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Exploring Sensitivity and Significance of Tamsulosin as Modified Release in Benign Prostatic Hyperplasia 探索坦索罗辛作为改良释放药在良性前列腺增生症中的敏感性和意义
Pub Date : 2024-03-14 DOI: 10.36348/sjmps.2024.v10i03.007
Ayesha Moin, M. Nagarjuna
This abstract outline the use of Tamsulosin, a selective α (1A and 1D)-adrenoreceptor blocker, to treat benign prostatic hyperplasia (BPH). The study's background highlights the most prevalent symptoms and prevalence of BPH in elderly men. The research objective and goal are to better understand the mechanism of action, pharmacokinetics, dose, clinical efficacy, safety, and tolerance of Tamsulosin, particularly in its modified release (MR) version. Considering evidence-based medicines have recently been made available, the treatment approach for current cases of benign prostatic hyperplasia has evolved. Considerations including therapeutic benefits, potential for morbidity, likely long-term effectiveness, and expenses must be made before selecting a therapy to relieve symptoms. When individuals with benign prostatic hyperplasia report with symptoms related to the lower urinary tract, the main treatment option is α1-adrenergic receptor antagonists. The technique includes a review of the literature on Tamsulosin's development, discovery, and approval, as well as its pharmacodynamics and pharmacokinetics. The findings show that Tamsulosin MR is successful in treating BPH, with a preference for the 0.4mg once-daily dose.
本摘要概述了使用选择性α(1A和1D)肾上腺素受体阻滞剂坦索罗辛治疗良性前列腺增生症(BPH)的情况。该研究的背景强调了良性前列腺增生症在老年男性中最普遍的症状和发病率。研究目的和目标是更好地了解坦索罗辛的作用机制、药代动力学、剂量、临床疗效、安全性和耐受性,特别是其改良释放(MR)版本。考虑到最近出现了循证药物,目前良性前列腺增生病例的治疗方法也发生了变化。在选择缓解症状的疗法之前,必须考虑治疗效果、潜在的发病率、可能的长期疗效和费用等因素。当良性前列腺增生患者出现与下尿路相关的症状时,主要的治疗方法是使用α1-肾上腺素能受体拮抗剂。该技术包括对有关坦索罗辛的开发、发现和批准,以及其药效学和药代动力学的文献综述。研究结果表明,坦索罗辛 MR 可成功治疗良性前列腺增生症,且首选 0.4 毫克的每日一次剂量。
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引用次数: 0
The Usefulness of Non-Invasive Liver Stiffness Measurements by Fibroscan in Predicting Clinically Significant Portal Hypertension in Cirrhotic Patients 纤支镜非侵入性肝脏硬度测量在预测肝硬化患者有临床意义的门静脉高压中的作用
Pub Date : 2024-03-06 DOI: 10.36348/sjmps.2024.v10i03.002
F. Bouhamou, M. Salihoun, I. Serraj, N. Kabbaj
Background: Liver stiffness measurement (LSM) has proposed as a non-invasive method for estimating the severity of fibrosis and the complications of cirrhosis. Measurement of the hepatic venous pressure gradient (HVPG) is the gold standard for assessing the presence of portal hypertension, but its invasiveness limits its clinical application. The aim of our study is to investigate if LSM could predict the size of Esophageal varices (EV) in patients with liver cirrhosis to limit upper endoscopic procedures only to those patients that really need it (patients with large EV or EV at risk for bleeding). Methods: Our retrospective study includes 46 cirrhotic patients over a period of 40 months between January 2019 and April 2022, at the Service of Digestive Functional Explorations of Hepato-gastroenterology of the University hospital Ibn-Sina of RABAT, all patients underwent a liver stiffness measurement by Transient elastography FibroScan. Results: Of the 46 cirrhotic patients included in this study, with a mean age of 58.5(21-90) years, 18 (39.1%) of patients were male and 28(60.9%) were female. the predominant etiology of cirrhosis was chronic viral hepatitis C 20 (43.5%). The area under the ROC curve of the diagnosis of large EVs (EV≥II) was 0.724 (95%CI). The optimal cut-off of elasticity was 20.5 for this purpose, with a sensitivity of 66.7%, specificity of 94.74%. Conclusions: these results indicate that Transient elastography FibroScan is a reliable, non-invasive method to assess portal hypertension and can be used for the screening and diagnosis of clinically significant portal hypertension.
