Background: This study was aimed to evaluate the outcomes of anesthetic management in a pregnant patient post orthotopic heart transplant secondary to dilated cardiomyopathy with severe left ventricular systolic function. Case Description: This is 25-year-old pregnant women, primigravida, gestational age at 34 weeks and 5 days that was electively admitted for further investigation in King Faisal Specialist Hospital and Research Center (KFSH&RC), Riyadh, Saudi Arabia, for multidisciplinary meeting, to properly optimize the patient status and approach the best possible outcome. The patient underwent orthotopic heart transplant in September 2011 due to dilated cardiomyopathy with severe left ventricular systolic dysfunction. The initial plan for this patient was pure neuraxial anesthesia, utilizing a Epidural and spinal combined anaesthesia. This, however, was complicated by an accidental dural puncture with an 18-gauge Tuohy needle, causing post dural puncture headache which was then later treated by an epidural blood patch. Conclusion: The perioperative management of such cases requires an intricate plan by an experienced team in a multidisciplinary approach to optimize intra and post operative outcomes for both mother and neonate. Keeping in mind all cardiac considerations of a transplanted heart and pregnancy, that normally involve the physiological, anatomical, and pharmacological changes and their role in the perioperative period. Anesthetic approach whether General anesthesia or neuroaxial anesthesia depends heavily on cardiac reserve and function.
{"title":"Anesthetic management of a patient with a transplanted heart undergoing a cesarean section: A case report","authors":"Nasser Alabdulkarim, Abdullah AlRaffa, Usama Saleh, Rawan Alandas, Norah Almajed, Alanood Alsaleem, Nawaf Alkhudryi, Mosaad Alhussein","doi":"10.54905/disssi.v28i144.e6ms3292","DOIUrl":"https://doi.org/10.54905/disssi.v28i144.e6ms3292","url":null,"abstract":"Background: This study was aimed to evaluate the outcomes of anesthetic management in a pregnant patient post orthotopic heart transplant secondary to dilated cardiomyopathy with severe left ventricular systolic function. Case Description: This is 25-year-old pregnant women, primigravida, gestational age at 34 weeks and 5 days that was electively admitted for further investigation in King Faisal Specialist Hospital and Research Center (KFSH&RC), Riyadh, Saudi Arabia, for multidisciplinary meeting, to properly optimize the patient status and approach the best possible outcome. The patient underwent orthotopic heart transplant in September 2011 due to dilated cardiomyopathy with severe left ventricular systolic dysfunction. The initial plan for this patient was pure neuraxial anesthesia, utilizing a Epidural and spinal combined anaesthesia. This, however, was complicated by an accidental dural puncture with an 18-gauge Tuohy needle, causing post dural puncture headache which was then later treated by an epidural blood patch. Conclusion: The perioperative management of such cases requires an intricate plan by an experienced team in a multidisciplinary approach to optimize intra and post operative outcomes for both mother and neonate. Keeping in mind all cardiac considerations of a transplanted heart and pregnancy, that normally involve the physiological, anatomical, and pharmacological changes and their role in the perioperative period. Anesthetic approach whether General anesthesia or neuroaxial anesthesia depends heavily on cardiac reserve and function.","PeriodicalId":18393,"journal":{"name":"Medical Science","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140409440","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 : 2024-02-29DOI: 10.54905/disssi.v28i144.e5ms3290
Noor H Almousa, Reem Tariq Alsubaie, Abdulelah Mohammed Khuraybah, Nawal Mohammed Alalyani
Background: For women who are of reproductive age, the most common cause of anal incontinence is obstetric anal sphincter injury (OASIS). We aimed to assess the subsequent delivery mode effects on quality of life and anal incontinence in women who had a history of OASIS. Method: Searches were done using the selection criteria of any study evaluating the effect of a second birth on quality of life and anal incontinence in women who had previously experienced OASIS, the search includes studies published to the end of 2022 in EMBASE, MEDLINE, CINAHL, and PubMed. Result: In addition to one item from outside sources, we gathered 911 articles by looking through electric databases. Finally, after filtering, we included seven complete articles to the review. Low AI measurement scores before a second delivery were revealed to be a strong predictor of normal continence following a later birth (An et al., 2014). In a prospective cohort research after first sphincter repair, according to Reid et al., (2014) in a follow-up period of 3 years, symptoms of AI were more prevalent in women who underwent recurrent caesarean sections. Studies by Fitzpatrick et al., (2016), Jordan et al., (2014), and Naidu et al., (2015) showed that women who delivered in the advised way afterward did not have a worsening symptom of AI. Conclusion: The existing guideline of a second vaginal delivery for women with a history of OASIS who do not exhibit AI symptoms or sphincter abnormalities is supported by this systematic review.
