Pub Date : 2023-01-01DOI: 10.5455/medarh.2023.77.74-76
Elma Hasković, A. Mustapić, Ilma Kobic, Belma Karadza, Subha Habib
Background: Hemangiomas are vascular tumors, i.e. neoplasms of the vascular network. These are the most common neoplasms in the age of infancy. They can be infantile and congenital. Objective: Present the case of a 7.5-year-old girl suffering from a benign vascular tumor–hemangiomatosis of the skin and liver, which is part of the autosomal recessive syndrome SDC (Spondylocostal dysostosis). Case presentation: This case shows that hemangiomas can be accompanied by other diseases as part of congenital syndromes or metabolopathies that are often genetically inherited. In the present case, it is an autosomal recessive form of SCD syndrome or spondylocostal dysostosis. Conclusion: It is important to consider SCD, i.e., spondylocostal dysostosis, as a rare autosomal recessive disease that can occur as part of hemangiomatosis. Recent studies from 2020 and 2013 have shown the efficacy of topical timolol as well as atenolol which can replace oral propranolol as the first-line agent in the treatment of hemangiomas. In randomized clinical trial (2020), when compared with propranolol, atenolol had similar efficacy and fewer adverse events in the treatment of infants with problematic infantile hemangiomas.
{"title":"Hemangioma–Benign Tumor in Childhood","authors":"Elma Hasković, A. Mustapić, Ilma Kobic, Belma Karadza, Subha Habib","doi":"10.5455/medarh.2023.77.74-76","DOIUrl":"https://doi.org/10.5455/medarh.2023.77.74-76","url":null,"abstract":"Background: Hemangiomas are vascular tumors, i.e. neoplasms of the vascular network. These are the most common neoplasms in the age of infancy. They can be infantile and congenital. Objective: Present the case of a 7.5-year-old girl suffering from a benign vascular tumor–hemangiomatosis of the skin and liver, which is part of the autosomal recessive syndrome SDC (Spondylocostal dysostosis). Case presentation: This case shows that hemangiomas can be accompanied by other diseases as part of congenital syndromes or metabolopathies that are often genetically inherited. In the present case, it is an autosomal recessive form of SCD syndrome or spondylocostal dysostosis. Conclusion: It is important to consider SCD, i.e., spondylocostal dysostosis, as a rare autosomal recessive disease that can occur as part of hemangiomatosis. Recent studies from 2020 and 2013 have shown the efficacy of topical timolol as well as atenolol which can replace oral propranolol as the first-line agent in the treatment of hemangiomas. In randomized clinical trial (2020), when compared with propranolol, atenolol had similar efficacy and fewer adverse events in the treatment of infants with problematic infantile hemangiomas.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85450621","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 : 2023-01-01DOI: 10.5455/medarh.2023.77.149-153
M. Khasawneh
Background: During the whole of the teaching and learning that takes place in a school, there is interaction not just between students but also between students and instructors and teachers and pupils. This calls for a response since it is a necessary component of the learning process. During the whole of the teaching and learning that takes place in a school, there is interaction not just between students but also between students and instructors and teachers and pupils. This calls for a response since it is a necessary component of the learning process. Objective: The purpose of this study is to investigate how children with special needs feel about participating in regular classroom activities. In order to learn what's going on and where we can start looking for answers, we need to look back at where we've been. Methods: The methodology of this study was qualitative in nature, and the technique was descriptive. Data is collected using a variety of methods, including observation, interviews, and documentation, and then categorized and evaluated using a process that begins with the elimination of extraneous information and ends with the formulation of a conclusion. Results: These results provide more evidence that unfavorable social views held by other students toward students with special needs have internal and external roots. These results also imply that kids with special needs suffer social limiting forces from the outside, especially those that stem from a general societal attitude of hostility. Some people just refuse to interact with families that have a special needs kid. Having trouble relating to others and withdrawing from the world are common reactions to negative events and behaviors among children with special needs. As a rule, this is because of their history of poor decisions and acts. This makes it crucial that we figure out what's triggering the response. Conclusion: Given the feasibility of these goals, a positive outlook is essential for children of all ages, including those with special needs and those growing normally.
