Pub Date : 2023-09-02DOI: 10.23958/ijirms/vol08-i09/1741
Islam Abdelraouf, S. Badr, IbtsamKhairat Ibrahim, Hatem Mohamed Elsokkary
Background: Brain (b-type) natriuretic peptide (BNP) is released into the circulation in response to ventricular dilatation and pressure overload conditions. Studies linked between levels of BNP and short/long term prognosis in patients of acute coronary syndrome (ACS). Aim: To evaluate the brain natriuretic peptide as a predictor of contrast induced acute kidney injury post percutaneous coronary intervention in patients with acute coronary syndrome. Patients and Methods: The study included 60 patients who presented to emergency room with diagnosis of ACS syndrome (ST segment elevation myocardial infarction (STEMI), non-ST segment elevation MI (NSTEMI) or unstable angina (UA)) who underwent to percutaneous coronary intervention. All participants subjected to history taking, clinical assessment, ECG, echocardiography and laboratory investigation (serum level of Troponin I, creatinine, blood urea and BNP). Results: Considering BNP levels at admission, CIN group has significantly elevated BNP level than non-CIN group (p<0.001). Value of BNP >69.0 pg/mL can strongly discriminate patients with CIN as AUC was 0.861 and p-value was <0.001 with sensitivity and specificity was81.8% & 92.6% respectively. Conclusion: BNP with cutoff value >69.0 pg/mL is a simple and easily measurable biomarker that can predict CIN in patients with acute myocardial infarction.
{"title":"Evaluation of Brain Natriuretic Peptide as a Predictor of Contrast Induced Acute Kidney Injury Post Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome","authors":"Islam Abdelraouf, S. Badr, IbtsamKhairat Ibrahim, Hatem Mohamed Elsokkary","doi":"10.23958/ijirms/vol08-i09/1741","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i09/1741","url":null,"abstract":"Background: Brain (b-type) natriuretic peptide (BNP) is released into the circulation in response to ventricular dilatation and pressure overload conditions. Studies linked between levels of BNP and short/long term prognosis in patients of acute coronary syndrome (ACS). Aim: To evaluate the brain natriuretic peptide as a predictor of contrast induced acute kidney injury post percutaneous coronary intervention in patients with acute coronary syndrome. Patients and Methods: The study included 60 patients who presented to emergency room with diagnosis of ACS syndrome (ST segment elevation myocardial infarction (STEMI), non-ST segment elevation MI (NSTEMI) or unstable angina (UA)) who underwent to percutaneous coronary intervention. All participants subjected to history taking, clinical assessment, ECG, echocardiography and laboratory investigation (serum level of Troponin I, creatinine, blood urea and BNP). Results: Considering BNP levels at admission, CIN group has significantly elevated BNP level than non-CIN group (p<0.001). Value of BNP >69.0 pg/mL can strongly discriminate patients with CIN as AUC was 0.861 and p-value was <0.001 with sensitivity and specificity was81.8% & 92.6% respectively. Conclusion: BNP with cutoff value >69.0 pg/mL is a simple and easily measurable biomarker that can predict CIN in patients with acute myocardial infarction.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73548462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-02DOI: 10.23958/ijirms/vol08-i09/1742
Ahmad Alessa, Ali Alanazi, Dalya Abudawood, Nezar Filfilan, Ammar Yamani, Abdulrahman Baeshen, Mohamed Abdelrafea, Ameerah Alnefai, Khalid Alharbi
This study aimed to explore the outcomes of using HFNC for patients with COVID-19. Forty-two studies were scanned using a scoping review, of which 22 were found eligible, satisfying the inclusion and inclusion criteria. Multiple patient outcomes were considered, including recovery time, oxygenation levels, reduced need for intubation in the future, ICU avoidance, and chances of respiratory distress. The findings suggest that HFNC remains more effective in treating patients with COVID-19-induced respiratory problems than traditional methods by indicating significantly improved oxygenation, reduced recovery time, reduced respiratory distress levels, and the need for invasive methods in the future. However, a few complications were also notable while considering its implementation on a wider scale, the most prominent being particle dispersion or airborne infection. However, the studies indicate that the complications and risks can be mitigated using precaution. The research seeks the validation of its findings through more comprehensive research in the future.
