SN Comprehensive Clinical Medicine最新文献

The study is oriented around the collection of already published data about treatment of chronic periodontitis according to specifics with or without antibiotics, given locally or systemically. Tetracycline and metronidazole, combined or not with amoxicillin according to the clinical indications of the pathology, are the most applied combinations indicated for the treatment of chronic periodontitis. This element is based on the fact that these antibiotics act specifically against the pathogenic bacteria of chronic periodontitis. The study is a review type. The collection of information is oriented around finding the trend of scientific research in this direction, towards how this data is sought through the results of review-type studies, or studies based on experiments performed in vitro or in vivo on teeth affected by this pathology. The preference for antibiotics and how it has evolved during the selected years in this study is another goal in itself for this study, to closely connect it with the evolution of the concept of how this pathology appears and who are its causes. The marketing of different antibiotic manufacturing firms, or the tendency to use combinations of antibiotics and the evaluation of this tendency, is another aim of this study. The electronic research was done in PubMed page, using the keywords according to certain combinations. The search time interval is 5 years, articles published in PubMed about chronic periodontitis, and the treatment of this pathology by means of antibiotics. This study supports the fact that the new trends for treatment of this pathology with or without antibiotics are also oriented towards the application or not of probiotics, knowing that the latters are currently under further exploration and evolution. It is known the fact that we live after the transition phase of COVID-19, where most of the population was treated with azithromycin, an antibiotic usually recommended for treatment of periodontal pathologies, as it appears “with the ability” to pour directly into the gingival fluid.

Children with patent ductus arteriosus (PDA) present with several degrees of hemodynamic states. It is not known if there is any link between ductal size and hemodynamic states. This study elicited the prevalence of hemodynamically significant PDA (hsPDA) and attempted to document the impact of ductal size on left output and aortic Doppler velocimetry. This is a cross-sectional study that assessed the prevalence of hsPDA and the relationship of ductal size and parameters of left ventricular function (LVF) in children and adolescents aged 3–19 years. The mean left ventricular mass (LVM) for respondents with PDA, 8.3 ± 5.3, was lower than that of the control, 14.3 ± 5.2, and the mean difference was found to be statistically significant (Mann–Whitney U = 7.270, p < 0.001). The prevalence of small, moderate, and large hsPDA was 40.7%, 35.6%, and 23.7% respectively. The commonest age of presentation of hsPDA is 1 month of age. There was a weak negative correlation between PDA size and ejection fraction (EF), increases in PDA size correlate with decreases in EF, but this was not found to be statistically significant (n = 59, r = − 0.233, p = 0.076). There was a weak positive correlation between PDA size and velocity, increases in PDA size correlate with increases in velocity, and this was not found to be statistically significant (n = 43, r = 0.252, p = 0.104). The prevalence of hsPDA in this study was high. The LVM in healthy children and adolescents was higher than in those with PDA. Left ventricular mass in children with PDA correlates inversely with descending aorta velocity.

Increasing evidence in the literature suggests the assessment of the frailty in the patients before the transcatheter aortic valve implantation (TAVI), but there is still a matter of debate about the standardized method to be used. We searched online the medical literature database (PubMed) from 2006 to 2023, covering the 17-year period that marked the development of the minimally invasive approach. We retrieved n.218 articles and 64 studies were evaluated. The preoperative assessment of frailty in the setting of the TAVI is a key point of the evaluation by the heart team in order to identify the patients at low or high risk of complications after surgery and to support the clinical decision in allocating the health care resources.