背景:肝脏僵硬度测量(LSM)被认为是估计肝纤维化严重程度和肝硬化并发症的一种无创方法。肝静脉压力梯度(HVPG)测量是评估是否存在门脉高压的金标准,但其侵入性限制了其临床应用。我们的研究旨在探讨 LSM 是否能预测肝硬化患者食管静脉曲张(EV)的大小,从而将上内镜手术仅限于真正需要的患者(EV 过大或有出血风险的患者)。研究方法我们的回顾性研究包括 46 名肝硬化患者,时间跨度为 2019 年 1 月至 2022 年 4 月,历时 40 个月,在 RABAT 伊本-西纳大学医院肝-胃肠病学消化功能检查处进行,所有患者都接受了瞬态弹性成像纤维扫描肝硬度测量。结果46例肝硬化患者的平均年龄为58.5(21-90)岁,其中18例(39.1%)为男性,28例(60.9%)为女性。诊断大EV(EV≥II)的ROC曲线下面积为0.724(95%CI)。弹性的最佳临界值为 20.5,灵敏度为 66.7%,特异度为 94.74%。结论:这些结果表明,瞬态弹性成像 FibroScan 是评估门静脉高压症的一种可靠、无创的方法,可用于筛查和诊断具有临床意义的门静脉高压症。
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引用次数: 0
Preparation and Evaluation of Sustained Release Matrix Tablets of Acelofenac and Comparision of Formulated and Marketed Product 阿塞洛芬酸缓释基质片的制备和评估以及制剂与市场产品的比较
Pub Date : 2024-03-06 DOI: 10.36348/sjmps.2024.v10i03.006
Vimal Singh, Vipin Kumar Sharma, Praveen Kumar, J. Kumar, Madhav Mohan, Neda Anzar, Tushar Cheetu, Raj Kumar
The aim of performing this study is to develop matrix tablet to improve the dissolution rate of aceclofenac and release the drug in a controlled manner over a period of 24 hours. Matrix tablets of aceclofenac, using various viscosity of hydrophilic polymer HPMC in two different proportions, hydrophobic polymer ethyl cellulose and Guar gum were prepared by wet granulation method and subjected to in vitro drug release studies. Tablets were evaluated for in vitro drug release profile in phosphate buffer with pH 7.5. The thickness and hardness of prepared tablets were 3.8 ± 0.2 to 3.9 ±0.2 mm and 4 ± 3 to 5 ± 3 kg/cm2, respectively. The friability was within the acceptable limits of pharmacopeial specifications (0.31 to 0.71%), which indicates the good mechanical strength of the tablets. The in vitro drug release from the proposed system was best explained by Higuchi’s model, indicating that drug release from tablets displayed a diffusion-controlled mechanism. Based on the study results, formulation F7 was selected as the best formulation.