{"title":"Scoping Review of the Use of High-Flow Nasal Cannulas in Covid-19 Patients","authors":"Ahmad Alessa, Ali Alanazi, Dalya Abudawood, Nezar Filfilan, Ammar Yamani, Abdulrahman Baeshen, Mohamed Abdelrafea, Ameerah Alnefai, Khalid Alharbi","doi":"10.23958/ijirms/vol08-i09/1742","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i09/1742","url":null,"abstract":"This study aimed to explore the outcomes of using HFNC for patients with COVID-19. Forty-two studies were scanned using a scoping review, of which 22 were found eligible, satisfying the inclusion and inclusion criteria. Multiple patient outcomes were considered, including recovery time, oxygenation levels, reduced need for intubation in the future, ICU avoidance, and chances of respiratory distress. The findings suggest that HFNC remains more effective in treating patients with COVID-19-induced respiratory problems than traditional methods by indicating significantly improved oxygenation, reduced recovery time, reduced respiratory distress levels, and the need for invasive methods in the future. However, a few complications were also notable while considering its implementation on a wider scale, the most prominent being particle dispersion or airborne infection. However, the studies indicate that the complications and risks can be mitigated using precaution. The research seeks the validation of its findings through more comprehensive research in the future.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83643510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-02DOI: 10.23958/ijirms/vol08-i09/1735
Yusuf Alsharaf, Mohamed Alsaif, Yakub Sayed
This review focuses on the recurrence of lumbar disc herniation after percutaneous endoscopic discectomy (PED) and the revision surgery options available for patients who require further treatment. PED is a minimally invasive surgical technique used to treat herniated discs in the lumbar spine. Although PED has many advantages over traditional open decompression and fusion surgery, recurrent herniation is a common complication that can lead to the need for revision surgery. It will provide insights into strategies for minimizing complications and improving outcomes of post-endoscopic revision discectomy. The goal is to assist clinicians in selecting the most appropriate revision surgery option for their patients based on individual risk factors and other relevant factors. Ultimately, the review aimed to improve patient outcomes and reduce the need for repeat surgery in cases of recurrent herniation following PED. Various surgical techniques have been described for revision procedures, including repeated endoscopic discectomy, open discectomy, minimally invasive microdiscectomy, and fusion. The choice of technique depends on the specific indications and individual patient characteristics. The review will discuss common options for revision surgery, including minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), micro-endoscopic discectomy (MED), and PED. Factors that increase the risk of recurrence after primary PED surgery, such as advanced age, obesity, and Modic changes, will also be discussed. Further research and long-term follow-up studies are warranted to enhance our understanding of the optimal management strategies and outcomes of post-endoscopic discectomy revision.
{"title":"Revision of Post-Endoscopic Discectomy: A Review","authors":"Yusuf Alsharaf, Mohamed Alsaif, Yakub Sayed","doi":"10.23958/ijirms/vol08-i09/1735","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i09/1735","url":null,"abstract":"This review focuses on the recurrence of lumbar disc herniation after percutaneous endoscopic discectomy (PED) and the revision surgery options available for patients who require further treatment. PED is a minimally invasive surgical technique used to treat herniated discs in the lumbar spine. Although PED has many advantages over traditional open decompression and fusion surgery, recurrent herniation is a common complication that can lead to the need for revision surgery. It will provide insights into strategies for minimizing complications and improving outcomes of post-endoscopic revision discectomy. The goal is to assist clinicians in selecting the most appropriate revision surgery