{"title":"Impact of subsequent birth and delivery mode for women with previous OASIS: Systemic review","authors":"Noor H Almousa, Reem Tariq Alsubaie, Abdulelah Mohammed Khuraybah, Nawal Mohammed Alalyani","doi":"10.54905/disssi.v28i144.e5ms3290","DOIUrl":"https://doi.org/10.54905/disssi.v28i144.e5ms3290","url":null,"abstract":"Background: For women who are of reproductive age, the most common cause of anal incontinence is obstetric anal sphincter injury (OASIS). We aimed to assess the subsequent delivery mode effects on quality of life and anal incontinence in women who had a history of OASIS. Method: Searches were done using the selection criteria of any study evaluating the effect of a second birth on quality of life and anal incontinence in women who had previously experienced OASIS, the search includes studies published to the end of 2022 in EMBASE, MEDLINE, CINAHL, and PubMed. Result: In addition to one item from outside sources, we gathered 911 articles by looking through electric databases. Finally, after filtering, we included seven complete articles to the review. Low AI measurement scores before a second delivery were revealed to be a strong predictor of normal continence following a later birth (An et al., 2014). In a prospective cohort research after first sphincter repair, according to Reid et al., (2014) in a follow-up period of 3 years, symptoms of AI were more prevalent in women who underwent recurrent caesarean sections. Studies by Fitzpatrick et al., (2016), Jordan et al., (2014), and Naidu et al., (2015) showed that women who delivered in the advised way afterward did not have a worsening symptom of AI. Conclusion: The existing guideline of a second vaginal delivery for women with a history of OASIS who do not exhibit AI symptoms or sphincter abnormalities is supported by this systematic review.","PeriodicalId":18393,"journal":{"name":"Medical Science","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140408966","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}
Objective: To elucidate the challenges associated with anesthesia and successful management strategies in a pregnant patient with severe pulmonary arterial hypertension and Eisenmenger physiology undergoing cesarean section. Background: Congenital heart disease is a leading cause of maternal cardiac deaths, with Eisenmenger's syndrome being high-risk due to potential complications. Pulmonary hypertension, characterized by an increase in mean pulmonary artery pressure, is associated with a high mortality rate between 30% and 56%. Advancements in medicine have improved the prognosis and quality of life for patients with pulmonary arterial hypertension. However, managing cesarean sections for parturients with Eisenmenger's syndrome remains challenging. Case notes: A 27-year-old primigravida with severe pulmonary arterial hypertension secondary to congenital heart disease, diagnosed with Eisenmenger physiology, underwent an emergency cesarean section at 32 weeks for optimal maternal and fetal outcomes. The multidisciplinary team opted for careful pre-operative assessment and invasive monitoring along with epidural anesthesia. Postoperatively, the patient faced complications, including thrombocytopenia, hematoma, and a positive COVID-19 diagnosis, yet was discharged in stable condition. Conclusion: Continuous vigilance throughout the perioperative and postoperative phases is crucial for optimizing outcomes in pregnant patients with Eisenmenger physiology. The successful outcome in this high-risk case underscores the importance of advanced medical modalities and multidisciplinary approaches in addressing the complexities of such pregnancies.