{"title":"Social Attitude of Children with Special Needs in The Learning Process","authors":"M. Khasawneh","doi":"10.5455/medarh.2023.77.149-153","DOIUrl":"https://doi.org/10.5455/medarh.2023.77.149-153","url":null,"abstract":"Background: During the whole of the teaching and learning that takes place in a school, there is interaction not just between students but also between students and instructors and teachers and pupils. This calls for a response since it is a necessary component of the learning process. During the whole of the teaching and learning that takes place in a school, there is interaction not just between students but also between students and instructors and teachers and pupils. This calls for a response since it is a necessary component of the learning process. Objective: The purpose of this study is to investigate how children with special needs feel about participating in regular classroom activities. In order to learn what's going on and where we can start looking for answers, we need to look back at where we've been. Methods: The methodology of this study was qualitative in nature, and the technique was descriptive. Data is collected using a variety of methods, including observation, interviews, and documentation, and then categorized and evaluated using a process that begins with the elimination of extraneous information and ends with the formulation of a conclusion. Results: These results provide more evidence that unfavorable social views held by other students toward students with special needs have internal and external roots. These results also imply that kids with special needs suffer social limiting forces from the outside, especially those that stem from a general societal attitude of hostility. Some people just refuse to interact with families that have a special needs kid. Having trouble relating to others and withdrawing from the world are common reactions to negative events and behaviors among children with special needs. As a rule, this is because of their history of poor decisions and acts. This makes it crucial that we figure out what's triggering the response. Conclusion: Given the feasibility of these goals, a positive outlook is essential for children of all ages, including those with special needs and those growing normally.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79578446","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 : 2022-02-01DOI: 10.5455/medarh.2022.76.12-16
Azra Bureković, Dženan Halilović, Anisa Sahbaz
Background: Hypothyroidism occurs as a consequence of chronic autoimmune inflammation of the thyroid gland, which occurs due to the reduced function in the secretion of hormones FT3 and FT4 and requires replacement therapy for life. CoV-19 infection has shown many complications in all organic systems, during the acute phase of infection and in the post COVID period. Objectives: The aim of the study was a) to compare the frequency of patient visits for hypothyroidism and the average dose of levothyroxine in the SANASA polyclinic in the year before COVID pandemic, in the early 2019, with the frequency of patient visits during COVID infection in 2020 and 2021; b) to determine the incidence of hypothyroidism after the COVID 19 infection, the time of onset of hypothyroidism after acute phase of the disease, and the average dose of levothyroxine; and c) to monitor the incidence of subclinical hypothyroidism, which did not require substitution, before and after COVID 19 infection. Methods: In the SANASA polyclinic from the 2019 database we found 58 patients, at the age between 18-70 years, 53 women and 2 men with hypothyroidism and 2 female and 1 male patients with subclinical hypothyroidism. In 2020 there were a total of 89 patients, 73 women and 4 men with hypothyroidism, and 9 women and 3 men with subclinical hypothyroidism. In the 2021 there were 101 patients, 86 women and 7 men with hypothyroidism and 7 female and 1 male patients with subclinical hypothyroidism. Results: There was a significant difference in the number of patients with hypothyroidism and subclinical hypothyroidism during 2020 and 2021 in relation to 2019. The average dose of levothyroxine per patient did not differ statistically, comparing all three years, as well as comparing those who were ill, compared to patients who did not have COVID-19. There were diagnoses of post COVID subclinical hypothyroidism in 2020, as in 2021, with an average time of diagnosis of 2 months after infection for clinical hypothyroidism and 8 weeks for subclinical hypothyroidism. Conclusion: CoV-19 infection adversely affects thyroid tissue causing clinical hypothyroidism, requiring levothyroxine substitution as well as subclinical hypothyroidism which should be monitored.
