPV 95.2%, and efficacy 98.3%). Conclusion In conclusion, AFP-L3 is a promising marker for diagnosis of HCC especially when combined with AFP, as the diagnostic sensitivity was optimum, so both markers can be used in the screening of HCC.

Effect of ambroxol on experimentally induced acute oxidative stress in the heart, kidney, and intestine in rats Mahmoud M Elfouli, Mohie E Said, Hanan T Emam, Nashwa H Abu-raia, Manar A Metwally Benha Medical Journal 2018 35(3):317-325 Background Intestinal ischemia–reperfusion (IR) is a frequently occurring phenomenon during abdominal and thoracic vascular surgery, small bowel transplantation, hemorrhagic shock, and surgery using cardiopulmonary bypass, carrying high morbidity and mortality. Ambroxol hydrochloride is an active N-desmethyl metabolite of bromhexine hydrochloride. Ambroxol is indicated as ‘secretolytic therapy in bronchopulmonary diseases associated with abnormal mucus secretion and impaired mucus transport’. Aim The present study was designed to evaluate the effect of ambroxol on experimentally induced acute organ oxidative stress in the form of remote organ injury including kidney and heart after intestinal IR. Materials and methods Thirty animals were classified into five groups. First group: normal control group, second group: nontreated intestinal IR group (intestinal IR was induced by mesenteric artery ligation), third group: ambroxol pretreated intestinal IR group (35 mg/kg), fourth group: ambroxol pretreated intestinal IR group (70 mg/kg), fifth group: ambroxol pretreated intestinal IR group (140 mg/kg). Results Ambroxol significantly reduced the malondialdehyde level in the heart and the kidney when compared with intestinal IR with no medication group. It also improved cardiac troponin and, kidney functions (urea and creatinine) and histopathological affection when compared with intestinal IR with no medication group. Conclusively, in this study ambroxol could have a protective effect against intestinal IR through its antioxidative and anti-inflammatory effect.

The potential combined effect of vitamins E and C on fluoride-induced hepatic toxicity in albino rats Amany M.S El Din, Rania N Sherif, Salwa M.M El Khyat, Yassmin G Salem Benha Medical Journal 2018 35(3):326-335 Background Fluoride is a well-determined nonbiodegradable and moderate pollutant, which at high levels causes serious health problems. Aim The present study was designed to investigate the histopathological changes in liver as a result of exposure to sodium fluoride in albino rats and the possible therapeutic effect of both vitamins E and C. Materials and methods Eighteen adult albino mice were divided into three groups (six rats per each group). The first group served as control. The second group was treated with 3.6 mg/kg body weight sodium fluoride for 30 days, and the third group received 3.6 mg/kg body weight of sodium fluoride for 30 days followed by vitamins E and C for the next 13 days. At the end of the treatment period, the animals were sacrificed by means of cervical dislocation and the liver was dissected out. Blood samples were taken for the assessment of serum glutamic-pyruvic transaminase and serum glutamic oxaloacetic transaminase. Results Liver tissue was cleared and used for assessing the histopathological changes. Liver tissue homogenate was used for the assessment of malondialdehyde and glutathione peroxidase levels. The histopathological results in the present study indicated that exposure to sodium fluoride for 30 days caused degenerative changes in the liver. Light microscopic examination revealed the degenerative changes in the liver, such as disorganization of the cell plates, dilation of the central vein, pyknotic nucleus, ballooned hepatocytes and hepatocytes with empty nuclei, and disturbed mucopolysaccharide metabolism in liver cells. Biochemical examination revealed elevated serum glutamic-pyruvic transaminase, serum glutamic oxaloacetic transaminase, and malondialdehyde and decreased glutathione peroxidase level. Conclusion Administration of vitamins E and C during the first 13 days of the recovery period of sodium fluoride intoxication revealed minimal improvement, which was detected at the biochemical and metabolic level.