本研究旨在开发基质片剂,以提高醋氯芬酸的溶解速率,并在 24 小时内以可控方式释放药物。研究人员采用湿法制粒法,以两种不同比例的亲水性聚合物 HPMC、疏水性聚合物乙基纤维素和瓜尔胶为原料,制备了不同粘度的醋氯芬酸基质片剂,并进行了体外药物释放研究。片剂在 pH 值为 7.5 的磷酸盐缓冲液中进行了体外药物释放谱评价。所制备片剂的厚度和硬度分别为 3.8 ± 0.2 至 3.9 ± 0.2 mm 和 4 ± 3 至 5 ± 3 kg/cm2。片剂的易碎性在药典规定的可接受范围内(0.31% 至 0.71%),这表明片剂具有良好的机械强度。樋口模型最能解释拟议体系的体外药物释放情况,表明片剂的药物释放表现出一种扩散控制机制。根据研究结果,配方 F7 被选为最佳配方。
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引用次数: 0
Hypertension during Pregnancy: A Systematic Review 孕期高血压:系统回顾
Pub Date : 2024-03-06 DOI: 10.36348/sjmps.2024.v10i03.005
Oula Souhail Tayar
Hypertension during pregnancy poses a substantial risk to maternal and fetal health. This systematic review aims to synthesize the existing literature on the prevalence, risk factors, and outcomes of hypertension during pregnancy. To comprehensively assess the global landscape of hypertension during pregnancy by identifying and analyzing eligible studies. We systematically searched electronic databases, including PubMed, Scopus, Embase, Medline, and Web of Science, from inception until December 2023. Eligible studies were selected based on predefined criteria. Data were extracted, and the quality of included studies was assessed. Meta-analysis was performed where appropriate. Among the 56 eligible studies, the pooled prevalence of hypertension during pregnancy was 12.3% (95% CI: 10.1%–14.5%). Common risk factors included maternal age >35 years (33.5%), obesity (27.8%), and previous hypertensive conditions (18.6%). Maternal complications were observed in 45.2% of cases, with preterm birth (23.7%) and low birth weight (18.9%) being predominant adverse outcomes. Variations in prevalence and risk factors were noted across geographic regions. This systematic review underscores the global burden of hypertension during pregnancy and its association with adverse maternal and neonatal outcomes. Key risk factors highlight the importance of targeted interventions and antenatal care strategies. Further research is needed to understand regional disparities and improve prevention and management strategies.
妊娠期高血压对孕产妇和胎儿的健康构成巨大风险。本系统性综述旨在对有关妊娠期高血压的患病率、风险因素和结果的现有文献进行综述。通过识别和分析符合条件的研究,全面评估全球妊娠期高血压的状况。我们系统地检索了从开始到 2023 年 12 月的电子数据库,包括 PubMed、Scopus、Embase、Medline 和 Web of Science。根据预先设定的标准筛选出符合条件的研究。提取数据并评估纳入研究的质量。在适当的情况下进行了元分析。在 56 项符合条件的研究中,妊娠期高血压的总患病率为 12.3%(95% CI:10.1%-14.5%)。常见的风险因素包括孕妇年龄大于 35 岁(33.5%)、肥胖(27.8%)和曾患高血压(18.6%)。45.2%的病例出现了产妇并发症,其中早产(23.7%)和出生体重不足(18.9%)是主要的不良后果。不同地区的发病率和风险因素存在差异。本系统综述强调了妊娠期高血压的全球负担及其与孕产妇和新生儿不良结局的关联。关键风险因素凸显了有针对性的干预措施和产前护理策略的重要性。要了解地区差异并改进预防和管理策略,还需要进一步的研究。
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引用次数: 0
Parameters of PCOS in Tertiary Hospital in Bangladesh 孟加拉国三级医院多囊卵巢综合症的参数
Pub Date : 2024-03-06 DOI: 10.36348/sjmps.2024.v10i03.003
Lucky Rahman
Background: Polycystic ovarian syndrome (PCOS) represents a complex endocrinopathy with significant metabolic implications. The Rotterdam criteria establish the diagnosis based on the presence of two of three criteria: ultrasound-confirmed polycystic ovaries, hyperandrogenism, and persistent anovulation. Objective: Our objective was to investigate hormonal and anthropometric parameters in PCOS patients compared to controls, aiming to elucidate predictive markers and metabolic aberrations. Method: A case-control study comprising 50 PCOS subjects and 50 controls was conducted, focusing on females aged 18-40 attending an obstetrics and gynecology department, Tertiary hospital. Hormonal assays and anthropometric measurements were performed following strict inclusion and exclusion criteria. Results: Significant differences emerged between PCOS and control groups across various parameters. PCOS individuals displayed elevated levels of TSH, LH, FSH, and prolactin, coupled with increased BMI and altered waist-to-hip ratio, indicating early metabolic disruptions. Notably, the LH:FSH ratio was lower in PCOS subjects, suggesting hormonal imbalances. Conclusion: High levels of thyroid-stimulating hormone, LH, FSH, and prolactin, coupled with elevated body mass index and waist-to-hip ratio, served as indicators of PCOS and early metabolic irregularities.