{"title":"Hypothyroidism and Subclinical Hypothyroidism as a Consequence of COVID-19 Infection","authors":"Azra Bureković, Dženan Halilović, Anisa Sahbaz","doi":"10.5455/medarh.2022.76.12-16","DOIUrl":"https://doi.org/10.5455/medarh.2022.76.12-16","url":null,"abstract":"Background: Hypothyroidism occurs as a consequence of chronic autoimmune inflammation of the thyroid gland, which occurs due to the reduced function in the secretion of hormones FT3 and FT4 and requires replacement therapy for life. CoV-19 infection has shown many complications in all organic systems, during the acute phase of infection and in the post COVID period. Objectives: The aim of the study was a) to compare the frequency of patient visits for hypothyroidism and the average dose of levothyroxine in the SANASA polyclinic in the year before COVID pandemic, in the early 2019, with the frequency of patient visits during COVID infection in 2020 and 2021; b) to determine the incidence of hypothyroidism after the COVID 19 infection, the time of onset of hypothyroidism after acute phase of the disease, and the average dose of levothyroxine; and c) to monitor the incidence of subclinical hypothyroidism, which did not require substitution, before and after COVID 19 infection. Methods: In the SANASA polyclinic from the 2019 database we found 58 patients, at the age between 18-70 years, 53 women and 2 men with hypothyroidism and 2 female and 1 male patients with subclinical hypothyroidism. In 2020 there were a total of 89 patients, 73 women and 4 men with hypothyroidism, and 9 women and 3 men with subclinical hypothyroidism. In the 2021 there were 101 patients, 86 women and 7 men with hypothyroidism and 7 female and 1 male patients with subclinical hypothyroidism. Results: There was a significant difference in the number of patients with hypothyroidism and subclinical hypothyroidism during 2020 and 2021 in relation to 2019. The average dose of levothyroxine per patient did not differ statistically, comparing all three years, as well as comparing those who were ill, compared to patients who did not have COVID-19. There were diagnoses of post COVID subclinical hypothyroidism in 2020, as in 2021, with an average time of diagnosis of 2 months after infection for clinical hypothyroidism and 8 weeks for subclinical hypothyroidism. Conclusion: CoV-19 infection adversely affects thyroid tissue causing clinical hypothyroidism, requiring levothyroxine substitution as well as subclinical hypothyroidism which should be monitored.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"48 1","pages":"12 - 16"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82973107","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 : 2022-02-01DOI: 10.5455/medarh.2022.76.29-33
Nguyen Thai Binh, Ngo-Thi Ly Ly, Phan Nhan Hien, Lê Tuấn Linh, Bui-Van Lenh, N. Duc
Background: The development of gallstones, also known as cholelithiasis, is one of the most common diseases associated with the gastrointestinal tract. In developing countries 10% to 15% of men and >25% of women experience gallstones. Objective: The aim of the study was to evaluate the outcomes following percutaneous transhepatic cholecystolithotomy by holmium laser in non–high-risk patients with symptomatic gallbladder stones. Methods: This was an intervention study without control and with longitudinal follow-up. Subjects included patients who had only gallbladder stones, a normal gallbladder contractility index, and required a conservative treatment. Results: The study included 44 patients (20 men, 24 women), with a mean age of 41.5 ± 13.4 years. The success rate was 97.7%, and only 1 of 44 patients required follow-up laparoscopic cholecystectomy. Gallstones were successfully removed from 43 of 44 patients (97.7%). The complication rate was 13.6% (6/44 patients), and only minor complications were reported for 5 of the 6 patients with complications. In 34 of 43 patients, follow-up examinations were performed after 1 and 6 months. The gallstone recurrence rate at six-month follow-up was 11.8%, and a collapsed gallbladder was detected in 1 of 34 patients, with the remaining 33 patients retaining normal gallbladder contractility indices (>40%). Conclusion: Percutaneous transhepatic cholecystolithotomy by holmium laser has a high gallstone removal rate (97.7%); however, recurrence remains a major problem. The complication rate was about 13.6%, most of which were minor complications. Cases associated with treatment failure or serious complications should be detected and treated promptly.