Antibiotics

Volume 72, Issue 1
	In this issue  Article   Brief Communications   Correspondence   Index  Also new      AOP
ARTICLE
Isolation and structure determination of a new cytotoxic peptide, curacozole, from Streptomyces curacoi based on genome mining Issara Kaweewan, Hisayuki Komaki, Hikaru Hemmi, Kanata Hoshino, Takeshi Hosaka et al.  The Journal of Antibiotics 2018 72 :1 - 7; October 11, 2018; 10.1038/s41429-018-0105-4 Abstract | Full Text
Helvamide, a new inhibitor of sterol O-acyltransferase produced by the fungus Aspergillus nidulans BF-0142 Takashi Fukuda, Takun Furukawa, Keisuke Kobayashi, Kenichiro Nagai, Ryuji Uchida et al. The Journal of Antibiotics 2018 72 :8 - 14; October 10, 2018; 10.1038/s41429-018-0101-8 Abstract | Full Text
Cyathane diterpenoids and drimane sesquiterpenoids with neurotrophic activity from cultures of the fungus Cyathus africanus Rong-Wei Kou, Shuang-Tian Du, Yi-Xiao Li, Xi-Tao Yan, Qiang Zhang et al.  The Journal of Antibiotics 2018 72 :15 - 21; October 16, 2018; 10.1038/s41429-018-0106-3 Abstract | Full Text
Synthesis and evaluation of biological activity of benzoxaborole derivatives of azithromycin Anna N. Tevyashova, Alexander M. Korolev, Elena P. Mirchink, Elena B. Isakova & Ilya A. Osterman  The Journal of Antibiotics 2018 72 :22 - 33; October 12, 2018; 10.1038/s41429-018-0107-2 Abstract | Full Text
Isolation of 4,4′-bond secalonic acid D from the marine-derived fungus Penicillium oxalicum with inhibitory property against hepatocellular carcinoma Li Chen, Ya-Ping Li, Xin-Xin Li, Zhi-Hao Lu, Qiu-Hong Zheng et al.  The Journal of Antibiotics 2018 72 :34 - 44; September 27, 2018; 10.1038/s41429-018-0104-5 Abstract | Full Text
BRIEF COMMUNICATIONS
Cytotoxic anthracycline and antibacterial tirandamycin analogues from a marine-derived Streptomyces sp. SCSIO 41399 Ziwen Cong, Xiaolong Huang, Yunhao Liu, Yuxuan Liu, Pei Wang et al.  The Journal of Antibiotics 2018 72 :45 - 49; September 26, 2018; 10.1038/s41429-018-0103-6 Abstract | Full Text
Augmented antibacterial activity of ampicillin with silver nanoparticles against methicillin-resistant Staphylococcus aureus (MRSA) Priyanka Surwade, Christopher Ghildyal, Chase Weikel, Todd Luxton, Derek Peloquin et al.  The Journal of Antibiotics 2018 72 :50 - 53; October 25, 2018; 10.1038/s41429-018-0111-6 Abstract | Full Text
CORRESPONDENCE
MS network-based screening for new antibiotics discovery Nobuhiro Koyama & Hiroshi Tomoda  The Journal of Antibiotics 2018 72 :54 - 56; October 23, 2018; 10.1038/s41429-018-0109-0 Abstract | Full Text
INDEX
Author Index for Volume 71 Akemi Yoshida  The Journal of Antibiotics 2019 72 :57 - 61; January 07, 2019; 10.1038/s41429-018-0116-1 Abstract | Full Text

Nature and Science of Medicine

Whom do you want to treat you? Definitely more than looks! Majid Abdulrahman Almadi, Tarek Kashour Journal of Nature and Science of Medicine 2019 2(1):1-2

Unleashing the immune system to conquer cancer Abdulrahman Alsultan Journal of Nature and Science of Medicine 2019 2(1):3-4

Fundamentals of laparoscopic surgery: Principles, implementation, and comparison to other modalities Abdulaziz Alkanhal Journal of Nature and Science of Medicine 2019 2(1):5-9 The minimally invasive laparoscopic surgery has gained popularity among various surgical specialties. However, unique skills are required to perform it. These skills are not transferable from open approach and are associated with a steep learning curve. Therefore, they need to be obtained in a safe-simulated environment. Fundamental laparoscopic surgery program is currently considered the gold standard for assessing laparoscopic skills and a mandatory requirement for board certification in the United States and for promotional advancement of residents in different surgical residency programs. Despite its proven benefits and its superiority when compared to other training models, challenges exist related to its implementation outside North America. The lack of sufficient eligible examiners is the major obstacle. Once overcome, one can aspire to achieve the remaining standards required for full implementation.

Direct current stimulation and epilepsy in Kingdom of Saudi Arabia: Opportunity and challenges Abdulrahman Al-Thaqib, Ali Mir, Raidah S Albaradie, Shahid Habib, Shahid Bashir Journal of Nature and Science of Medicine 2019 2(1):10-13 Transcranial direct current stimulation (tDCS) is one type of neuromodulation, which is an emerging technology that holds promise for the future studies on therapeutic and diagnostic applications in treatment of neurological and psychiatric diseases. Epilepsy is a major problem with devastating effects on patients and their caregivers and has a tremendous socioeconomic impact on families and health-care systems in the Saudi Arabia and worldwide. tDCS is a low-cost, noninvasive portable neuromodulation technique which can transiently decrease or increase cortical excitability in humans and which was invasively demonstrated to reduce epileptiform discharges in animals. This article reviews the tDCS as tools of neuromodulation for epilepsy and discusses the opportunities and challenges available for clinicians and researchers interested in advancing neuromodulation therapy. The aim of this review is to highlight the usefulness of tDCS and to generate an interest that will lead to appropriate studies that assess the true clinical value of tDCS for epilepsy among local clinician and scientist.