option for their patients based on individual risk factors and other relevant factors. Ultimately, the review aimed to improve patient outcomes and reduce the need for repeat surgery in cases of recurrent herniation following PED. Various surgical techniques have been described for revision procedures, including repeated endoscopic discectomy, open discectomy, minimally invasive microdiscectomy, and fusion. The choice of technique depends on the specific indications and individual patient characteristics. The review will discuss common options for revision surgery, including minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), micro-endoscopic discectomy (MED), and PED. Factors that increase the risk of recurrence after primary PED surgery, such as advanced age, obesity, and Modic changes, will also be discussed. Further research and long-term follow-up studies are warranted to enhance our understanding of the optimal management strategies and outcomes of post-endoscopic discectomy revision.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78940449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.23958/ijirms/vol08-i09/1729
Murtala, Audu Ngabea
Background: Percutaneous coronary intervention (PCI) remains one of the most important treatment modality for all the spectrum of artherosclerotic coronary artery disease. Post PCI patients are routinely admitted into the cardiac intensive care unit (ICCU) for observation and further management during which blood pressure (BP) and other hemodynamic parameters are monitored. Blood pressure (BP) monitoring is vital for the management of hemodynamically unstable patients in the cardiac intensive care Unit (ICCU). Despite errors from inaccurate calibration, movement artifacts and over or underdamping, invasive arterial blood pressure (IABP) monitoring remains the preferred method of monitoring BP in hemodynamically unstable patients. Nonetheless, automated noninvasive BP (NIBP) monitoring is commonly used in critically ill patients in cardiac ICU. Aim of study: To compare IABP using radial and femoral arterial line with NIBP monitoring, and to determine if radial and femoral arterial lines can be used interchangeably in patients undergoing PCI. Methodology: A total of eighty post PCI patients who had arterial line cannulation during PCI and admitted into ICCU were enrolled. Study participants were divided into two groups of Fourty (40) patients each. One group had IABP monitoring via right femoral artery line while the second group had IABP monitoring via right radial artery cannular. A cuff was placed on the left arm for concurrent noninvasive BP monitoring in all 80 patients. Data were obtained by performing noninvasive blood pressure (NIBP) t and concurrent IABP four times at one hourly intervals with first reading taken at time of admission to cardiac intensive care unit labelled (T1). NIBP values were compared with IABP values as the reference standard. Results: There were significant differences between systolic IABP as well as mean arterial invasive blood pressure measurements obtained through both radial and femoral routes compared with noninvasive blood pressure measurements (NIBP). No statistically significant differences in invasive blood pressure measurements between the radial and femoral catheter routes was detected. Conclusion: Noninvasive blood pressure measurement alone is insufficient for monitoring of post PCI patients admitted to cardiac intensive care unit after coronary angioplasty. The femoral and radial arterial lines can be used interchangeably for blood pressure monitoring in cardiac intensive care unit.
{"title":"Comparison Between Noninvasive and Invasive Blood Pressure Monitoring in Post Percutaneous Coronary Intervention Patients Admitted to Cardiac Intensive Care Unit","authors":"Murtala, Audu Ngabea","doi":"10.23958/ijirms/vol08-i09/1729","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i09/1729","url":null,"abstract":"Background: Percutaneous coronary intervention (PCI) remains one of the most important treatment modality for all the spectrum of artherosclerotic coronary artery disease. Post PCI patients are routinely admitted into the cardiac intensive care unit (ICCU) for observation and further management during which blood