{"title":"Percutaneous Transhepatic Cholecystolithotomy by Holmium Laser for Non–high-Risk Patients with Symptomatic Gallbladder Stones","authors":"Nguyen Thai Binh, Ngo-Thi Ly Ly, Phan Nhan Hien, Lê Tuấn Linh, Bui-Van Lenh, N. Duc","doi":"10.5455/medarh.2022.76.29-33","DOIUrl":"https://doi.org/10.5455/medarh.2022.76.29-33","url":null,"abstract":"Background: The development of gallstones, also known as cholelithiasis, is one of the most common diseases associated with the gastrointestinal tract. In developing countries 10% to 15% of men and >25% of women experience gallstones. Objective: The aim of the study was to evaluate the outcomes following percutaneous transhepatic cholecystolithotomy by holmium laser in non–high-risk patients with symptomatic gallbladder stones. Methods: This was an intervention study without control and with longitudinal follow-up. Subjects included patients who had only gallbladder stones, a normal gallbladder contractility index, and required a conservative treatment. Results: The study included 44 patients (20 men, 24 women), with a mean age of 41.5 ± 13.4 years. The success rate was 97.7%, and only 1 of 44 patients required follow-up laparoscopic cholecystectomy. Gallstones were successfully removed from 43 of 44 patients (97.7%). The complication rate was 13.6% (6/44 patients), and only minor complications were reported for 5 of the 6 patients with complications. In 34 of 43 patients, follow-up examinations were performed after 1 and 6 months. The gallstone recurrence rate at six-month follow-up was 11.8%, and a collapsed gallbladder was detected in 1 of 34 patients, with the remaining 33 patients retaining normal gallbladder contractility indices (>40%). Conclusion: Percutaneous transhepatic cholecystolithotomy by holmium laser has a high gallstone removal rate (97.7%); however, recurrence remains a major problem. The complication rate was about 13.6%, most of which were minor complications. Cases associated with treatment failure or serious complications should be detected and treated promptly.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"34 1","pages":"29 - 33"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86365806","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 : 2022-02-01DOI: 10.5455/medarh.2022.76.55-61
Ahmad M Radaideh, Mutaz A. Alrawashdeh, Abedallah H. Al Khateeb, O. Obeidat, M. Tabar, S. B. Essa, Mohammad Alkhatatba, Meqdam Albayati, Moath A Albashaireh
Background: Tibia shaft fractures are one of the most common long-bone fractures, second most common open sport-related injuries and they are estimated to occur in 4 percent of the senior population. Objective: Management of tibial fractures has been updating to achieve the best outcomes and avoid complications especially when talking about most common long bone fractures. Less invasive fixation techniques are the preferred ones to reduce surrounding soft tissue injury, improve healing process and decrease complications. Minimally invasive percutaneous plate osteosynthesis (MIPPO) and Intramedullary nailing (IMN) are the least invasive and most popular modalities used nowadays. This study compares outcomes and complications of both modalities. Methods: This is a retrospective cohort study conducted in orthopedics department at KAUH-Jordan. Patients were followed up for a mean of 15.3 months. Only MIPPO and IMN were used, and exclusively tibial shaft fractures were included. Open fractures were classified according to the Gustilo-Anderson classification. Results: Ninety patients with a mean age of 36.9 years (range, 9-79) were observed. Fifty nine of them were treated with IMN; nine of them had complications. Thirty one patients were treated with MIPPO and only three developed complications. Three patients treated with IMN had non-union, whereas none of MIPPO patients developed non-union. Only perioperative blood loss was more when MIPPO was used taking into consideration the amount in the suction tube, amount of fluid irrigation and soaked gauze. Conclusion: In treating tibial shaft fractures, MIPPO appears to cause fewer complications and provides better healing environment therefore attributes to lower non-union rates than IMN. Larger sample size might be needed to provide better results.