Prepubertal vulvovaginitis Salwa Mohammed Neyazi Journal of Nature and Science of Medicine 2019 2(1):14-22 Vulvovaginitis is one of the most common gynecologic complaints in prepubertal girls. It accounts for 40%–80% of visits to pediatric gynecology services. It arouses parental anxiety because of the perceived rarity of vulvovaginitis in children, the fear of sexual abuse or concerns over lack of appropriate supervision, and hygiene in daycare or school. The majority of cases are due to nonspecific vulvovaginitis in which vaginal cultures will grow organisms considered to be part of the normal flora. The condition is easily managed with good perineal hygiene. In reluctant cases, oral antibiotics or local estrogen cream may be helpful. A small percentage will have a specific etiology and vaginal cultures will identify the pathogen. Most of these pathogens will be intestinal organisms, respiratory organisms, or sexually transmitted diseases. The isolation of sexually transmitted organisms should alert the physician to investigate for child sexual abuse. Other causes of prepubertal vulvovaginitis include systemic illness and foreign bodies which will result in foul-smelling bloody discharge most commonly toilet paper which can be removed by in-office vaginal irrigation but requires a cooperative child otherwise we may have to do vaginoscopy under general anesthesia.

Celiac disease in children Anjum Saeed, Asaad Mohamed Assiri, Huma Arshad Cheema Journal of Nature and Science of Medicine 2019 2(1):23-28 Celiac disease (CD) is a chronic enteropathy due to ingestion of gluten and related products leading to villous injury and its various manifestations. It has a strong genetic tendency with the presence of human leukocyte antigen (HLA-DQ 2, DQ 8) in more than 98% of these patients with CD. Western studies documented 0.5%–1% prevalence of CD but it is not an uncommon condition in the Arabic peninsula. Classical gastrointestinal (GI) manifestations are common in the toddler's age group while non-GI manifestations predominate in the adolescents and older children. High-risk groups and associated conditions need special considerations for screening CD. European and Americans guidelines are available for diagnosing these children and recommend to screen with anti-tissue transglutaminase antibodies which have got very high sensitivity and specificity. North American guidelines recommend to do small bowel biopsies and interpreted by Marsh grading. Gluten-free diet for the rest of life is still a recognized therapy for these children under the supervision of an expert dietician dealing with CD. National awareness programs and seminars may help in identifying this underdiagnosed condition to avoid morbidity and mortality related to this lifelong disorder.

Does physicians' gender have any influence on patients' choice of their treating physicians? Ghadah Alyahya, Hind Almohanna, Abdullah Alyahya, Mubarak Aldosari, Laila Mathkour, Abdulrahman Aldhibaib, Youssef Al-Namshan, Najwa Al-Mously Journal of Nature and Science of Medicine 2019 2(1):29-34 Objectives: The purpose of this study was to determine whether physicians' gender has any influence on patients' choice of their treating physician. Methods: A survey was conducted in different public places in Riyadh, Saudi Arabia, to determine preferences for the gender of a physician under various health-care aspects. Results: Three thousand and fifteen people participated in this cross-sectional survey. The majority of participants had no gender preference regarding their physician's attitude and professional competence. However, 49.8% of the female participants preferred a female physician and 37.4% of the male participants preferred a male physician when discussing family and psychological problems. Regarding general and genital examination, 65.8% and 86.4% of women and 53% and 67.5% of men, respectively, preferred to be examined by a physician of their same gender. The majority of women preferred a female physician during breast examination (90.1%) and delivery (71.4%). With regard to medical specialties, men preferred a male general surgeon (48.6%), male urologist (65.1%), and male orthopedic surgeon (54.4%). On the other hand, women preferred a female urologist (58.1%) and had no gender preference regarding their general surgeon (48.1%) and orthopedic surgeon (51.4%). Conclusion: Findings of this study highlight the difference in participants' choice for the gender of their treating physician in different medical specialties. Women participants preferred a female physician for psychosocial counseling and when visiting a gynecologist, obstetrician, or urologist. In addition, women of childbearing age favored a female physician during delivery. Men preferred a physician of the same gender when being treated by a urologist, general surgeon, or orthopedic surgeon.

