Letter from the Editors

Dear Colleagues! Our Authors and Friends! New Year 2022 rushes towards humanity. This universal arrangement of life on our planet presupposes changes. Their essence is in hopes for the best. We wish all of us not just hopes but confidence in the victory of good over evil, reasons over greed and cruelty. We hope that the Planet will overcome humankind's most severe viral attack – the SARS-CoV2 pandemic. We hope that the future brings us victories over epidemics, serious diseases, hunger, and lack of water. We hope that all types of violence, military conflicts, political, economic, religious confrontations will be stopped in a New Year. We are opening the third year of our journal, which was focused on different aspects of medicine. Last year we published eight papers from seven countries experts, each substantially contributed to medicine. We talked about COVID-19 pandemic, vital pediatric problems, and adult medicine. We will continue our mission to support and distribute the most valuable medical knowledge in the New Year. May the New Year celebrations bring only joy and harmony to your homes, souls, and the reasoning, which illuminate confidence in the future for our beautiful multinational green Planet - Earth! "Every end is a new beginning…." We wish you and your family a Happy Holidays! We hope that your New Year will be filled with peace, new ideas, and success! Editorial office

Parents’ Perception on Childhood Obesity and its Prevention; a Population-Based Observational Study in Jazan, Saudi Arabia with Intention to Develop Self Instructional Module

Globally, Childhood obesity is one of the most serious public health challenges in the 21st century. In 2017, the Commission on Ending Childhood Obesity (ECHO) reported that worldwide obesity increased 10-fold among children and adolescents during the last 40 years. According to World Health Organization (WHO) & Childhood Obesity Surveillance Initiative (COSI) data, childhood obesity rates are highest in the Southern European Countries in the World. Childhood obesity is one of the most important public concerns due to increased incidence with a high morbidity rate. This study was intended to identify the parent's attitude on causes and its prevention of childhood obesity in Jazan province. With the Stratified Random sampling method, 100 obese children's parents were selected. Initially, personal information was obtained about a child and mother, and then "Google Form" 5-point Likert's scale was administered to assess parents' attitude on obesity and its prevention. It has four domains (General information on obesity - 2 questions, causes of obesity - 14, consequences of obesity - 4, and prevention of obesity - 10) with 30 questions. The results of the study are expressed as mean and standard deviation (mean percentage). The parent’s attitude score was expressed in terms of obesity 5.86 ± 1.27 (58.6%), causes 38.75 ± 6.52 (55.36%), consequences 11.65 ± 2.36 (58.25%) and prevention 29 ± 5.15 (58%). The overall mean score and standard deviation were 86.67 ± 13.81 (54.84%). The parents had an average attitude score (64.57%) on the causes and prevention of childhood obesity. There was no association between attitude scores with the demographic variables, except the variable age associated with attitude scores. Obesity prevention requires effective intervention measures. The research study proposed that family education and impulse are essential for treating childhood obesity. Schools play a significant role in promoting healthy eating habits and physical activity.

Rheumatoid arthritis in a sickle cell patient: a dangerous association?

Introduction - The diagnosis of rheumatoid arthritis remains a challenge because sickle cell disease can result in various rheumatological manifestations, including joint and bone pain. The concomitant presence of rheumatoid arthritis and sickle cell disease makes the therapeutic management of both conditions problematic. Observation - A 24-year-old man, a nurse by profession, has been followed for 10 years for homozygous sickle cell disease at the Sickle Cell Disease Research Center (CRLD) of Bamako, Mali. He has presented for 8 months symmetrical polyarthritis with morning stiffness of 3 hours, distinct from the usual vaso-occlusive crisis. The Analog Visual Scale was estimated at 80/100. He reported unquantified weight loss and asthenia. The physical examination showed a deformity in bilateral ulnar deviation, flexion of the right elbow, twelve painful joints, and five swollen joints. Normochromic normocytic anemia (hemoglobin 8.3g/dl), inflammatory syndrome with C - Reactive Protein (CRP) 130.91 mg, and Sedimentation Rate (ESR) 72mm at the first hour were noted. Rheumatoid Factor was weakly positive at 21.3 IU and Anti Citrullinated Peptide Antibodies at 385.2 IU. The radiography discovered bilateral erosive carpets without associated tarsitis and osteonecrosis of both femoral heads. The diagnosis of a very active immunopositive erosive rheumatoid arthritis meeting the criteria of ACR / EULAR 2010 was retained. A treatment based on prednisone 10 mg per day was initiated, associated with methotrexate at a dosage of 15 mg weekly in single-dose, folic acid, calcium, and vitamin D. Conclusion - The coexistence of rheumatoid arthritis in sickle cell patients makes the diagnosis of polyarthritis difficult.