pressure (BP) and other hemodynamic parameters are monitored. Blood pressure (BP) monitoring is vital for the management of hemodynamically unstable patients in the cardiac intensive care Unit (ICCU). Despite errors from inaccurate calibration, movement artifacts and over or underdamping, invasive arterial blood pressure (IABP) monitoring remains the preferred method of monitoring BP in hemodynamically unstable patients. Nonetheless, automated noninvasive BP (NIBP) monitoring is commonly used in critically ill patients in cardiac ICU. Aim of study: To compare IABP using radial and femoral arterial line with NIBP monitoring, and to determine if radial and femoral arterial lines can be used interchangeably in patients undergoing PCI. Methodology: A total of eighty post PCI patients who had arterial line cannulation during PCI and admitted into ICCU were enrolled. Study participants were divided into two groups of Fourty (40) patients each. One group had IABP monitoring via right femoral artery line while the second group had IABP monitoring via right radial artery cannular. A cuff was placed on the left arm for concurrent noninvasive BP monitoring in all 80 patients. Data were obtained by performing noninvasive blood pressure (NIBP) t and concurrent IABP four times at one hourly intervals with first reading taken at time of admission to cardiac intensive care unit labelled (T1). NIBP values were compared with IABP values as the reference standard. Results: There were significant differences between systolic IABP as well as mean arterial invasive blood pressure measurements obtained through both radial and femoral routes compared with noninvasive blood pressure measurements (NIBP). No statistically significant differences in invasive blood pressure measurements between the radial and femoral catheter routes was detected. Conclusion: Noninvasive blood pressure measurement alone is insufficient for monitoring of post PCI patients admitted to cardiac intensive care unit after coronary angioplasty. The femoral and radial arterial lines can be used interchangeably for blood pressure monitoring in cardiac intensive care unit.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78636456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.23958/ijirms/vol08-i09/1734
J. Mamah, Robison Onoh, Micheal Orji, Ugoji DARLINTON-PETER CHIBUZOR, Chichetaram Otu, O. Umeora
An accurate tool to identify fetuses at risk of in-utero compromise in women with Preeclampsia is unknown. We studied the hemodynamic changes in the fetal umbilical and middle cerebral arteries and their association with pregnancy outcomes. This was a cross-sectional study among eligible pregnant women with Preeclampsia. We conducted a Doppler evaluation of the fetal umbilical and middle cerebral artery indices. The neonatal APGAR scores, birth weight, NICU admission and perinatal deaths were documented. Maternal complications were documented. Data analysis was undertaken with Statistical Package for Social Sciences (IBM-SPSS, version 22, Chicago II, USA). Means were compared using the Z-test for continuous variables, while categorical variables were compared with Chi-square. Relationships were assessed using Pearson's correlation, with significance at P< 0.05. The accuracy of Doppler indices was calculated using contingency tables. There was a statistically significant association between fetal complications and Doppler indices but not with maternal complications. The Sensitivity of Doppler indices was higher with fetal umbilical artery Doppler indices, while the middle cerebral artery indices were more specific. Accuracy is better when Doppler indices are combined with the cerebro-placental ratio. In women with normal Doppler indices, the indices decreased with advancing gestational age, but values were higher when compared with nomograms. In conclusion, we found an association between fetal Doppler indices of the umbilical artery and adverse fetal outcomes. Abnormal umbilical artery Doppler indices suggest fetal compromise, while normal middle cerebral artery Doppler is reassuring.