Comparison of flow cytometric and immunohistochemical immunophenotyping data for diagnosis of B-cell neoplasms and classic hodgkin's lymphoma Fatma Saeed Alqahtani, Karim Hamda Farhat, Mashael Marzouq Alshebly Journal of Nature and Science of Medicine 2019 2(1):35-40 Objective: This study was aimed to compare the results of immunophenotyping by flow cytometry (FC) and immunohistochemistry (IHC) in the diagnosis of B-cell lymphomas and classic Hodgkin's lymphoma (cHL). Methods: This was a retrospective cohort study of 280 patients with chronic B-cell neoplasms and cHL performed between 2008 and 2013. Percentages of B- and T-cell markers detected by FC and IHC were compared regardless of the final diagnosis. Results: FC and IHC results were obtained from 280 patient medical records. There were 155 (55.4%) patients with non-Hodgkin's lymphoma (NHL), 110 (39.3%) with cHL, and 15 (5.4%) with chronic lymphocytic leukemia (CLL). Disparity between FC and IHC was observed for CD19 expression in cHL group where 73.6% (n = 81) CD19 expression was detected by FC and 59.1% (n = 65) detected by IHC (P < 0.02). In NHL group, a higher percentage (81.3%; n = 126) of CD19 was detected by FC as opposed to 61.3% (n = 95) detected by IHC (P < 0.0001). CD19 expression was no different between the two groups. CD20 expression assessed by FC (61.3%; n = 95) was lower than 85.2% (n = 132) detected by IHC in NHL group (P < 0.0001). Whereas no differences were observed in cHL, IHC performed better (100%; n = 15) than FC (66.7%; n = 10) for CD20 detection in CLL group (P < 0.01). In cHL and NHL groups, flow cytometric detections of CD21 of 61.8% and 56.1% were higher than 46.4% (P < 0.02) and 41.9% (P < 0.01) detection rates by IHC. No disparities were observed between FC and IHC detection rates for CD5, CD10, CD23, and CD30 expressions. Conclusion: There was a considerable amount of disparity between FC and IHC results, warranting further evaluation.

The top 100 articles on hepatitis C Manar Aleid, Othman Tawfiq Almutairi, Latifah Alfahad, Mohammed Jameel, Nouf Almutairi, Bandar Al-Judiabi Journal of Nature and Science of Medicine 2019 2(1):41-47 Background: Hepatitis C infection is considered one of the most common hepatological infections. Many papers have been published, but none have listed the most influential work in the field of hepatitis C. Objectives: The aim of this study is to produce a bibliometric historical review on hepatitis C and its management. Methods: We underwent a title-specific search using Scopus database in 2017; using hepatitis C as our search term. The top 100 most cited articles were obtained and analyzed. Results: The top 100 articles received an average of 1273 citation per paper. The most productive years of publication ranged between 1999 and 2003 which accounted for 33 articles in our list. The top two journals in our list were New England Journal and Hepatology Journal with a contribution to 21 and 20 articles in our list, respectively. Research study category was accounted as the most common study category (60%). The top two specialties of contribution were Medicine (26 articles) and Hepatology (25 articles). Albrecht, J and Mchutchison have produced 9 and 8 articles, respectively, from our 160 authors list. The majority of the papers were created in the United States of America (62%). Conclusions: The identification and clustering of the top 100 most impactful work in hepatitis C serve as an excellent overview of the current trends of publication in the field of hepatitis C to identify areas of research inadequacy and to serves as an efficient guide to achieving evidence-based clinical practice.

General public awareness, knowledge, and beliefs toward palliative care in a Saudi population Hasan Mohammed Alkhudairi Journal of Nature and Science of Medicine 2019 2(1):48-53 Objectives: Public awareness of palliative care (PC) is satisfactory in only twenty countries in 2013, which does not include Saudi Arabia in spite of the global efforts done to enhance the public awareness of PC. This study was conducted to evaluate the awareness, knowledge, and beliefs of the Saudi adult population about PC. Methods: A cross-sectional design study was conducted in December 2017 using a self-administered questionnaire survey that was sent through Google Docs to assess the Saudi general public on the awareness of PC. Results: There were 1987 (out of 3164, 62.8% response rate) Saudi adults who responded to the survey, in which 60.3% were males (mean age: 39.50 years, median: 39.0 years, and range: 15–77 years). There were 321 (16.2%) respondents who reported that they know PC and 454 (22.8%) answered that they have heard or were aware of PC. A total of 755 (38.2%) believe that PC improves the quality of life of sick people and 684 (34.4%) believe that PC can reduce the physical suffering of patients. Knowledge of PC was not statistically significantly affected by gender, place of residence, and marital status. On the other hand, employment and having higher levels of education led to better knowledge and more awareness of PC. Conclusion: The current study demonstrated that the knowledge and awareness of PC is still low among surveyed Saudis. There is a need for the government to advocate institutions to functionally devote programs and initiatives and promote literacy of PC in the general population. Nongovernmental sectors should also participate in programs to improve the knowledge and awareness of PC.