A 71-Year-Old Man Presenting with Anemia and a Solitary Skin Lesion Associated with Primary Cutaneous Marginal Zone Lymphoma

A 71-year-old man with a solitary red lesion on his left arm, which initially thought to be a hematoma, was admitted for inpatient evaluation of anemia, which after a positive direct Coombs test was qualified as autoimmune hemolytic anemia. The patient also presented with hoarseness and biopsies from the swelled nasopharynx and an enlarged right tonsil were obtained. Due to uncertain diagnosis and the patient’s previous history of malignancy, (low grade lymphoproliferative lymphoma) skin and bone marrow biopsies were performed. Unfortunately, the patient’s status rapidly deteriorated as a result of septic shock. The obtained skin, nasopharynx, and tonsil biopsies became available after the patient died and showed marginal zone lymphoma with no evidence of lymphoproliferative neoplasm in the bone marrow. This case demonstrates the diagnostic complexity of nodal marginal zone lymphoma complicated by severe life-threatening autoimmune hemolytic anemia in an elderly patient with multimorbidity, which presents management challenges for health care providers.

Can Medicinal Mushrooms Fight Against SARS-CoV-2/COVID-19?

The power of mushrooms as medicine was recognized nearly two thousand years ago. They are nature’s miniature pharmaceutical factories, rich in a vast array of novel constituents and wide open for exploration. Reishi mushroom also called “the mushroom of immortality” yields miraculous health benefits and contains over 400 bioactive compounds, which have a number of medicinal effects. Medicinal Basidiomycetes mushrooms (including reishi mushroom, almond mushroom, pom-pom mushroom, and maitake mushroom) are usually consumed in China, Japan, Thailand, and Korea as immune response modifiers for prevention of cancer, or as nutritional support during chemotherapy, and for chronic inflammatory conditions such as hepatitis and other diseases. Presently medicinal mushrooms are mainly used as dietary supplements or functional food. Special precautions should be there, like cooking procedure, amount to consume, source of collection, and most importantly hypersensitivity (allergy) of individual person before consumption. Nevertheless, they have the potential to become real drugs from medicinal plants. Also, to explore them as dietary supplements, preclinical and clinical trials, and legal authorization are necessary.

Comparative Analysis of Acid-base Status Parameters in Newborn with Congenital Surgical Malformations During Perioperative Care Based on Types of Anesthesia

Introduction: Congenital malformations (CM) are most common in newborns and infants in the first year of life and require surgical correction in the first hours, days, months of life. Surgical interventions in severely ill babies with malformations can lead to catabolic stress, circulatory and respiratory disorders, metabolism shifts, water-electrolyte, protein, and acid-base status disorders. This study aimed to compare acid-base status in newborns and infants with congenital surgical pathology under different types of combined anesthesia. Materials and methods: This retrospective study included 150 newborns and infants with CM who required surgery. The patients were divided into three groups based on types of provided anesthesia: inhalation by Sevoran (sevoflurane) and regional anesthesia (group I); inhalation of Sevoran and intravenous anesthesia by Fentanyl (group II); and intravenous combination of Fentanyl and 20% Sodium Oxybutyrate (group III). The analysis included: acid-base status, peripheral oximetry, and the need for an oxygen mixture inhaled by the patient. Results In group I, there was a significant reduction in partial tension of CO2 and increased pH from the pre-surgical status, at the time of induction of anesthesia, during the most painful, traumatic stage, and after surgery compared to group II and III. Peripheral O2 saturation was not critically reduced at all stages of observation except in babies of group I compared to group III at the stage of induction of anesthesia (97.79 ± 2.45 vs. 98.79 ± 1.63, p = 0.0194) and at the most painful period of surgery (96.29 ± 3.47 vs. 98.10 ± 2.47, p = 0.0368). In group I, newborns and infants required higher oxygen concentrations in the inhalation mixture. There was a significant difference in FiO2 between groups I and III during the most painful stage of surgery (0.47 ± 0.29 and 0.33 ± 0.2, p = 0.0071), and immediately after surgery (0.34 ± 0, 19 and 0.26 ± 0.13, p = 0.0246). Conclusion: Among the newborns and infants with CM requiring surgical intervention and combined anesthesia, the most substantial acid-base status changes were observed in the group where anesthesia was provided by Sevoran (sevoflurane) and regional anesthesia (Group I).

State of Renal Blood Flow in Premature Children with Hemodynamically Significant Patent Ductus Arteriosus