{"title":"Outcomes of Treating Tibial Shaft Fractures Using Intramedullary Nailing (IMN) versus Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO)","authors":"Ahmad M Radaideh, Mutaz A. Alrawashdeh, Abedallah H. Al Khateeb, O. Obeidat, M. Tabar, S. B. Essa, Mohammad Alkhatatba, Meqdam Albayati, Moath A Albashaireh","doi":"10.5455/medarh.2022.76.55-61","DOIUrl":"https://doi.org/10.5455/medarh.2022.76.55-61","url":null,"abstract":"Background: Tibia shaft fractures are one of the most common long-bone fractures, second most common open sport-related injuries and they are estimated to occur in 4 percent of the senior population. Objective: Management of tibial fractures has been updating to achieve the best outcomes and avoid complications especially when talking about most common long bone fractures. Less invasive fixation techniques are the preferred ones to reduce surrounding soft tissue injury, improve healing process and decrease complications. Minimally invasive percutaneous plate osteosynthesis (MIPPO) and Intramedullary nailing (IMN) are the least invasive and most popular modalities used nowadays. This study compares outcomes and complications of both modalities. Methods: This is a retrospective cohort study conducted in orthopedics department at KAUH-Jordan. Patients were followed up for a mean of 15.3 months. Only MIPPO and IMN were used, and exclusively tibial shaft fractures were included. Open fractures were classified according to the Gustilo-Anderson classification. Results: Ninety patients with a mean age of 36.9 years (range, 9-79) were observed. Fifty nine of them were treated with IMN; nine of them had complications. Thirty one patients were treated with MIPPO and only three developed complications. Three patients treated with IMN had non-union, whereas none of MIPPO patients developed non-union. Only perioperative blood loss was more when MIPPO was used taking into consideration the amount in the suction tube, amount of fluid irrigation and soaked gauze. Conclusion: In treating tibial shaft fractures, MIPPO appears to cause fewer complications and provides better healing environment therefore attributes to lower non-union rates than IMN. Larger sample size might be needed to provide better results.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"7 1","pages":"55 - 61"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87509214","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 : 2022-02-01DOI: 10.5455/medarh.2022.76.34-38
Dedy Hermansyah, Wahyu Indra, D. Paramita, E. S. Siregar
Background: Sentinel lymph node biopsy is one of the minimally invasive techniques that can confirm the presence of metastasis of regional lymph nodes in cancer. Sentinel lymph node biopsy can be done with a lymph mapping technique using blue-dye, radiotracer, or a combination of both. In developing countries, sentinel lymph node biopsy is often done with a single agent, which is the blue dye. The limitation of conducting SLNB in Indonesia is the availability of patent blue dye and radioisotope tracer. To overcome that, a hormonal receptor is expected to aid in predicting sentinel lymph node metastasis. Objective: The aim of this study was to investigate the hormonal receptor as a prognostic factor of sentinel lymph node metastasis in breast cancer. Methods: This study was conducted in Universitas Sumatera Utara Teaching Hospital with the acknowledgment from the Ethics Committee of the respected hospital by the number of 116/KEP/USU/2020. Total of 51 patients participated in this research. Results: Statistically, the p-value in each immunohistochemistry group is > 0.05 in all ER (+) / PR (+); ER (+) / PR (-); ER (-) / PR (+) groups. This shows that there is no significant relationship between hormonal receptors on sentinel lymph node metastases. Conclusion: The statistical evaluation showed that there is no significant correlation between the hormonal receptor and sentinel lymph node metastasis (p>0.05), but is found clinically significant. Therefore, hormonal receptors should be considered as a predicting factor for sentinel lymph node metastasis.