Human Biology

Health care: Where are we heading? Monali Amit Shah Advances in Human Biology 2019 9(1):1-1

The incidence of brain tumours in Iran: A systematic review and meta-analysis Soheil Hassanipour, Gholamreza Namvar, Mohammad Fathalipour, Mohammad Ghorbani, Elham Abdzadeh, Saber Zafarshamspour, Shirin Riahi, Abdollah Mohammadian-Hafshejani, Hamid Salehiniya Advances in Human Biology 2019 9(1):2-7 Background: Brain tumours (BTs) constitute approximately 88% of all central nervous system tumours. The present study aimed to determine the age-standardised rate (ASR) of BTs in Iran. Methods: A comprehensive search was conducted on all studies of BTs incidence using Medline/PubMed, Scopus, Embase, Google Scholar and Web of Sciences as international databases and Scientific Information Database, MagIran, IranMedex and IranDoc as Iranian databases until April 2018. This systematic review was done based on the preferred reporting items for systematic reviews and meta-analyses. Results: The primary search yielded 312 relevant studies. A total of 17 studies were included after more detailed retrieval. The results of the random-effect model were demonstrated the ASR of BTs was 4.16 (95% confidence interval [CI], 3.20–5.12) for males and 3.40 (95% CI, 2.67–4.13) for females. Conclusion: The incidence of BTs is lower in Iran compared to other parts of the world. The incidence of nervous system cancers is increasing base on region, geographical, and economic conditions in Iran. Hence, training programmes can be considered to reduce the risk factors, complications of nervous system cancers and early diagnosis of nervous tumors.

The effect of placenta abruption on the risk of intrauterine growth restriction: A meta-analysis Ensiyeh Jenabi, Salman Khazaei, Bita Fereidooni Advances in Human Biology 2019 9(1):8-11 There is a contradict findings on the effect of placenta abruption on the risk of intrauterine growth restriction (IUGR). Therefore, the objective of present meta-analysis was to identify all the eligible studies to assess the effect of placenta abruption on the risk of IUGR. The major electronic databases, including PubMed, Scopus and Web of Science, were searched to identify relevant published studies. The literature search included 551 articles until January 2018 with 35,201 participants. In the end, a total of seven references were remained for this meta-analysis. Two independent authors reviewed the retrieved the studies and extracted data. I2 statistics was used to assess of heterogeneity. The random effects model was conducted to assess pooled effects size. the results of study showed that placenta abruption has a significant effect on the risk of IUGR based on odds ratio results (2.06; 95% confidence interval: 1.57, 2.55). The result reported of the measure of effect was homogeneous (I2 = 0.0%). we presented based on reports in epidemiological studies that placenta abruption is a risk factor for IUGR.

Is breech presentation associated with autism spectrum disorders among children: A meta-analysis Ensiyeh Jenabi, Saeid Bashirian, Salman Khazaei Advances in Human Biology 2019 9(1):12-15 The meta-analysis of case–control and cohort studies was conducted to obtain the association between breech presentation and the risk of autism spectrum disorder (ASD) among children. The search for relevant studies in major electronic databases was performed including; Web of Science, PubMed and Scopus up to May 2018. The odds ratio (ORs) with 95% confidence intervals (CI) was extracted from eligible studies. The pooled estimate of OR was not indicated a significant association between breech presentation and risk of ASD among children (OR = 1.15, 95% CI = 0.93–1.37), but this association was significant in the unadjusted analysis (OR = 1.32, 95% CI = 1.05–1.58). Our findings were not showed that breech presentation is associated with increased risk of ASD among children.

The incidence of testicular cancer in Iran from 1996 to 2017: A systematic review and meta-analysis Soheil Hassanipour, Mohammad Ghorbani, Milad Derakhshan, Hamed Fouladseresht, Shokrollah Mohseni, Elham Abdzadeh, Shirin Riahi, Morteza Arab-Zozani, Hamed Delam, Hamid Salehiniya Advances in Human Biology 2019 9(1):16-20 Objective: Testicular cancer (TC), although it is one of the most unusual cancers, seems to be increasing. There is no accurate information on the incidence of this cancer in Iran. The present study is conducted to evaluate the incidence rates of TC in Iran. Methods: A systematic search was conducted on all published studies of TC incidence using Medline/PubMed, Scopus, Embase, Web of Science, Google Scholar and four Iranian databases (Scientific Information Database, MagIran, IranMedex and IranDoc) until June 2018. This systematic review was done according to the preferred reporting items for systematic reviews and meta-analyses. Result: The database searching yielded 132 potentially relevant studies. A total of 11 studies were included in the study. The results of the random-effects model were demonstrated that the age-standardised rate (ASR) of TC was 1.13, 95% confidence interval (0.97–1.29) among Iranian males. Conclusion: ASR for TC in Iran is lower than the world average; however, it has a higher incidence than other Asian countries.

Effect of cryopreservation on the structural and functional integrity of human periodontal ligament stem cells: A systematic review Rujuta Krishnakant Pandya, Monali Shah, Yesha Shroff, Mrugank Vyas Advances in Human Biology 2019 9(1):21-27 Aim: The aim of the present systematic review was to assess the effect of cryopreservation on the human periodontal ligament (PDL) stem cells and their ability for periodontal regeneration. Materials and Methods: An electronic search without time restrictions was conducted up to August 2017 in indexed databases using the combination of different keywords including cryopreservation, cryofixation, vitrification and human periodontal ligament stem cells. The exclusion criteria included reviews, commentaries, letters to the editor, interviews and updates. The relevant articles were included and data extraction was processed. Results: Dimethyl sulphoxide was used as a cryoprotectant in all the studies which yielded good results. The magnetic freezing proves to be better than the normal freezer. The cryopreserved cells showed no significant difference for viability, proliferation, and regenerative capacities as compared to the fresh human PDL stem cells (PDLSCs), in vitro as well as in vivo. Conclusion: Cryopreservation of the human PDLSCs would serve as an opportunity for future regenerative therapy for the periodontium.