Irritable Bowel Syndrome (IBS) and Nonalcoholic Fatty Liver Disease (NAFLD) are among most sought gastrointestinal and liver related conditions worldwide. Both of them may share common risk factors. Nonalcoholic Fatty Liver Disease (NAFLD) patients having metabolic dysfunctions are termed as Metabolic Dysfunction associated Fatty Liver Disease (MAFLD). Data are sparse regarding the frequency of Metabolic Dysfunction associated Fatty Liver Disease (MAFLD) among Irritable Bowel Syndrome (IBS) patients. We have conducted a cross sectional comparative study at the outpatient department of SRNGIH to find out the frequency of Non Alcoholic Fatty Liver Disease (NAFLD) and Metabolic dysfunction associated Fatty Liver Disease (MAFLD) among patients with Irritable Bowel Syndrome (IBS). Out of 219 patients,121 patients had IBS. Irritable Bowel Syndrome—Diarrhea Predominant (IBS-D) was the most prominent type (55%). One third (n = 39) of the IBS (32.23%) patients had Non Alcoholic Fatty Liver Disease (NAFLD). One tenth [n = 12] had Metabolic dysfunction associated Fatty Liver Disease (MAFLD). Significantly younger patients had NAFLD among IBS patients compared to Non-IBS patients [p = 0.023]. Non-IBS patients had significantly more Low Density Lipoprotein (LDL) compared to IBS patients (p = 0.040). Serum triglycerides were more among IBS patients having NAFLD compared to non-IBS patients having NAFLD (p = 0.022). Serum Alanine Aminotransferase (S. ALT) were significantly higher in IBS patients with NAFLD than in IBS patients without NAFLD (p = 0.006). Body Mass Index (BMI) was significantly higher in IBS patients with MAFLD than IBS patients without MAFLD. Total and LDL cholesterol were significantly higher in IBS with MAFLD patients than in IBS without MAFLD. One third of the Irritable Bowel Syndrome (IBS) patients had Nonalcoholic Fatty Liver Disease (NAFLD). Metabolic dysfunction associated Fatty Liver Disease (MAFLD) was less prevalent among patients with IBS. However, further study with bigger samples is needed for further understanding between the two conditions.

The objective of the study was to determine the safety profile of lurasidone and olanzapine in the treatment of schizophrenia. All consecutive patients of schizophrenia attending the Psychiatry outpatient department of IGMC, Shimla (Approval no. HFW(MC-II)B(12)ETHICS/2020/3930) were screened for enrolment in the study of 1 year duration (March 2019–Feb 2020). The patients enrolled (100 patients) were divided into two treatment groups (50 in each group), Group A (lurasidone) and Group B (olanzapine). During the follow-up period, investigations such as lipid profile, fasting blood sugar, ECG, blood pressure, and body weight were noted to assess the safety profile of the drug. Results showed that the mean systolic blood pressure at baseline in the olanzapine group was 125.12 ± 8.37 and the mean age was 33.50 ± 11.35 at the first follow-up, which was done at 2–4 weeks, while the same for the lurasidone group was 31.71 ± 10.44 at 2–4 weeks. The mean serum HDL level at baseline in the olanzapine group was 43.38 ± 1.28 while 39.46 ± 1.12 at first follow-up; however, it was 49.64 ± 1.29 at baseline and 45.19 ± 1.22 at first follow-up for the lurasidone group; this exhibited a p value of < 0.001 which was highly significant. The mean age for the olanzapine group was 33.24 ± 11.00 at the second follow-up which was done at 8 weeks, while the same for the lurasidone group was 31.91 ± 10.60 at 8 weeks. It can be concluded from the study that lurasidone is more preferable than olanzapine for the treatment of schizophrenia, depending on the patient's financial situation, tolerance level, and accessibility.

Parathyroid adenoma is a parathyroid proliferative disorder where the patients typically present with evidence of primary hyperparathyroidism where the diagnosis is challenging especially in a resource-poor setting like Sri Lanka and requires multiple imaging modalities. We present a case of a 52-year female who presented with non-resolving long-standing back pain for more than 5 years, associated with progressive bilateral hip joint and shoulder joint pain with generalized body aches with prolonged fatigue who was found to have hypercalcemia and later diagnosed with primary hyperparathyroidism and parathyroid adenoma with multinodular goiter. She had a tremendous clinical improvement following the resection of the parathyroid adenoma along with a total thyroidectomy preserving other parathyroid glands. This case concludes that parathyroid adenoma diagnosis requires high clinical suspicion when patients present with vague symptoms and hypercalcaemic symptoms and should proceed with a workup with multiple imaging modalities depending on the availability for early diagnosis to prevent potential complications. Surgical resection of parathyroid adenoma preserving normal gland results in a good prognosis with complete symptomatic relief within a few months.