{"title":"Anesthetic management and role in a patient with severe pulmonary hypertension with Eisenmenger physiology undergoing a cesarean section","authors":"Nasser Alabdulkarim, Nisar Soomro, Salaheddin Zubek, Norah Almajed, Alanood Alsaleem, Rahaf Althnayan","doi":"10.54905/disssi.v28i144.e7ms3293","DOIUrl":"https://doi.org/10.54905/disssi.v28i144.e7ms3293","url":null,"abstract":"Objective: To elucidate the challenges associated with anesthesia and successful management strategies in a pregnant patient with severe pulmonary arterial hypertension and Eisenmenger physiology undergoing cesarean section. Background: Congenital heart disease is a leading cause of maternal cardiac deaths, with Eisenmenger's syndrome being high-risk due to potential complications. Pulmonary hypertension, characterized by an increase in mean pulmonary artery pressure, is associated with a high mortality rate between 30% and 56%. Advancements in medicine have improved the prognosis and quality of life for patients with pulmonary arterial hypertension. However, managing cesarean sections for parturients with Eisenmenger's syndrome remains challenging. Case notes: A 27-year-old primigravida with severe pulmonary arterial hypertension secondary to congenital heart disease, diagnosed with Eisenmenger physiology, underwent an emergency cesarean section at 32 weeks for optimal maternal and fetal outcomes. The multidisciplinary team opted for careful pre-operative assessment and invasive monitoring along with epidural anesthesia. Postoperatively, the patient faced complications, including thrombocytopenia, hematoma, and a positive COVID-19 diagnosis, yet was discharged in stable condition. Conclusion: Continuous vigilance throughout the perioperative and postoperative phases is crucial for optimizing outcomes in pregnant patients with Eisenmenger physiology. The successful outcome in this high-risk case underscores the importance of advanced medical modalities and multidisciplinary approaches in addressing the complexities of such pregnancies.","PeriodicalId":18393,"journal":{"name":"Medical Science","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415448","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 : 2024-01-27DOI: 10.54905/disssi.v28i143.e3ms3256
Iryna Batih
{"title":"Prevalence of maxillofacial anomalies and their relation to periodontal diseases in young people","authors":"Iryna Batih","doi":"10.54905/disssi.v28i143.e3ms3256","DOIUrl":"https://doi.org/10.54905/disssi.v28i143.e3ms3256","url":null,"abstract":"","PeriodicalId":18393,"journal":{"name":"Medical Science","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140492788","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 : 2024-01-27DOI: 10.54905/disssi.v28i143.e2ms3286
Mohammed Sagheer Albarqi, Saad Alsaad, Mania Salem Al-baqawi, Kamal K. Alsofyani, Fahad Bader AlGhounaim, Mohammed Sultan Alshehri, Rakan Abdullah Alshareef, Mortada Hassan Aljassas, Faisal Naif Alshammari, Ahmed Alsiwar
{"title":"Efficacy of Airway Pressure Release Ventilation in treating acute respiratory distress syndrome","authors":"Mohammed Sagheer Albarqi, Saad Alsaad, Mania Salem Al-baqawi, Kamal K. Alsofyani, Fahad Bader AlGhounaim, Mohammed Sultan Alshehri, Rakan Abdullah Alshareef, Mortada Hassan Aljassas, Faisal Naif Alshammari, Ahmed Alsiwar","doi":"10.54905/disssi.v28i143.e2ms3286","DOIUrl":"https://doi.org/10.54905/disssi.v28i143.e2ms3286","url":null,"abstract":"","PeriodicalId":18393,"journal":{"name":"Medical Science","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491980","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 : 2024-01-27DOI: 10.54905/disssi.v28i143.e4ms3285