The effect of diabetes on nerve–muscle conduction of tibial and peroneal nerve association with habit and habitat in Bikaner Region Ekta Soni, Priyanka Soni, Jitendra Kumar Acharya Advances in Human Biology 2019 9(1):28-31 Introduction: Diabetes is due to defect in Beta cell of islets of Langerhans, that is seen in pancreas. This defect is responsible for disturbance in blood glucose level. Other factors which are also responsible includes diet, hereditary, immunological factor, lack of exercise etc., The damage to nerves in DM has been assumed to be a result of the interaction of metabolic defects complicated by vasa nervorum abnormalities. Nerve conduction velocity, are standard measurement used to confirm the presence or absence of diabetic neuropathy. In Nerve conduction velocity study common nerves that are studied are common peroneal nerve, tibial nerve and sural nerve. Materials and Methods: The study was planned in Physiology Department in close collaboration with Department of Medicine (Diabetic Section), S.p.mc. Bikaner. A total of 100 subjects for study from diabetic centre, were selected. Institutional ethical clearance was taken before commencement of study from ethical committee of our institution. Results: In present study, maximum number of patients were non-smokers in both study and control groups (87% and 91% respectively) and this difference was found statistically insignificant (P > 0.05). We observed that the patients were vegetarian in both study and control groups and this difference was found statistically insignificant (P > 0.05). The mean peroneal nerve in study group was 42.26 ± 1.95 m/s and in control group it was 52.05 ± 4.78 m/s and the difference was found statistically highly significant (P < 0.001) and mean value of tibial nerve in study group was 41.71 ± 2.29 m/s and in control group it was 49.84 ± 2.67 m/s and the difference was found statistically highly significant (P < 0.001). Conclusion: In our study, we concluded that nerve conduction velocities decreases in tibial and common peroneal nerve in diabetic patients as compared to control. Nerve conduction velocities also decrease with increasing age, increased HbA1C >6.5%.

New insight into the role of electronic apex locators in detecting simulated horizontal root fractures: An In vitro study Mukti M Shah, Vaishali V Parekh, Nidhi J Patel, Parth V Dodiya, Dipak H Chauhan Advances in Human Biology 2019 9(1):32-36 Aim and Objectives: The aim of this study is to check the accuracy of two different electronic apex locators (EALs): Canal Pro and Root ZX – in locating simulated horizontal root fractures (HRFs). Materials and Methods: Forty-five recently extracted, single-rooted, human permanent teeth were selected for the study. Endodontic access cavity was prepared, and canal patency was checked using no. 10-K file. Horizontal fractures were simulated using 0.2-mm thick diamond disk in coronal, middle and/or apical third of root by operator one, until half of the canal was exposed circumferentially. Using both the apex locators, all the fractures were detected by the second operator to confirm the accuracy of EALs. The actual length of the fractures was then measured under ×2.5 magnification, and results were subjected to statistical analysis. Results: Results were analysed using the one-way analysis of variance and Tukey's post hoc test, and the differences between all the test samples were analysed. All the measurements were compared to the actual values separately. A statistically significant difference was determined at 95% confidence level (P ≤ 0.05). Conclusion: Investigated both the EAL are capable of detecting simulated HRF and that the Canal Pro showed a higher accuracy rate.

To determine the prevalence of glucose-6-phosphate dehydrogenase deficiency using a novel water-soluble tetrazolium-8 formazan method' for neonatal screening in region of Himachal Pradesh, India Seema Sharma, Milap Sharma Advances in Human Biology 2019 9(1):37-41 Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most significant enzyme defect in India with an incidence ranging from 2% to 27.9% in different communities. Prolonged neonatal jaundice and haemolytic crisis are known to occur in children with G6PD deficiency. Hence, screening of a population for G6PD deficiency is paramount. A Novel water soluble tetrazolium-8 (WST-8) Formazan Method has been used in this study for in-field mass-screening of G6PD in the region of Himachal Pradesh, India. Materials and Methods: In this prospective study, 5652 neonates were screened to assay G6PD activity using WST8/1-methoxy phenazine methosulphate method within the first 48 h of life. Orange colour at the end of the procedure indicated normal G6PD activity while pink or colourless appearance indicated G6PD deficiency. Results: After the screening of 5652 neonates, the prevalence of G6PD deficiency was 12.4%. 45 newborns (6%) had a severe G6PD deficiency. Males were more affected than females (70:30). Furthermore, males had higher prevalence of deficiency than females (64% [n = 29] and 16% [n = 16]). Conclusions: G6PD deficiency assessment by the method used for population screening in the study was easy to do and quite simple. Following this, the high prevalence of this deficiency was noted in Himachal Pradesh. This study highlights the need to do neonatal screening of G6PD deficiency in population so that untowards complications like haemolytic crisis, complications due to neonatal jaundice can be avoided.