背景:多囊卵巢综合征(PCOS)是一种复杂的内分泌疾病,对代谢有重大影响。鹿特丹标准根据以下三项标准中的两项进行诊断:超声证实的多囊卵巢、高雄激素和持续性无排卵。研究目的我们的目的是研究多囊卵巢综合症患者的激素和人体测量参数与对照组的比较,旨在阐明预测指标和代谢畸变。研究方法:我们进行了一项病例对照研究,其中包括 50 名多囊卵巢综合征患者和 50 名对照组患者,重点是在三级医院妇产科就诊的 18-40 岁女性。按照严格的纳入和排除标准进行了激素测定和人体测量。结果显示多囊卵巢综合症组和对照组在各种参数上存在显著差异。多囊卵巢综合症患者的促甲状腺激素(TSH)、促甲状腺激素(LH)、前列腺激素(FSH)和催乳素水平升高,同时体重指数(BMI)增加,腰臀比改变,表明早期代谢紊乱。值得注意的是,多囊卵巢综合症受试者的促甲状腺激素(LH)与前列腺激素(FSH)的比率较低,这表明他们的内分泌失调。结论高水平的促甲状腺激素、LH、FSH 和催乳素,加上体重指数和腰臀比的升高,是多囊卵巢综合征和早期代谢失调的指标。
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引用次数: 0
Clinical Population about Diabetes during Pregnancy: A Systematic Literature Review 关于孕期糖尿病的临床人群:系统性文献综述
Pub Date : 2024-03-06 DOI: 10.36348/sjmps.2024.v10i03.004
Oula Souhail Tayar
Diabetes during pregnancy, including gestational diabetes mellitus (GDM) and pre-existing diabetes, presents significant challenges to maternal and fetal health. Clinical populations encompass diverse pregnant individuals, each with unique risk factors and outcomes related to diabetes in pregnancy. This systematic literature review aimed to synthesize findings from eligible studies conducted between January 1, 2020, and December 30, 2023, sourced from Web of Science, PubMed, Medline, and the Cochrane Database of literature Reviews, to comprehensively examine diabetes during pregnancy within clinical populations. We followed established systematic review methodologies, including study selection, data extraction, and analysis. Eligible studies underwent rigorous screening to ensure relevance and quality. Data were systematically extracted to identify trends and patterns in epidemiology, risk factors, clinical management, and outcomes. Among the 15 eligible studies, our analysis revealed variations in the prevalence of diabetes during pregnancy across clinical populations, ranging from 5% to 15%. Socioeconomic factors, ethnicity, and maternal age were significant risk factors. Clinical management strategies varied, with insulin therapy predominant in pre-existing diabetes cases (68%) and dietary interventions in GDM (45%). Fetal macrosomia occurred in 18% of cases, while neonatal hypoglycemia affected 14% of infants born to mothers with diabetes. This systematic literature review highlights the multifaceted nature of diabetes during pregnancy in clinical populations. Variations in prevalence and risk factors underscore the importance of tailored healthcare interventions. Diverse management approaches necessitate individualized care plans. The prevalence of adverse outcomes necessitates vigilant monitoring and timely interventions. Our findings inform evidence-based practices research priorities, and support improved care for pregnant individuals with diabetes in clinical populations.