Ibtesam Fawaz Alshammari, Salem Abdulaziz Islam, Sara Ali Ahmed Halawi, Mahmood Ahmad Nasser Boeisa, Rayan Ali Barakat, Hassan Mayudh Almalki
{"title":"Seminal Plasma effectiveness in IVF treatment: Systematic review","authors":"Ibtesam Fawaz Alshammari, Salem Abdulaziz Islam, Sara Ali Ahmed Halawi, Mahmood Ahmad Nasser Boeisa, Rayan Ali Barakat, Hassan Mayudh Almalki","doi":"10.54905/disssi.v28i143.e4ms3285","DOIUrl":"https://doi.org/10.54905/disssi.v28i143.e4ms3285","url":null,"abstract":"","PeriodicalId":18393,"journal":{"name":"Medical Science","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140492533","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 : 2024-01-27DOI: 10.54905/disssi.v28i143.e1ms3284
Tahani Mohammed Aljuhani, Ghofran Saleem Alhejaili, Mohand Ebrahim A Nooli, Daliyah Abdulhamid Alqulaiti, Shahad Saud Aljohani, Lubna Ahmed Murtada, Renad Mohammed Alsaedi
{"title":"Heterotopic Pregnancy in spontaneous pregnancy after previous Assisted Reproductive Techniques (ART)","authors":"Tahani Mohammed Aljuhani, Ghofran Saleem Alhejaili, Mohand Ebrahim A Nooli, Daliyah Abdulhamid Alqulaiti, Shahad Saud Aljohani, Lubna Ahmed Murtada, Renad Mohammed Alsaedi","doi":"10.54905/disssi.v28i143.e1ms3284","DOIUrl":"https://doi.org/10.54905/disssi.v28i143.e1ms3284","url":null,"abstract":"","PeriodicalId":18393,"journal":{"name":"Medical Science","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140493251","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 : 2023-11-30DOI: 10.54905/disssi.v27i141.e378ms3251
Ebtehal G Albeshir, Reem A Albluwi, Ibtisam K Almubarak, Abdulmohsen Alrabea, Norman B Cook, George J Eckert, Anderson T Hara, Frank Lippert
{"title":"The impact of mouth rinses on the efficacy of fluoride dentifrices in preventing enamel and dentin erosion/abrasion","authors":"Ebtehal G Albeshir, Reem A Albluwi, Ibtisam K Almubarak, Abdulmohsen Alrabea, Norman B Cook, George J Eckert, Anderson T Hara, Frank Lippert","doi":"10.54905/disssi.v27i141.e378ms3251","DOIUrl":"https://doi.org/10.54905/disssi.v27i141.e378ms3251","url":null,"abstract":"","PeriodicalId":18393,"journal":{"name":"Medical Science","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139202708","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 : 2023-11-30DOI: 10.54905/disssi.v27i141.e372ms3203
F. Alqudaihi, Walla Al Qudaihi, Norman Blaine Cook
{"title":"Aesthetic and functional enhancement using anterior implant supported Cantilever Partial Fixed Dental Prostheses: A 5-year case report","authors":"F. Alqudaihi, Walla Al Qudaihi, Norman Blaine Cook","doi":"10.54905/disssi.v27i141.e372ms3203","DOIUrl":"https://doi.org/10.54905/disssi.v27i141.e372ms3203","url":null,"abstract":"","PeriodicalId":18393,"journal":{"name":"Medical Science","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139203205","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 : 2023-11-30DOI: 10.54905/disssi.v27i141.e373ms3242
Shilpa Chourasia, Kiran Mendhe, Urja Tahalramani
{"title":"Combined effect of blood flow restriction training and proprioceptive training on conservatively managed multiligament knee injury patient: A case report","authors":"Shilpa Chourasia, Kiran Mendhe, Urja Tahalramani","doi":"10.54905/disssi.v27i141.e373ms3242","DOIUrl":"https://doi.org/10.54905/disssi.v27i141.e373ms3242","url":null,"abstract":"","PeriodicalId":18393,"journal":{"name":"Medical Science","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139206422","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}
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