{"title":"Role of Hormonal Receptor in Predicting Sentinel Lymph Node Metastasis in Early Breast Cancer","authors":"Dedy Hermansyah, Wahyu Indra, D. Paramita, E. S. Siregar","doi":"10.5455/medarh.2022.76.34-38","DOIUrl":"https://doi.org/10.5455/medarh.2022.76.34-38","url":null,"abstract":"Background: Sentinel lymph node biopsy is one of the minimally invasive techniques that can confirm the presence of metastasis of regional lymph nodes in cancer. Sentinel lymph node biopsy can be done with a lymph mapping technique using blue-dye, radiotracer, or a combination of both. In developing countries, sentinel lymph node biopsy is often done with a single agent, which is the blue dye. The limitation of conducting SLNB in Indonesia is the availability of patent blue dye and radioisotope tracer. To overcome that, a hormonal receptor is expected to aid in predicting sentinel lymph node metastasis. Objective: The aim of this study was to investigate the hormonal receptor as a prognostic factor of sentinel lymph node metastasis in breast cancer. Methods: This study was conducted in Universitas Sumatera Utara Teaching Hospital with the acknowledgment from the Ethics Committee of the respected hospital by the number of 116/KEP/USU/2020. Total of 51 patients participated in this research. Results: Statistically, the p-value in each immunohistochemistry group is > 0.05 in all ER (+) / PR (+); ER (+) / PR (-); ER (-) / PR (+) groups. This shows that there is no significant relationship between hormonal receptors on sentinel lymph node metastases. Conclusion: The statistical evaluation showed that there is no significant correlation between the hormonal receptor and sentinel lymph node metastasis (p>0.05), but is found clinically significant. Therefore, hormonal receptors should be considered as a predicting factor for sentinel lymph node metastasis.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"7 1","pages":"34 - 38"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88734065","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 : 2022-02-01DOI: 10.5455/medarh.2022.76.23-28
A. Gerakaris, Francesk Mulita, I. Koniari, Eleni Artopoulou, V. Mplani, G. Tsigkas, Mohammed Elseoud, Nicholas Kounis, D. Velissaris
Background: Digoxin is a cardiac glycoside, derived from the plant Digitalis purpurea. For many years digitalis has been widely used in the treatment of heart failure (HF), owing to its cardiotonic and neurohormonal effects and atrial fibrillation (AF), due to its parasympathomimetic effect on the AV node. Objective: The aim of this paper is to evaluate the available evidence on the safety and efficacy of digoxin in patients with HF and AF, by reviewing the pertinent literature. Methods: We conducted a PubMed/MEDLINE and SCOPUS search to evaluate the currently available evidence on the administration of digoxin and its association with all-cause mortality risk in patients with AF and HF. Results: Several observational analyses of clinical trials and meta-analyses have shown conflicting results on the safety and efficacy of digoxin administration in patients with AF and HF. According to these results, digoxin should be avoided in patients without HF, as it is associated with worse outcomes. On the other hand, in patients with AF and HF digoxin should be used with caution. Conclusion: The impact of digoxin on all-cause mortality and adverse effects in these patients remains unclear based on the current evidence. More trials at low risk of bias evaluating the effects of digoxin are needed.
{"title":"Digoxin Impact on Heart Failure Patients with Atrial Fibrillation","authors":"A. Gerakaris, Francesk Mulita, I. Koniari, Eleni Artopoulou, V. Mplani, G. Tsigkas, Mohammed Elseoud, Nicholas Kounis, D. Velissaris","doi":"10.5455/medarh.2022.76.23-28","DOIUrl":"https://doi.org/10.5455/medarh.2022.76.23-28","url":null,"abstract":"Background: Digoxin is a cardiac glycoside, derived from the plant Digitalis purpurea. For many years digitalis has been widely used in the treatment of heart failure (HF), owing to its cardiotonic and neurohormonal effects and atrial fibrillation (AF), due to its parasympathomimetic effect on the AV node. Objective: The aim of this paper is to evaluate the available evidence on the safety and efficacy of digoxin in patients with HF and AF, by reviewing the pertinent literature. Methods: We conducted a PubMed/MEDLINE and SCOPUS search to evaluate the currently available evidence on the administration of digoxin and its association with all-cause mortality risk in patients with AF and HF. Results: Several observational analyses of clinical trials and meta-analyses have shown conflicting results on the safety and efficacy of digoxin administration in patients with AF and HF. According to these results, digoxin should be avoided in patients without HF, as it is associated with worse outcomes. On the other hand, in patients with AF and HF digoxin should be used with caution. Conclusion: The impact of digoxin on all-cause mortality and adverse effects in these patients remains unclear based on the current evidence. More trials at low risk of bias evaluating the effects of digoxin are needed.