妊娠期糖尿病(包括妊娠糖尿病(GDM)和原有糖尿病)给孕产妇和胎儿的健康带来了巨大挑战。临床人群包括不同的孕妇,每个人都有与妊娠期糖尿病相关的独特风险因素和结果。本系统性文献综述旨在综合 2020 年 1 月 1 日至 2023 年 12 月 30 日期间从 Web of Science、PubMed、Medline 和 Cochrane 文献综述数据库中进行的符合条件的研究结果,以全面研究临床人群中的妊娠期糖尿病。我们遵循既定的系统综述方法,包括研究选择、数据提取和分析。对符合条件的研究进行了严格筛选,以确保研究的相关性和质量。我们系统地提取了数据,以确定流行病学、风险因素、临床管理和结果的趋势和模式。在 15 项符合条件的研究中,我们的分析显示不同临床人群的孕期糖尿病患病率存在差异,从 5% 到 15% 不等。社会经济因素、种族和孕产妇年龄是重要的风险因素。临床管理策略也各不相同,胰岛素治疗在原有糖尿病病例中占主导地位(68%),而饮食干预在 GDM 中占 45%。18%的病例出现胎儿巨大儿,14%的糖尿病母亲所生婴儿出现新生儿低血糖。本系统性文献综述强调了临床人群妊娠期糖尿病的多面性。患病率和风险因素的差异凸显了量身定制医疗干预措施的重要性。不同的管理方法要求制定个性化的护理计划。不良后果的发生需要警惕性监测和及时干预。我们的研究结果为循证实践研究的重点提供了信息,并支持改善对临床人群中糖尿病孕妇的护理。
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引用次数: 0
Prevalence of Drug Abuse and its Risk Factors among Attendees of Healthcare Centers in Saudi Arabia: A Systematic Review 沙特阿拉伯医疗保健中心就诊者的药物滥用流行率及其风险因素:系统回顾
Pub Date : 2024-03-05 DOI: 10.36348/sjmps.2024.v10i03.001
Ahmed A. Alsayed Alhashim, Jamal Khaled S. Aljamal, A. Alkhayyal, Abdulluh Aljasim, Nora Alkhatam, Abdulrhman S AlTuraif, Ahmed A. Alazmi, D. Alkhateeb, Khallad Tariq Abdulaziz Alsahalwi, H. Alsubaie, Fatima Almulhim, M. Alshammary
Objectives: To investigate the prevalence and associated factors of drug abuse among the Saudi population. Methods: To locate relevant material, we searched PubMed, SCOPUS, Web of Science, and Science Direct thoroughly. The Rayyan QRCI was used during the procedure. Results: We included six studies with a total of 33222 patients, and 20,803 (62.6%) were males. Drug abuse prevalence ranged from 2.4% to 58.8%. The most common drugs used were amphetamine-cannabis benzodiazepine, Amphetamines & cannabis, Stimulants & cannabis, Heroin & alcohol, Khat chewing, and Marijuna & narcotic drugs. Patients' age, smoking habits, past medical history, and age at the beginning of drug use, male gender unmarried people, and Saudi nationals, used drugs at substantially greater rates. Interestingly, participants with higher education levels were more likely to use drugs such as amphetamines and cannabis while lower educational attainment were more likely to use Khat. Conclusion: When it came to substance misuse, the general Saudi population that visited health facilities had a pretty high rate. In light of these findings, we recommend carrying out additional research to obtain more precise and pertinent information about the incidence of substance usage in Saudi Arabia. To determine the incidence of morphine abuse across various populations, including healthcare professionals and people with chronic pain—such as sickle cell patients—we advised conducting additional research.