Evaluation of the accessible level of iodine in marketed iodised salt in Iran: A comparison with standard recommended values Abolfazl Mohammadbeigi, Ali Salehi, Hamidreza Heidari, Mahdi Asadi-Ghalhari Advances in Human Biology 2019 9(1):42-45 Background: Iodine is one of the essential micronutrients for synthesise and secrete adequate amounts of thyroid gland hormones. Its deficiency is the most important threatening causes for human health. The aim of this study was to evaluate iodine concentration in marketed edible salt samples in Qom city and to compare with existing standards and offering solutions necessary to fix the probably problems. Materials and Methods: A cross-sectional, descriptive study was carried out on 60 samples of 20 brands of marketed edible salt in Qom during 2017. Iodine concentration was evaluated by the British Pharmacopoeia titration method. Results: According to the national standard of Iran during this study, iodine concentration in 51.67% of salt samples was in acceptable limits and 48.33% of samples were out of acceptable ranges. None of the tested samples had iodine content more than the standard limit. Conclusions: To improve salt fortification status and removing iodine deficiency in society, the following actions should be considered: enforcing producers to follow national and international standards, continuous monitoring the producers, necessary legal actions against offending manufacturers and appropriate measures by health ministry and relevant authorities.

Pediatric Neuropsychology

Review of Neurodevelopmental Disorders in Children and Adolescents

Investigating the BRIEF and BRIEF-SR in Adolescents with Mild Traumatic Brain Injury Abstract To date, limited research has investigated the Behavioral Rating Inventory of Executive Function (BRIEF) and BRIEF Self-Report (BRIEF-SR) in adolescents presenting exclusively with mild traumatic brain injuries (mTBI). The present study was retrospective and included 163 adolescents (43% male; M age = 14.80; M days since injury = 34.10) referred for neuropsychological evaluation after mTBI. Results revealed that mean BRIEF and BRIEF-SR clinical scale scores in the sample were generally similar to those in the standardization sample, commensurate with previous literature on the trajectory of cognitive and symptom recovery after mTBI. Adolescents reported significantly higher scores than their parents only on Emotional Control, with no differences emerging on other clinical scales. Confirmatory factor analyses indicated that the two-factor model of the BRIEF-SR (Metacognition and Behavioral Regulation; Comparative Fit Index (CFI) = 0.97) provided relatively and statistically significant better fit than a one-factor model extracted in exploratory analyses. Results also indicated that a three-factor model of the BRIEF capturing Metacognition, Behavioral Regulation, and Emotional Regulation (CFI = 0.98) provided relatively and significantly better fit than the two-factor model. These results suggested that adolescents in the post-acute phase of mTBI recovery may rate their own executive dysfunction in terms of metacognitive and behavioral difficulties, while their parents may observe executive dysfunction in these two dimensions in addition to emotional dysfunction. Relationships to previous literature, limitations of the present study, and implications for clinical practice are discussed.

Test and Book Reviews in Pediatric Neuropsychology

Correction to: Automatized Sequences as a Performance Validity Test? Difficult If You Have Never Learned Your ABCs In the original article the name of author Allyson G. Harrison was misspelled. The original article has been updated and her name is correct here.

Pediatric Performance Validity Testing: State of the Field and Current Research

One-Minute PVT: Further Evidence for the Utility of the California Verbal Learning Test—Children's Version Forced Choice Recognition Trial Abstract Objective To replicate previous research on the forced choice recognition trial for the California Verbal Learning Test—Children's Version (FCR-C). Method Classification accuracy of the FCR-C was computed in 178 children referred for neuropsychological assessment to a tertiary care hospital. Results FCR-C ≤ 14 produced the best combination of sensitivity (.12–.42) and specificity (.88–.96). Unlike some of the criterion performance validity tests (PVTs), base rate of failure on the FCR-C was evenly distributed across age ranges. Conclusion The FCR-C is a quick and inexpensive PVT, unaffected by cognitive maturation, and highly specific to psychometrically defined invalid performance.

