Pub Date : 2024-07-08DOI: 10.36348/sjmps.2024.v10i07.002
Dr. Laila Sharmin Diba, Major Dr. Md. Mofizul Islam, Dr. Naila Zaman Khan, Dr. Katherine Benfer, Dr. Razia Sultana, Dr. Umme Qulsum Sonia
Background: Cerebral Palsy (CP) is a prevalent motor disability affecting children globally, emphasizing the need for early identification and intervention. The Rapid Neurodevelopmental Assessment (RNDA) offers a comprehensive approach to predict CP and other motor developmental trajectories in high-risk neonates. Objective: This longitudinal cohort study aims to evaluate the effectiveness of RNDA in predicting CP and motor developmental trajectories. Method: Seventy term neonates from Dhaka Shishu (Children) Hospital were included, with neurodevelopmental assessments conducted using RNDA. Assessments were performed at 3 months and 6-9 months, with CP evaluation at 12 months using clinical examinations. Results: Prolonged labor (44.3%) and delayed cry after birth (31.4%) were common among the study patients (n=70), with varying modes of delivery including normal vaginal delivery (50.0%), vaginal delivery with complications (12.9%), and lower uterine cesarean section (37.1%). Muscle tone, primitive reflexes, gross and fine motor skills, epilepsy, and microcephaly were evaluated across visits to identify impending CP. Significant associations were found between hypertonicity, primitive reflex impairment, gross motor impairment, and fine motor impairment with impending CP across visits, particularly in the 3rd visit (p<0.05). Sensitivity, specificity, accuracy, and predictive values varied across parameters and visits, with fine motor skills and gross motor skills showing the highest sensitivity in the 3rd visit (86.4% and 100.0%, respectively). Additionally, abnormal EEG, USG of the brain, and MRI findings were significantly associated with impending CP, with USG of the brain demonstrating the highest sensitivity (93.3%) and MRI showing the highest specificity (70.0%). Conclusion: RNDA emerges as a valuable tool for early prediction of CP and motor developmental trajectories in high-risk neonates. Early identification through RNDA facilitates timely interventions, optimizing long-term neurodevelopmental outcomes.
{"title":"Prediction of Cerebral Palsy and Other Motor Developmental Trajectories in High-Risk Neonate Using the Rapid Neurodevelopmental Assessment (RNDA)","authors":"Dr. Laila Sharmin Diba, Major Dr. Md. Mofizul Islam, Dr. Naila Zaman Khan, Dr. Katherine Benfer, Dr. Razia Sultana, Dr. Umme Qulsum Sonia","doi":"10.36348/sjmps.2024.v10i07.002","DOIUrl":"https://doi.org/10.36348/sjmps.2024.v10i07.002","url":null,"abstract":"Background: Cerebral Palsy (CP) is a prevalent motor disability affecting children globally, emphasizing the need for early identification and intervention. The Rapid Neurodevelopmental Assessment (RNDA) offers a comprehensive approach to predict CP and other motor developmental trajectories in high-risk neonates. Objective: This longitudinal cohort study aims to evaluate the effectiveness of RNDA in predicting CP and motor developmental trajectories. Method: Seventy term neonates from Dhaka Shishu (Children) Hospital were included, with neurodevelopmental assessments conducted using RNDA. Assessments were performed at 3 months and 6-9 months, with CP evaluation at 12 months using clinical examinations. Results: Prolonged labor (44.3%) and delayed cry after birth (31.4%) were common among the study patients (n=70), with varying modes of delivery including normal vaginal delivery (50.0%), vaginal delivery with complications (12.9%), and lower uterine cesarean section (37.1%). Muscle tone, primitive reflexes, gross and fine motor skills, epilepsy, and microcephaly were evaluated across visits to identify impending CP. Significant associations were found between hypertonicity, primitive reflex impairment, gross motor impairment, and fine motor impairment with impending CP across visits, particularly in the 3rd visit (p<0.05). Sensitivity, specificity, accuracy, and predictive values varied across parameters and visits, with fine motor skills and gross motor skills showing the highest sensitivity in the 3rd visit (86.4% and 100.0%, respectively). Additionally, abnormal EEG, USG of the brain, and MRI findings were significantly associated with impending CP, with USG of the brain demonstrating the highest sensitivity (93.3%) and MRI showing the highest specificity (70.0%). Conclusion: RNDA emerges as a valuable tool for early prediction of CP and motor developmental trajectories in high-risk neonates. Early identification through RNDA facilitates timely interventions, optimizing long-term neurodevelopmental outcomes.","PeriodicalId":508857,"journal":{"name":"Saudi Journal of Medical and Pharmaceutical Sciences","volume":"106 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141667027","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 : 2024-07-04DOI: 10.36348/sjmps.2024.v10i07.001
Zied Gaifer, Bashayer Alrufayi Rawan Alahmadi, Montaha Demyati, Moneer Mohammed
Hepatotoxicity can potentially arise in hospitalized patients with Candida infections due to antifungal medications. Ongoing research has focused on the hepatotoxicity profiles of fluconazole and anidulafungin. Nevertheless, a limited number of studies have directly compared the hepatotoxicity of these two antifungals. This study compares the hepatotoxic effects of anidulafungin and fluconazole in patients hospitalized with Candida infections. This retrospective study was conducted at the Prince Mohamed Bin Abdelaziz Hospital in Saudi Arabia to compare the hepatotoxicity of fluconazole and anidulafungin in patients with Candida infection. The liver function test results were analyzed using linear mixed models, with adjustments made for confounding factors. The investigation comprised 202 cases, of which 85 (42%) were treated with fluconazole and 117 (58%) was treated with anidulafungin—mortality and prevalence of candidemia and septic shock in the Anidulafungin group (p 0.001). There was no significant difference between the two groups regarding age, gender, duration of treatment, or concomitant use of hepatotoxic drugs. Analyses utilizing Linear Mixed-Effects Models revealed higher alanine aminotransferase (ALT) (p = 0.001) and aspartate aminotransferase (AST) (p = 0.001) levels in the Anidulafungin group initially; however, after adjusting for covariates, these differences were no longer statistically significant. The levels of alkaline phosphatase (ALP) and gamma-glutamyl transferase (GTT) did not differ significantly between groups after controlling for confounding variables. However, the Anidulafungin group had substantially higher bilirubin levels than the Fluconazole group, and this difference remained significant after adjusting for potential confounding variables (p = 0.022). In summary, this study contributes to understanding the relative hepatotoxicity of anidulafungin and fluconazole. After controlling for confounding variables, it was found that there were no significant differences in liver enzyme levels between the two groups. When assessing the hepatotoxicity of these antifungal agents, it is imperative to consider the individual patient characteristics, underlying health conditions, and concurrent administration of other hepatotoxic medications.