调查目的调查沙特人口中药物滥用的流行率和相关因素。方法为查找相关资料,我们全面搜索了 PubMed、SCOPUS、Web of Science 和 Science Direct。在此过程中使用了 Rayyan QRCI。结果:我们共收录了六项研究:我们纳入了六项研究,共有 33222 名患者,其中 20803 人(62.6%)为男性。药物滥用率从 2.4% 到 58.8% 不等。最常见的药物是苯丙胺-大麻-苯并二氮杂卓、苯丙胺和大麻、兴奋剂和大麻、海洛因和酒精、咀嚼哈特、马利筋和麻醉药品。从患者的年龄、吸烟习惯、既往病史和开始吸毒的年龄来看,男性未婚者和沙特国民的吸毒率要高得多。有趣的是,教育程度较高的参与者更倾向于使用安非他明和大麻等毒品,而教育程度较低的参与者则更倾向于使用阿拉伯茶。结论就药物滥用而言,到医疗机构就诊的沙特普通民众的滥用率相当高。鉴于这些发现,我们建议开展更多研究,以获得有关沙特阿拉伯药物滥用发生率的更准确、更相关的信息。为了确定不同人群(包括医疗保健专业人员和慢性疼痛患者,如镰状细胞患者)的吗啡滥用率,我们建议开展更多研究。
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引用次数: 0
Prevalence of Bronchial Asthma among Secondary School Students 中学生支气管哮喘的患病率
Pub Date : 2024-02-26 DOI: 10.36348/sjmps.2024.v10i02.012
Juwel Das, Sayeed Haq, Palash Sarker, Bijoy Pal
Background: Bronchial asthma, a prevalent chronic respiratory condition, poses a significant health concern among secondary school students in Bangladesh, particularly in the bustling urban centers with associated environmental challenges. Objective: This study aimed to determine the prevalence of bronchial asthma and its associated factors among secondary school students. Method: This cross-sectional study, conducted from January to June 2023, aimed to assess the prevalence of bronchial asthma among 250 secondary school students (aged 10-15 yrs) in Bangladesh. The study employed a structured questionnaire, including the International Study of Asthma and Allergies in Childhood (ISAAC) asthma questionnaire, to collect socio-demographic details and assess asthma prevalence. Results: The findings revealed a mean age of 12.9 years, with an equal distribution of males and females. Notably, 11.6% had been diagnosed with asthma by a doctor. Factors such as sex, age, monthly family income, history of childhood pneumonia, and passive smoking exposure showed significant associations with bronchial asthma. Logistic regression analysis identified being male (OR=2.32, p=0.042), a history of childhood pneumonia (OR=3.10, p=0.007), and maternal asthma (OR=2.739, p=0.032) as predictors of bronchial asthma. The prevalence was higher in males and those with a history of childhood pneumonia or maternal asthma. Conclusion: This study emphasizes the need for comprehensive health initiatives targeting the identified risk factors to mitigate the impact of bronchial asthma on the health and academic performance of secondary school students in Bangladesh. Addressing childhood pneumonia and reducing passive smoking exposure are crucial strategies for preventing the development of bronchial asthma in this vulnerable population.
背景:支气管哮喘是一种普遍存在的慢性呼吸道疾病,对孟加拉国中学生的健康构成了严重威胁,尤其是在熙熙攘攘的城市中心,环境问题也随之而来。研究目的本研究旨在确定中学生支气管哮喘的患病率及其相关因素。研究方法这项横断面研究于 2023 年 1 月至 6 月进行,旨在评估孟加拉国 250 名中学生(10-15 岁)中支气管哮喘的患病率。研究采用了结构化问卷,包括国际儿童哮喘和过敏研究(ISAAC)哮喘问卷,以收集社会人口详情并评估哮喘患病率。结果显示调查结果显示,哮喘患者的平均年龄为 12.9 岁,男女比例相当。值得注意的是,11.6%的人曾被医生诊断患有哮喘。性别、年龄、家庭月收入、儿童肺炎病史和被动吸烟等因素与支气管哮喘有显著关联。逻辑回归分析表明,男性(OR=2.32,P=0.042)、儿童肺炎史(OR=3.10,P=0.007)和母亲哮喘(OR=2.739,P=0.032)是预测支气管哮喘的因素。男性和有儿童肺炎或产妇哮喘病史者的发病率更高。结论本研究强调,有必要针对已确定的风险因素采取综合保健措施,以减轻支气管哮喘对孟加拉国中学生健康和学习成绩的影响。应对儿童肺炎和减少被动吸烟是预防这一弱势群体患支气管哮喘的关键策略。
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引用次数: 0
Case Report: Budd-Chiari Syndrome (BCS) on Hepatocellular Carcinoma (HCC): Primary or Secondary Cause? 病例报告:肝细胞癌 (HCC) 上的巴德-恰里综合征 (BCS):原发还是继发?