Automatized Sequences as a Performance Validity Test? Difficult If You Have Never Learned Your ABCs Abstract Accurate identification of symptom exaggeration is essential when determining whether or not data obtained in pediatric evaluations are valid or interpretable. Apart from using freestanding performance validity tests (PVTs), many researchers encourage use of embedded measures of test-related motivation, including the newly developed automatized sequences test (AST). Such embedded measures are based on identification of performance patterns that are implausible if the test taker is investing full effort; however, it is unclear whether or not persons with pre-existing cognitive difficulties such as specific learning disabilities (SLD) might be falsely accused of poor test motivation due to actual but impaired learning of basic sequences. This study examined the specificity of the AST by reviewing performance of 83 SLD adolescents. Anywhere from 22 to 41% of SLD adolescents investing good effort failed one or more of the tasks included in the AST, and those with lower intelligence scores had higher rates of failure. Clinicians should therefore be cautious if using this PVT with individuals who have a documented history of reading, learning, or intellectual problems.

Detecting Invalid Performance in Youth with Traumatic Brain Injury Using the Child and Adolescent Memory Profile (ChAMP) Lists Subtest Abstract Background Neuropsychological assessment must include determinants of validity. This study sought to develop an embedded performance validity indicator for the Child and Adolescent Memory Profile (ChAMP) Lists verbal memory subtest. Methods Children and adolescents (N = 103; mean age = 14.6 years, SD = 2.4, range = 8–18) who were on average 25 weeks (SD = 15.1) post-traumatic brain injury (TBI; 85% mild and 15% moderate-severe) were administered ChAMP Lists and two stand-alone performance validity tests (PVTs; Test of Memory Malingering; Medical Symptom Validity Test). Nineteen patients were deemed to have invalid performance defined as failure on both PVTs. Binary logistic regression and classification statistics were used to determine a cutoff score for invalid performance on ChAMP Lists using failure on two PVTs as the criterion. Results Invalid performance was not associated with demographics, injury type, or time since injury, but was significantly correlated with ChAMP Lists scaled scores. Only ChAMP Lists Recognition predicted validity grouping and had excellent discrimination (area under the curve of 93%). A cutoff scaled score of 7 or less on ChAMP Lists Recognition achieved sensitivity for invalid performance at 79% while maintaining specificity at 91%. A more stringent cutoff score of 5 or less on ChAMP Lists Recognition achieved sensitivity for invalid performance at 63% with specificity at 95%. Conclusion This study yields a promising embedded performance validity indicator for ChAMP Lists Recognition with good sensitivity and excellent specificity for detecting invalid performance in youth with TBI.

Why Children Fail the Test of Memory Malingering: Review of False Positive Performance in Pediatric Studies Abstract Rationale The Test of Memory Malingering (TOMM) is a commonly utilized performance validity test currently recommended for pediatric use with children as young as 5 years of age. Yet, a small sample of children struggles to pass the TOMM due to true cognitive difficulties. The systematic search and review identified the reported cases of false positive and overall failing TOMM performance in children. The goal of this project was to increase the understanding of the cognitive constructs and minimum cognitive abilities necessary for children to pass the TOMM. The secondary goal was to use the existing data to suggest clinical guidelines related to use of the TOMM with children. Methods and Results A comprehensive search of PubMed/MEDLINE, EMBASE, Web of Science, and PsycINFO was conducted, returning an initial 12,052 results. After duplicate articles were removed, 10,583 remained; 61 were evaluated for eligibility and 22 were included as our final sample. Results suggested that false positives were observed in children with low IQ, memory issues, complex medical presentation, and younger children. Conclusions Without relevant, quality validation and normative studies, the TOMM should not be used clinically with young children or children suspected of having significant cognitive issues. Failing performance on the TOMM does not necessarily indicate poor effort or invalidate the neuropsychological profile. Instead, it may be reflective of other factors, particularly in children below age 6, children with lower intellectual abilities (especially FSIQ ≤ 75), children with multiple diagnoses, or children with more severe neurological diagnoses. Clinical recommendations are also discussed.

The Rey-Osterrieth Complex Figure: a Useful Measure of Organizational Skills for Adolescents with ADHD? Abstract Deficits in organization, time management, and planning (OTMP) abilities are common in adolescents with attention-deficit/hyperactivity disorder (ADHD) and contribute to impairment. Assessment of these skills is vital, but few measures have been validated for youth with ADHD. The Rey-Osterrieth Complex Figure (ROCF) task is frequently used in research and clinical settings despite limited validity evidence. The present study evaluated whether ROCF performance, as scored via the Boston Qualitative Scoring System, exhibited validity as a measure of OTMP skills in a large (N = 285) sample of adolescents comprehensively diagnosed with ADHD. ROCF performance exhibited minimal associations with measures of OTMP, executive functioning, or aspects of academic impairment affected by OTMP abilities; all correlations were nonsignificant after accounting for the influence of intelligence. Further, ROCF task performance did not differ by ADHD presentation or medication status. Correlations with other variables that may be confounded with ROCF performance (anxiety symptoms, depressive symptoms, parent education) also demonstrated nonsignificant correlations with all BQSS scores. The ROCF may not adequately capture OTMP abilities of adolescents with ADHD; future directions for the assessment of OTMP skills are discussed.