一个准确的工具，以确定胎儿在宫内危及风险的先兆子痫妇女是未知的。我们研究了胎儿脐动脉和大脑中动脉的血流动力学变化及其与妊娠结局的关系。这是一项在符合条件的先兆子痫孕妇中进行的横断面研究。我们对胎儿脐动脉和大脑中动脉指数进行了多普勒评估。记录新生儿APGAR评分、出生体重、新生儿重症监护病房入院情况和围产期死亡情况。记录了产妇并发症。数据分析采用Statistical Package for Social Sciences (IBM-SPSS, version 22, Chicago II, USA)。连续变量的均值比较采用z检验，分类变量的均值比较采用卡方检验。采用Pearson相关法评价相关性，P< 0.05为显著性。用列联表计算了多普勒指数的精度。胎儿并发症与多普勒指数有统计学意义相关，但与母体并发症无统计学意义。胎儿脐动脉多普勒指数敏感性较高，而大脑中动脉多普勒指数特异性较强。多普勒指标与脑胎盘比值结合，准确率较高。在多普勒指数正常的妇女中，指数随着孕龄的增加而下降，但与nomogram相比，数值更高。总之，我们发现胎儿脐动脉多普勒指数与胎儿不良结局之间存在关联。脐动脉多普勒指数异常提示胎儿受损，而大脑中动脉多普勒正常则令人放心。
{"title":"Fetal Umbilical Artery Velocimetry Indices and Pregnancy Outcome Among Preeclamptic Women at the Federal Teaching Hospital, Abakaliki, Southeast Nigeria","authors":"J. Mamah, Robison Onoh, Micheal Orji, Ugoji DARLINTON-PETER CHIBUZOR, Chichetaram Otu, O. Umeora","doi":"10.23958/ijirms/vol08-i09/1734","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i09/1734","url":null,"abstract":"An accurate tool to identify fetuses at risk of in-utero compromise in women with Preeclampsia is unknown. We studied the hemodynamic changes in the fetal umbilical and middle cerebral arteries and their association with pregnancy outcomes. This was a cross-sectional study among eligible pregnant women with Preeclampsia. We conducted a Doppler evaluation of the fetal umbilical and middle cerebral artery indices. The neonatal APGAR scores, birth weight, NICU admission and perinatal deaths were documented. Maternal complications were documented. Data analysis was undertaken with Statistical Package for Social Sciences (IBM-SPSS, version 22, Chicago II, USA). Means were compared using the Z-test for continuous variables, while categorical variables were compared with Chi-square. Relationships were assessed using Pearson's correlation, with significance at P< 0.05. The accuracy of Doppler indices was calculated using contingency tables. There was a statistically significant association between fetal complications and Doppler indices but not with maternal complications. The Sensitivity of Doppler indices was higher with fetal umbilical artery Doppler indices, while the middle cerebral artery indices were more specific. Accuracy is better when Doppler indices are combined with the cerebro-placental ratio. In women with normal Doppler indices, the indices decreased with advancing gestational age, but values were higher when compared with nomograms. In conclusion, we found an association between fetal Doppler indices of the umbilical artery and adverse fetal outcomes. Abnormal umbilical artery Doppler indices suggest fetal compromise, while normal middle cerebral artery Doppler is reassuring.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"328 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80415624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.23958/ijirms/vol08-i09/1731
P. Manoria, MT Noor
Background: Etiology of extra hepatic biliary obstruction (EHBO) is often a diagnostic dilemma. To differentiate between benign and malignant causes is of utmost important. Therefore, we conduct a study to know the various predictors of malignancy in it. Material and Methods: 138 consecutive patients diagnosed as EHBO were included in the study. After detail history, examination and investigations patients were divided into benign and malignant groups. Univariate and multivariate logistic regression analysis was done. Receiver operating characteristics curve was drawn to determine the optimal diagnostic cut- off value for predicting malignancy. Results: On univariate analysis patients with malignant EHBO were older, had more loss of weight, cholestatic symptoms, presence of hepatomegaly, palpable gall bladder, higher mean serum bilirubin [18.45±8.09 vs 9.70±9.40 mg/dl (p value <0.001)] and higher mean serum alkaline phosphatase [517.38±234.01 vs 356.44±208.98 IU/L (p value <0.001)]. Area under curve showed cut off value for serum bilirubin of >16.5 mg/dl (sensitivity 61.9%, specificity 84.3% and 95% confidence interval 0.751-0.896) and of serum alkaline phosphatase of >455IU/L (sensitivity 52.4%, specificity 82.9% and 95% confidence interval 0.651-0.824) as a predictor of malignancy. Multivariate analysis showed palpable gall bladder and serum bilirubin > 16.5 mg/dl to be independent predictors of malignancy. Conclusion: In patients with EHBO palpable gall bladder, serum bilirubin > 16.5 mg/dl and serum alkaline phosphatase > 455 IU/ L are important discriminating factors for malignancy.
