From the Editor
..........................................................................................................................

In this issue there are a variety of papers from the region discussing wide topics of interest to medical specialty and primary health care.

A paper from Saudi Arabia examined fostering self-directed learning (SDL) in residency program in family medicine in Saudi Arabia. It investigated the most effective ways to help in appropriate application of Self-directed learning in residency program. Learning is maximized when it is self-directed so that residents study material that is most relevant to them. Medical residents learn best when they learn according to their perceived needs and competency gaps which (learner-centered needs and gaps) more than teacher-centered ones. Residents engage in self-directed learning by first identifying a clinical problem, then pursuing the learning task, next acquiring the new knowledge or skill, and finally practicing the new knowledge or skill. In this paper, I have described a curricular intervention that employs several educational and administrative modalities to foster the self-direction in learning in family medicine training program in Saudi Arabia.

A paper from Turkey looked at Cholelithiasis may also be a consequence of metabolic syndrome. The study was performed in Internal Medicine Polyclinics on routine check up patients. All cases with cholelithiasis or already performed cholecystectomy for cholelithiasis were put into the first and age and sex-matched control cases were put into the second groups. One hundred and forty-four cases either with cholelithiasis or already performed cholecystectomy for cholelithiasis were detected among 3.437 cases, totally (4.1%). One hundred and sixteen (80.1%) of them were female with a mean age of 53.6 years. Obesity was significantly higher (54.8% versus 43.7%, p<0.01). There are significant relationships between cholelithiasis and parameters of the metabolic syndrome including female predominance, elder age, BMI, obesity, hypertension, and hypertriglyceridemia. On the other hand, the significantly lower prevalence of hyperbetalipoproteinemia in the cholelithiasis patients should be researched with further studies.

Baradaran et al looked at SUMO1 pseudogene 3 (SUMO1P3) expression in human gastric cancer and its clinical significances. Fresh gastric cancer and adjacent non-tumor tissues were collected from 182 GC patients, who admitted to the Alzahra Hospital, Isfahan, Iran. Quantitative reverse transcription-polymerase chain reaction was used to investigate the SUMO1P3 levels. Then, the association between the level of SUMO1P3 in gastric cancer tissues and the clinicopathological features of patients with gastric cancer was analyzed. The results showed that SUMO1P3 levels in male were not significantly higher than those in female (p = 0.485). No significant deference of SUMO1P3 expression was observed between patients under 64 years old and above (p = 0.155). The SUMO1P3 levels were not associated with perineural invasion (p = 0.319), lymphatic invasion (p = 0.797), invasion depth (p = 0.790), location of the tumor (p = 0.811), tumor size (p = 0.635), and grading (p = 0.289). The authors concluded that these results indicated that in our patient population and according to the used method in this study, pseudogene-expressed lncRNA SUMO1P3 may not be a potential biomarker in the diagnosis of gastric cancer.

A medical record review that was performed at Lahey Hospital Medical Center (Jordan), medical records in the period between 12/2003 and 12/2013 were reviewed, 1098 medical records were reviewed, those were carrying diagnosis OF Herpetic Eye Disease (HED) and were divided into 2 groups according to the etiological agent: Herpes Simplex virus (HSV) (n=473) , Varicella Zoster Virus (VZV) (n=625). The groups were evaluated for the age at diagnosis and the etiologies of elevated Intra ocular Pressure (IOP), whether its HED related ( trabeculitis, steroid response), or non HED Glaucoma Related Diagnosis. Although many of the features between HSV and VZV subgroups are similar, the VZV group was older and appeared to have more prolonged hypertensive course than the HSV group. 4.3% of patients with HED have significant elevated IOP directly related to disease or treatment. Secondary glaucoma is a consequence of Herpetic Eye disease, but fortunately surgical intervention is rarely required to control IOP.

A paper from Iran looked whether Decoy Cell Viruria in Kidney Transplant Patients. correlate with Renal Function? This analytic cross-sectional study conducted in Transplant Center of Alzahra Hospital, Isfahan, Iran between Jun 2014 and June 2015. Clinical screening for polyomavirus infection done by means of urine cytological evaluation for decoy cells. Urine samples were analyzed in three steps including 2-4 months after transplantation, three and six months later. Thirty-three patients (22 male and 11 female) received kidney transplant from living donors. The average of patients' age was 41.9±12.83 (range: 20-63 years. Peritoneal and hemodialysis were used for 15.6% and 84.4% of recipients. The occurrence of decoy cell viruria at the time of enrollment, 3 and 6 months later found in 18.2%, 10.7% and zero, respectively. The authors concluded that urine cytology is easy to perform and of low cost, it is a useful tool for the investigation of active polyoma virus infection. Moreover, the findings advocate that the presence of decoy cells along with high creatinine is a better indicator of the virus presence.

Azadi et al looked at Gum Sisymbrium irio effect on the quality attributes of baguettes.
In this study, gum Sisymbrium irio at different levels of Control, 1/0, 1/5 and 2/0 percent and wheat flour, in loaf bread and its impact on the quality attributes including technological features, colours and staling throughout the day, various storage mechanisms were evaluated. The results of the evaluation of technical features, showed that gum Sisymbrium irio increased humidity, reduced stiffness and reduced bran volume compared with the control bread. By increasing the hold time, stale bread and buns control treated with different levels of gum Sisymbrium irio significantly increased.

Fazel et al attempted to determine how frequently pregnant asthmatics are sensitive to food and inhalation allergen. Euroimmun tests were performed to identify the prevalence of sensitivity towards allergens among pregnant asthmatics. A total of 1,603 women were selected from those who had visited Mobini Hospital in Iran August 2014-April 2015. The authors drew blood samples from these women and, postpartum, from their infants. These were used to measure IgE and RAST to inhalation and food allergens. Descriptive and comparative statistical analyses were performed. The results were analyzed using SPSS version 20. A total of 1,603 pregnant women referred to Mobini Hospital -Iran were included in the analysis. Thirty-four pregnant asthmatics were confirmed as having asthma. The authors concluded that their results suggest that there is no association of some inhalation and food allergens with maternal and fetal IgE. Forthcoming studies should take this into account, i.e. trying to detect different local allergens that perhaps have potential maternofetal transfer.

.........................................................................................................................