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"40 1","pages":"23 - 28"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83267700","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 : 2022-02-01DOI: 10.5455/medarh.2022.76.62-65
Elshazali Widaa Ali, Ibrahim Ibrahim
Background: Thrombosis plays a crucial role in the morbidity and mortality of coronavirus disease-19 (COVID-19). About one-third of COVID-19 patients experience a thrombotic event, most commonly pulmonary embolism. Based on published data, the mechanism of thrombosis in COVID-19 patients seems to be multi-factorial. Methods: In this article, we reviewed the publsihed data concerning with thrombosis in COVID-19 and summarized the predisposing factors and the mechanisms behind COVID-19 related thrombosis. Results: Inflammatory response to SARS-CoV-2 and the consequent hyperviscosity thought to cause endothelial damage and initiate coagulation. Furthermore, inflammation promotes platelet activation and exerts a pathogenic effect on endothelial cells. The presence of anticardiolipin and anti–β2-glycoprotein antibodies in some patients with COVID-19 suggests that SARS-CoV-2, like many other viral infections, induces the formation of antiphospholipid antibodies, which provoke hypercoagulability. Thrombophilic mutations, mainly factor V Leiden and prothrombin G20201A mutations, can be a contributing factor in the development of thrombosis in COVID-19 patients, and they are associated with increased disease severity and pulmonary embolism. However, the research concerning with the association of thrombophilic mutations with COVID-19 related thrombosis showed conflict results. Conclusion: The mechanism of thrombosis in COVID-19 patients seems to be multifactorial. Endothelial damage, antiphospholipid antibodies, inflammation, hyperviscosity, and thrombophilic mutations are the main factors that predispose COVID-19 patients to. thrombosis.
{"title":"Multi-factorial Mechanism Behind COVID-19 Related Thrombosis","authors":"Elshazali Widaa Ali, Ibrahim Ibrahim","doi":"10.5455/medarh.2022.76.62-65","DOIUrl":"https://doi.org/10.5455/medarh.2022.76.62-65","url":null,"abstract":"Background: Thrombosis plays a crucial role in the morbidity and mortality of coronavirus disease-19 (COVID-19). About one-third of COVID-19 patients experience a thrombotic event, most commonly pulmonary embolism. Based on published data, the mechanism of thrombosis in COVID-19 patients seems to be multi-factorial. Methods: In this article, we reviewed the publsihed data concerning with thrombosis in COVID-19 and summarized the predisposing factors and the mechanisms behind COVID-19 related thrombosis. Results: Inflammatory response to SARS-CoV-2 and the consequent hyperviscosity thought to cause endothelial damage and initiate coagulation. Furthermore, inflammation promotes platelet activation and exerts a pathogenic effect on endothelial cells. The presence of anticardiolipin and anti–β2-glycoprotein antibodies in some patients with COVID-19 suggests that SARS-CoV-2, like many other viral infections, induces the formation of antiphospholipid antibodies, which provoke hypercoagulability. Thrombophilic mutations, mainly factor V Leiden and prothrombin G20201A mutations, can be a contributing factor in the development of thrombosis in COVID-19 patients, and they are associated with increased disease severity and pulmonary embolism. However, the research concerning with the association of thrombophilic mutations with COVID-19 related thrombosis showed conflict results. Conclusion: The mechanism of thrombosis in COVID-19 patients seems to be multifactorial. Endothelial damage, antiphospholipid antibodies, inflammation, hyperviscosity, and thrombophilic mutations are the main factors that predispose COVID-19 patients to. thrombosis.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"33 1","pages":"62 - 65"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88526386","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 : 2022-02-01DOI: 10.5455/medarh.2022.76.39-44