{"title":"Predictors of Malignancy in Patients of Extra Hepatic Biliary Obstruction","authors":"P. Manoria, MT Noor","doi":"10.23958/ijirms/vol08-i09/1731","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i09/1731","url":null,"abstract":"Background: Etiology of extra hepatic biliary obstruction (EHBO) is often a diagnostic dilemma. To differentiate between benign and malignant causes is of utmost important. Therefore, we conduct a study to know the various predictors of malignancy in it. Material and Methods: 138 consecutive patients diagnosed as EHBO were included in the study. After detail history, examination and investigations patients were divided into benign and malignant groups. Univariate and multivariate logistic regression analysis was done. Receiver operating characteristics curve was drawn to determine the optimal diagnostic cut- off value for predicting malignancy. Results: On univariate analysis patients with malignant EHBO were older, had more loss of weight, cholestatic symptoms, presence of hepatomegaly, palpable gall bladder, higher mean serum bilirubin [18.45±8.09 vs 9.70±9.40 mg/dl (p value <0.001)] and higher mean serum alkaline phosphatase [517.38±234.01 vs 356.44±208.98 IU/L (p value <0.001)]. Area under curve showed cut off value for serum bilirubin of >16.5 mg/dl (sensitivity 61.9%, specificity 84.3% and 95% confidence interval 0.751-0.896) and of serum alkaline phosphatase of >455IU/L (sensitivity 52.4%, specificity 82.9% and 95% confidence interval 0.651-0.824) as a predictor of malignancy. Multivariate analysis showed palpable gall bladder and serum bilirubin > 16.5 mg/dl to be independent predictors of malignancy. Conclusion: In patients with EHBO palpable gall bladder, serum bilirubin > 16.5 mg/dl and serum alkaline phosphatase > 455 IU/ L are important discriminating factors for malignancy.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88281113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-16DOI: 10.23958/ijirms/vol08-i08/1730
A. Alnassar
Background: Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic complication of ovulation induction therapy. I hereby present a rare case of a large, isolated right-sided pleural effusion causing respiratory compromise following IVF. The clinical presentation of abdominal ascites is known to be common in OHSS, with isolated pleural effusions being a rare finding. Case presentation: The reported case is a rare example of an isolated pleural effusion in a 36-year-old lady with polycystic ovarian syndrome (PCOS) and ongoing sessions of IVF due to infertility. The patient was hospitalized due to shortness of breath. A chest x-ray was performed and revealed a large pleural effusion in the right hemithorax. Ultrasound-guided thoracentesis was safely performed without complications. Conclusions: I hereby present a rare clinical manifestation of OHSS presenting with a large isolated pleural effusion. Patients being treated for infertility with ovulation induction should be assessed and monitored frequently for the prevention of developing OHSS.
{"title":"A Large Isolated Pleural Effusion in the Right Hemithorax as an Unusual Manifestation Following IVF","authors":"A. Alnassar","doi":"10.23958/ijirms/vol08-i08/1730","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i08/1730","url":null,"abstract":"Background: Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic complication of ovulation induction therapy. I hereby present a rare case of a large, isolated right-sided pleural effusion causing respiratory compromise following IVF. The clinical presentation of abdominal ascites is known to be common in OHSS, with isolated pleural effusions being a rare finding. Case presentation: The reported case is a rare example of an isolated pleural effusion in a 36-year-old lady with polycystic ovarian syndrome (PCOS) and ongoing sessions of IVF due to infertility. The patient was hospitalized due to shortness of breath. A chest x-ray was performed and revealed a large pleural effusion in the right hemithorax. Ultrasound-guided thoracentesis was safely performed without complications. Conclusions: I hereby present a rare clinical manifestation of OHSS presenting with a large isolated pleural effusion. Patients being treated for infertility with ovulation induction should be assessed and monitored frequently for the prevention of developing OHSS.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75053722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-16DOI: 10.23958/ijirms/vol08-i08/1733
Priscila Delgado Macías, Omar Varela Barraza, A. S. Sánchez Terán, Fernando Germes Piña, Michelle Alejandra Macías Grageda, Arturo Luévano González
We present a case of Giant condyloma of Bushke-Löwenstein (GCBL) in a 15-year-old pregnant woman from the Tarahumara ethnic group. GCBL is a rare sexually transmitted disease caused by the the Human Papillomavirus (HPV) with a high risk of malignant transformation. Surgical resection is the main treatment, but managing GCBL during pregnancy requires careful consideration. This case highlights a rare and challenging condition that shares features with both classic condyloma acuminata and squamous cell carcinoma, making its differentiation difficult and the importance of comprehensive sexual education, culturally sensitive healthcare, and follow-up care in underserved communities. Challenges in post-surgical monitoring and limited knowledge of perinatal outcomes underscore the need for increased awareness, prevention, and early detection strategies, including HPV vaccination.