Introduction: Hemodynamically significant patent ductus arteriosus (HSPDA) lowers the renal circulation because of the "ductal stealing phenomenon," which can change the renal blood flow. The aim: To study the state of blood flow in the main renal artery and interlobar renal artery in premature infants with HSPDA. Materials and methods: 74 preterm newborns (gestational age 29-36 weeks) were divided into three groups: І - 40 children with HSPDA, ІІ - 17 children with patent ductus arteriosus (PDA) without hemodynamic disorders, ІІІ - 17 children with closed ductus arteriosus. Color ultrasound Doppler scan of the vascular bed of the kidneys was performed using a microconvex sensor with a frequency of 5-8 MHz ("TOSHIBA" Nemso XG model SSA-580A (Japan) from the main renal artery to the interlobar renal arteries of the right kidney. The following parameters of renal blood flow were studied: peak systolic velocity (PSV), end-diastolic velocity (EDV), resistance index (RI). Results: Peak systolic velocity (PSV) in the main renal artery and interlobar renal arteries did not differ significantly between groups. On the first, third, and tenth days of life, there was a significant decrease in the EDV of blood flow and increased RI in the main renal artery. The EDV of blood flow and RI in the interlobar renal artery on the first day of life did not differ depending on PDA's presence and its hemodynamic significance. On the third and tenth days of life and in the interlobar renal artery, a significant decrease in EDV of blood flow and increased RI were noted. These renal blood flow characteristics were closely related to the size of the PDA on the first day of life. Conclusion: A feature of renal hemodynamics in HSPDA in premature infants is a decrease in the EDV of blood flow in the main renal artery and interlobar renal artery, as well as an increase in the RI of these vessels, directly correlating with the size of the PDA in the first day of life. During the first ten days of life, dynamic control revealed a slowed process of restoration of renal blood flow in babies with HSPDA, despite the PDA's closure.

Helping Patients with COVID-19: Perspectives and Reality

The presented data of the mini-review strongly suggest that the role of the COVID-19 virus as the sole cause of the disaster is exaggerated and indicates the urgent need to revise the general system of views on the nature of acute pneumonia. The current pandemic cannot be explained solely by the sudden aggression of the virus itself. Continuing important and necessary research on ways to prevent the disease and the ability of the coronavirus to penetrate the body's tissues, doctors should not forget about the general mechanisms of the development of the pathological process.

Letter from the Editors

Dear Colleagues! Friends! Happy New Year! A sunny new day! With new bright thoughts, new horizons! With new ideas and progressive projects! With new warm light feelings! With new hopes! Yes, the world is faced with horrendous challenges in 2020: environmental and, one by one, natural disasters, pandemic, hunger, political and financial crises, permanent "hot" and "cold" wars between countries, governments, minds ... But new promising solutions were also born: truces, negotiations, small and not so victories, alliances of progressive forces, new vaccines and medications, new experiences in all earthly spheres of life, and the development on the Moon and Mars! The editorial board of JIMSA, a clinical journal born in this challenging time of trials for the survival of the planet Earth, believes that the Human mind will prevail. Good thoughts and intentions will prevail. And we will all share experiences of big and small victories in the name of preserving the lives of our loved ones, our compatriots, our equals in mind, and so different in the mental and spiritual makeup of earthlings. JIMSA in New 2021 is a stable international platform for professional communication! We are opened to new scientific and clinical research discussions and ideas. We, under no circumstances, will put up with informational deprivation. We are pleased with your desire to share research findings, new ideas, discuss results and cases with the international medical community to benefit our patients. We welcome international cooperation in the critical fields of Global Human Health using our journal's pages. We are open to effective partnerships with authors, experts, reviewers, and medical practitioners to advance medical knowledge. We sincerely wish every, every, every one: no grief, no melancholy and only good intentions, incredible travel and new interesting acquaintances, a surge of energy and creative strength, each of the presented New 365 days of the New Year.

Letter of Editor

In the Universe, time is tirelessly moving into the Future. Each new unit of time is a witness of the birth of new ideas, current events, modern lives. Our consciousness determines their significance. Today's vitality of the Planet Earth is determined by our friendship, tolerance, compassion, positive emotions, and enjoyment of each other's successes. Our personal space (each of us!) includes natural resources, information networking, individuals' consciousness, perception of the world, different points of view, correct and incorrect decisions, and actions. We all challenge kindness in Eternity, regardless of everyone's beliefs and religions. We are looking for the aspiration and holidays of a SOUL. We all coming to the Great Holliday Season. And the whole world is waiting for the Miracle of Hope to come on a New Year. We wish you and your family a Happy Holidays! We hope that your New Year will be filled with Peace, new ideas, and success! These days, the Editors of the «Journal of Internal Medicine Science and Art,» a new journal born in the tough 2020, are fully confident in this journal project's viability and success, its effectiveness in the professional informational space of medical professionals, and experts. We are opened to new scientific and clinical research discussions and ideas. We, under no circumstances, will put up with informational deprivation. We are pleased with your desire to share research findings, new ideas, discuss results and cases with the international medical community to benefit our patients. We welcome international cooperation in the critical fields of Global Human Health using our journal's pages. We are open to effective partnerships with authors, experts, reviewers, and medical practitioners to advance medical knowledge. We appreciate everyone who contributed to our success this year. It has been an honor and a pleasure working with you! We are thankful for your professionalism, science, and educational support; that was a real pleasure working with you. Thank you for the opportunity to serve you! As the year ends, we think our relationship will continue in 2021: we are looking forward to contributing to the future medical field's success. Our sincerest warm greetings, and all good wishes to you; let your days be filled with happiness, success, and prosperity in the coming NEW Year! "Every end is a new beginning."