N. D. Anh, Tran Anh Duc, Nguyen Thi Thu Ha, Duong-Thi Tra Giang, D. T. Dat, Phan Thi Huyen Thuong, Nguyen Khac Toan, Nguyen Tai Duc, N. Duc
Background: Induction of labor (IOL) is a technique to establish vaginal delivery when the risks for continuing the pregnancy for mother or baby are higher than the risks of delivery. It is usually performed in high-risk pregnancies, but can also be beneficial in low-risk populations, as shown in the ARRIVE trial. Objective: To evaluate the effectiveness and safety of slow-release vaginal dinoprostone (prostaglandin E2 10 mg) for labor induction in women with low-risk pregnancies. Methods: A prospective study was performed at Hanoi Obstetrics and Gynecology Hospital, Vietnam. We recruited women with low-risk pregnancies from 39 weeks + 0 days to 40 weeks + 6 days of gestation and an unfavorable cervix. Women who participated received 10 mg intravaginal slow-release dinoprostone (Propess) for induction of labor. Labor, deliveries, and post-partum management were performed according to the local protocol. Results: From September 2020 to March 2021, 102 low-risk women were eligible to participate in the study. Among these women, 67.6% had vaginal deliveries, 6.9% had postpartum bleeding, and 3.9% experienced tachysystole. All newborns were healthy, with good APGAR scores. None of the women needed respiratory support or intensive care unit admission. All other maternal or fetal complications were explored. The rate of cesarean section was 3.8 higher in nulliparous than multiparous women and 2.2 times higher in women who did not receive epidural analgesia than in those who did. The risk of cesarean section increased if the time between labor induction and active labor was greater than 12.5 hours. Conclusion: Slow-release dinoprostone insert is safe and effective for the induction of labor in low-risk pregnant women. The risk of cesarean section was elevated in nulliparous patients and those who did not receive epidural analgesia during labor. As the time from labor induction to active labor increased, the risk of cesarean section increased.
{"title":"Dinoprostone Vaginal Insert for Induction of Labor in Women with Low-Risk Pregnancies: A Prospective Study","authors":"N. D. Anh, Tran Anh Duc, Nguyen Thi Thu Ha, Duong-Thi Tra Giang, D. T. Dat, Phan Thi Huyen Thuong, Nguyen Khac Toan, Nguyen Tai Duc, N. Duc","doi":"10.5455/medarh.2022.76.39-44","DOIUrl":"https://doi.org/10.5455/medarh.2022.76.39-44","url":null,"abstract":"Background: Induction of labor (IOL) is a technique to establish vaginal delivery when the risks for continuing the pregnancy for mother or baby are higher than the risks of delivery. It is usually performed in high-risk pregnancies, but can also be beneficial in low-risk populations, as shown in the ARRIVE trial. Objective: To evaluate the effectiveness and safety of slow-release vaginal dinoprostone (prostaglandin E2 10 mg) for labor induction in women with low-risk pregnancies. Methods: A prospective study was performed at Hanoi Obstetrics and Gynecology Hospital, Vietnam. We recruited women with low-risk pregnancies from 39 weeks + 0 days to 40 weeks + 6 days of gestation and an unfavorable cervix. Women who participated received 10 mg intravaginal slow-release dinoprostone (Propess) for induction of labor. Labor, deliveries, and post-partum management were performed according to the local protocol. Results: From September 2020 to March 2021, 102 low-risk women were eligible to participate in the study. Among these women, 67.6% had vaginal deliveries, 6.9% had postpartum bleeding, and 3.9% experienced tachysystole. All newborns were healthy, with good APGAR scores. None of the women needed respiratory support or intensive care unit admission. All other maternal or fetal complications were explored. The rate of cesarean section was 3.8 higher in nulliparous than multiparous women and 2.2 times higher in women who did not receive epidural analgesia than in those who did. The risk of cesarean section increased if the time between labor induction and active labor was greater than 12.5 hours. Conclusion: Slow-release dinoprostone insert is safe and effective for the induction of labor in low-risk pregnant women. The risk of cesarean section was elevated in nulliparous patients and those who did not receive epidural analgesia during labor. As the time from labor induction to active labor increased, the risk of cesarean section increased.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"29 1","pages":"39 - 44"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89347882","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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