Pub Date : 2024-02-26 DOI: 10.36348/sjmps.2024.v10i02.013
M. Bouissehak, M. Kadiri, F. Chabib, C. Berhili, N. Lagdali, M. Borahma, I. Benelbardhadi, F. Ajana
This is the case of a 63-year-old female patient admitted for management of a liver mass discovered incidentally on imaging. The patient presented with weight loss and prutitus, and on clinical examination had collateral venous circulation and scraping lesions. Abdominal ultrasound coupled with Doppler showed a hepatic tissue mass with left-sided portal thrombosis. Hepatic MRI confirmed the diagnosis and also revealed SBC with infiltration of the left and median hepatic veins. Liver biopsy confirmed diagnosis of hepatocellular carcinoma (HCC)in cirrhotic liver. Etiological work-up for prothrombotic factors and cirrhosis was negative. The patient was a candidate for palliative treatment. But our dilemma: is this a case of primary or secondary BCS? Scholars Middle East Publishers
这是一名 63 岁女性患者的病例,她因在影像学检查中偶然发现肝脏肿块而入院接受治疗。患者出现体重减轻和瘙痒,临床检查有侧支静脉循环和刮擦病变。腹部超声和多普勒显示肝组织肿块伴左侧门脉血栓形成。肝脏核磁共振成像证实了诊断,还发现了左侧和正中肝静脉浸润的 SBC。肝活检确诊为肝硬化肝细胞癌(HCC)。促血栓形成因素和肝硬化的病因检查结果均为阴性。患者可以接受姑息治疗。但我们的难题是:这是一例原发性还是继发性 BCS?中东学者出版社
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引用次数: 0
Iron Deficiency Anemia: The Contribution of Upper Digestive Endoscopy in Etiological Investigation 缺铁性贫血:上消化道内窥镜在病因调查中的贡献
Pub Date : 2024-02-19 DOI: 10.36348/sjmps.2024.v10i02.010
Y. Essadni, M. Salihoun, F. Bouhamou, M. Acharki, I. Serraj, N. Kabbaj
Iron-deficiency anemia is very common among patients in gastroenterology. The digestive system plays a key role in the pathophysiology of iron-deficiency. Indeed, digestive causes are one the most fequent etiology. This is why endoscopic evaluation is part of the etiological assessment of iron-deficiency anemia. The aim of this study is to investigate the usefulness of esophagogastroduodenoscopy (EGD) and histopathology in the etiological diagnosis of iron-deficiency anemias. Materials and Methods: This is a monocentric study conducted from January 2019 to December 2023. All patients with iron-deficiency anemia who underwent EGD were included. Various data were recorded, including patients' epidemiological information, laboratory findings, and results from endoscopic examinations. Results: Out of 2960 EGD, 576 (19,5%) were included in the study. The mean age of the patients was 49.81 years, ranging from 18 to 83 years. The male-to-female sex ratio was 0.67. It is notable that 47.5% of the patients had various medical histories: inflammatory bowel