{"title":"Giant Condyloma of Bushke-Löwenstein (GCBL) in Pregnancy: A Case Report","authors":"Priscila Delgado Macías, Omar Varela Barraza, A. S. Sánchez Terán, Fernando Germes Piña, Michelle Alejandra Macías Grageda, Arturo Luévano González","doi":"10.23958/ijirms/vol08-i08/1733","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i08/1733","url":null,"abstract":"We present a case of Giant condyloma of Bushke-Löwenstein (GCBL) in a 15-year-old pregnant woman from the Tarahumara ethnic group. GCBL is a rare sexually transmitted disease caused by the the Human Papillomavirus (HPV) with a high risk of malignant transformation. Surgical resection is the main treatment, but managing GCBL during pregnancy requires careful consideration. This case highlights a rare and challenging condition that shares features with both classic condyloma acuminata and squamous cell carcinoma, making its differentiation difficult and the importance of comprehensive sexual education, culturally sensitive healthcare, and follow-up care in underserved communities. Challenges in post-surgical monitoring and limited knowledge of perinatal outcomes underscore the need for increased awareness, prevention, and early detection strategies, including HPV vaccination.","PeriodicalId":14008,"journal":{"name":"International Journal of Innovative Research in Medical Science","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76012235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-02DOI: 10.23958/ijirms/vol08-i08/1719
M. Alruwaili
The Perinatal period, encompassing pregnancy and the postpartum stage, is a critical time that significantly affects women's mental health and overall well-being. Suicides and suicidal ideation pose pressing public health concerns during this period. High-risk factors, including depression and other mental disorders such as schizophrenia, anxiety, bipolar disorder, and adjustment disorder, further emphasize the need for attention. Healthcare providers play a vital role in identifying at-risk women and connecting them with the necessary resources and mental health services.
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Pub Date : 2023-08-01DOI: 10.23958/ijirms/vol08-i08/1720
Dr Awad Mohamed, Mawia Alamein, Fatma Gammer, E. Elmakki, Dr Eltayeb Hamid, Dr Eyad Gadour, Dr Mohamed Abdelhameed, Dr Mohammed Ibrahim Alamean, Professor Saad Subahi
Background: Non-ST-segment elevation acute coronary syndrome (NSTEACS) is a common presentation of acute coronary syndrome. Revascularization as treatment for Acute Coronary syndrome in the republic of Sudan is free to all comers whether STEMI of NSTEMI. Urgent revascularization within the 24hrs mark, however, is only offered to patients with STEMI, as the ST segment elevation in the presenting ECG is believed to indicate an occluded culprit coronary artery and hence, the urgency to open the occluded culprit artery. This puts patients with NSTEMI categorically in a different lower risk stratum in terms of urgency for treatment. The frequency and outcomes of NSTEMI patients with occluded culprit coronary artery despite absence of ECG ST elevation in Africa, as general, are yet to be fully elucidated. Objectives: This prospective single study aimed to investigate the frequency and outcomes of NSTEMI (No ST segment elevation) Sudanese patients proven to have an occluded culprit coronary