disease (IBD) in 19.13% of cases, history of non-steroidal anti-inflammatory drug (NSAID) use in 12.17%, coeliac disease in 6.13%, cirrhosis with portal hypertension in 8.70%. All patients underwent EGD. An abnormality was found in 63.4% of cases, including: Esophageal lesions: gastroesophageal varices in 13.3% of cases, erosive esophagitis in 7.5%, esophageal tumor in 0.6% of cases. Gastric lesions: erosive gastritis in 35% of cases, ulcerative gastritis in 22%, erythematous gastritis in 17%, gastric tumor in 15% of cases, supra-centimetric hyperplastic polyps in 5% of cases. Bulboduodenal lesions: erosive bulboduodenitis in 25% of cases, ulcerative bulboduodenitis in 18%, duodenal fold rarefaction in 16%, angiodysplasia in 3.5%. Gastric and duodenal biopsies were systematically performed. Duodenal biopsies showed a celiac disease aspect in 7.6% of cases, and nonspecific duodenitis in 4.6% of cases. Gastric biopsies revealed gastritis with Helicobacter pylori (Hp) in 57.6% of cases. Thus, the diagnostic yield of EGD was 47.33%. Conclusion: Iron deficiency anemia are common medical conditions in daily clinical practice. The multiple etiologies of iron deficiency anemia and the nonspecificity of symptoms make diagnosis difficult. Gastrointestinal lesions are frequently observed in patients with iron deficiency anemia. Digestive endoscopy has a great value in the etiological investigation of this pathology. Gastroscopy allows for the etiological diagnosis for many patients that’s why it is systematically recommended do it.
缺铁性贫血在消化内科病人中非常常见。消化系统在缺铁性贫血的病理生理学中起着关键作用。事实上,消化系统是最常见的病因之一。因此,内窥镜评估是缺铁性贫血病因评估的一部分。本研究旨在探讨食管胃十二指肠镜(EGD)和组织病理学在缺铁性贫血病因诊断中的作用。材料和方法:这是一项单中心研究,研究时间为 2019 年 1 月至 2023 年 12 月。所有接受胃肠道造影术的缺铁性贫血患者均被纳入其中。记录各种数据,包括患者的流行病学信息、实验室检查结果和内镜检查结果。结果:在 2960 例胃肠镜检查中,有 576 例(19.5%)被纳入研究。患者的平均年龄为 49.81 岁,从 18 岁到 83 岁不等。男女性别比为 0.67。值得注意的是,47.5%的患者有各种病史:19.13%的病例有炎症性肠病(IBD),12.17%的病例有非甾体抗炎药(NSAID)使用史,6.13%的病例有乳糜泻,8.70%的病例有肝硬化伴门脉高压。所有患者均接受了胃肠道造影检查。63.4%的病例发现异常,包括食管病变:胃食管静脉曲张占 13.3%,侵蚀性食管炎占 7.5%,食管肿瘤占 0.6%。胃部病变:35%的病例为糜烂性胃炎,22%为溃疡性胃炎,17%为红斑性胃炎,15%为胃肿瘤,5%为上皮增生性息肉。十二指肠病变:糜烂性十二指肠炎占 25%,溃疡性十二指肠炎占 18%,十二指肠褶皱稀疏占 16%,血管增生占 3.5%。对胃和十二指肠进行了系统的活检。十二指肠活检结果显示,7.6%的病例伴有乳糜泻,4.6%的病例伴有非特异性十二指肠炎。胃活检显示,57.6%的病例患有幽门螺旋杆菌(Hp)胃炎。因此,胃肠镜检查的诊断率为 47.33%。结论缺铁性贫血是日常临床实践中常见的病症。缺铁性贫血病因多样,症状无特异性,给诊断带来困难。缺铁性贫血患者经常会出现消化道病变。消化内镜检查在这种病因学研究中具有重要价值。胃镜检查可以对许多患者进行病因学诊断,因此被系统地推荐进行胃镜检查。
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Saudi Journal of Medical and Pharmaceutical Sciences
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