artery (TIMI flow 0). Methods: In this prospective single-center study, 100 NSTEACS conductive patients who were admitted to Al-Shaab Teaching Hospital Khartoum- Sudan from January to April 2022 were examined. Data regarding demographics, medical history, clinical presentations, laboratory investigation, electrocardiography (ECG) findings, echocardiogram, coronary angiography (CAG), management strategies, medications at discharge and follow up, 30-day outcomes, and 6-month mortality rates were collected. All patients underwent standard medical management and CAG within 24-48 hours of admission. Results: In total, 100 consecutive patients with NSTEACS were enrolled in this study, with 20% (n = 20) having occluded culprit artery (OCA) and 80% (n = 80) have no occluded culprit artery (non-OCA). Patients with OCA were younger (mean age 57.6 ± 10.7 years vs. 64.3 ± 11.1 years, p = 0.002) and predominantly male (70% vs. 48.8%, p = 0.06) as compared to those with non-OCA. Patients with OCA had a higher percentage of major cardiovascular risk factors (diabetes, hyperlipidemia, and smoking) than patients with non-OCA, except for hypertension, which was higher among patients with non-OCA (70% vs. 45%, p = 0.045). At admission, patients with OCA had a higher percentage of heart failure (20% vs. 7.5%, p = 0.05) and a lower ejection fraction (mean EF% 49.5 ± 13.7 vs. 54.3 ± 9.5, p = 0.04) as compared to patients with non-OCA. T-wave inversion was the most common ECG finding in both groups. With regard to the culprit coronary artery, the right coronary artery (RCA) was the most frequently involved in NSTEACS patients with OCA (60%), followed by the left circumflex artery (LCX) (20%), left anterior descending artery (LAD) (15%), and obtuse marginal artery (5%). In contrast, the LAD was the most involved vessel in NSTEACS patients with non-OCA (72%), followed by the RCA (49%) and the LCX (34%). The 30-day outcomes showed that the incidence of re-infarction, recurrent chest pain, and
背景:非st段抬高急性冠状动脉综合征(NSTEACS)是急性冠状动脉综合征的常见表现。在苏丹共和国，血管重建术作为急性冠脉综合征的治疗对所有患者免费，无论是STEMI还是NSTEMI。然而，只有STEMI患者才需要在24小时内进行紧急血运重建，因为在出现心电图的ST段抬高被认为是罪魁祸首冠状动脉闭塞，因此需要紧急打开闭塞的罪魁祸首动脉。这使得非stemi患者在治疗急迫性方面处于不同的低风险阶层。在非洲，尽管没有心电图ST段抬高，但NSTEMI患者的罪魁祸首冠状动脉闭塞的频率和结果尚未完全阐明。目的:本前瞻性单中心研究旨在调查非ST段抬高(No ST段抬高)苏丹患者被证实有罪魁祸首冠状动脉闭塞(TIMI流量0)的频率和结果。方法:在这项前瞻性单中心研究中，研究了2022年1月至4月在苏丹喀土穆Al-Shaab教学医院收治的100例NSTEACS传导患者。收集有关人口统计学、病史、临床表现、实验室调查、心电图(ECG)结果、超声心动图、冠状动脉造影(CAG)、管理策略、出院和随访时用药、30天结局和6个月死亡率的数据。所有患者在入院24-48小时内均接受了标准的医疗管理和CAG。结果:本研究共纳入100例连续的NSTEACS患者，其中20% (n = 20)有罪魁动脉闭塞(OCA)， 80% (n = 80)没有罪魁动脉闭塞(非OCA)。与非OCA患者相比，OCA患者更年轻(平均年龄57.6±10.7岁比64.3±11.1岁，p = 0.002)，且以男性为主(70%比48.8%，p = 0.06)。OCA患者的主要心血管危险因素(糖尿病、高脂血症和吸烟)比例高于非OCA患者，但高血压在非OCA患者中较高(70%比45%，p = 0.045)。入院时，与非OCA患者相比，OCA患者的心力衰竭比例更高(20% vs. 7.5%， p = 0.05)，射血分数更低(平均EF% 49.5±13.7 vs. 54.3±9.5,p = 0.04)。t波反转是两组中最常见的心电图表现。关于罪魁祸首冠状动脉，NSTEACS合并OCA患者最常累及的是右冠状动脉(RCA)(60%)，其次是左旋动脉(LCX)(20%)、左前降支(LAD)(15%)和钝缘动脉(5%)。相比之下，在非oca的NSTEACS患者中，LAD是最受损伤的血管(72%)，其次是RCA(49%)和LCX(34%)。30天的结果显示，OCA患者的再梗死、复发性胸痛和心律失常发生率高于非OCA患者(分别为15% vs. 5%、25% vs. 11.3%和10% vs. 2.5%)。然而，两组在心力衰竭或死亡发生率方面没有显著差异。在6个月的随访中，OCA患者的死亡率高于非OCA患者(15% vs. 3.8%， p = 0.05)。结论:在本研究中，我们可以得出结论，在相当数量的患者中，NSTEMI是罪魁祸首动脉完全闭塞的结果，在目前的心电图上没有显示ST段升高。与非oca患者相比，这些患者有更高的主要心血管危险因素患病率，更差的临床表现和更差的预后。在合并OCA的NSTEACS患者中，RCA是最常受累的血管，而在非OCA患者中，LAD是最常受累的血管。
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