{"title":"Hepatotoxicity Patterns of Anidulafungin and Fluconazole in the Management of Candida Infections: A Comparative Study among Hospitalized Patients","authors":"Zied Gaifer, Bashayer Alrufayi Rawan Alahmadi, Montaha Demyati, Moneer Mohammed","doi":"10.36348/sjmps.2024.v10i07.001","DOIUrl":"https://doi.org/10.36348/sjmps.2024.v10i07.001","url":null,"abstract":"Hepatotoxicity can potentially arise in hospitalized patients with Candida infections due to antifungal medications. Ongoing research has focused on the hepatotoxicity profiles of fluconazole and anidulafungin. Nevertheless, a limited number of studies have directly compared the hepatotoxicity of these two antifungals. This study compares the hepatotoxic effects of anidulafungin and fluconazole in patients hospitalized with Candida infections. This retrospective study was conducted at the Prince Mohamed Bin Abdelaziz Hospital in Saudi Arabia to compare the hepatotoxicity of fluconazole and anidulafungin in patients with Candida infection. The liver function test results were analyzed using linear mixed models, with adjustments made for confounding factors. The investigation comprised 202 cases, of which 85 (42%) were treated with fluconazole and 117 (58%) was treated with anidulafungin—mortality and prevalence of candidemia and septic shock in the Anidulafungin group (p 0.001). There was no significant difference between the two groups regarding age, gender, duration of treatment, or concomitant use of hepatotoxic drugs. Analyses utilizing Linear Mixed-Effects Models revealed higher alanine aminotransferase (ALT) (p = 0.001) and aspartate aminotransferase (AST) (p = 0.001) levels in the Anidulafungin group initially; however, after adjusting for covariates, these differences were no longer statistically significant. The levels of alkaline phosphatase (ALP) and gamma-glutamyl transferase (GTT) did not differ significantly between groups after controlling for confounding variables. However, the Anidulafungin group had substantially higher bilirubin levels than the Fluconazole group, and this difference remained significant after adjusting for potential confounding variables (p = 0.022). In summary, this study contributes to understanding the relative hepatotoxicity of anidulafungin and fluconazole. After controlling for confounding variables, it was found that there were no significant differences in liver enzyme levels between the two groups. When assessing the hepatotoxicity of these antifungal agents, it is imperative to consider the individual patient characteristics, underlying health conditions, and concurrent administration of other hepatotoxic medications.","PeriodicalId":508857,"journal":{"name":"Saudi Journal of Medical and Pharmaceutical Sciences","volume":" 125","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680305","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 : 2024-06-05DOI: 10.36348/sjmps.2024.v10i06.002
F. Mghyly, H. E. Bacha, S. Mechhor, M. Cherkaoui, N. Benzzoubeir, I. Errabih
Ulcerative colitis and Crohn's disease have an approximately 2-3-fold increased risk of colorectal cancers. The risk factors most frequently associated with the risk of these cancers in inflammatory bowel disease are those indicative of chronic inflammation, primary sclerosing cholangitis, previous dysplasia, and a family history of colorectal cancers. The pace of CRC surveillance in this population will be determined by the presence of these risk factors, and the surveillance modality is based on colonoscopy with chromoendoscopy and targeted biopsies. In the absence of staining, systematic biopsies can be performed.
{"title":"Colorectal Cancer in Inflammatory Bowel Disease: Risk Factors and Surveillance Modalities, Experience of A Gastroenterology Department","authors":"F. Mghyly, H. E. Bacha, S. Mechhor, M. Cherkaoui, N. Benzzoubeir, I. Errabih","doi":"10.36348/sjmps.2024.v10i06.002","DOIUrl":"https://doi.org/10.36348/sjmps.2024.v10i06.002","url":null,"abstract":"Ulcerative colitis and Crohn's disease have an approximately 2-3-fold increased risk of colorectal cancers. The risk factors most frequently associated with the risk of these cancers in inflammatory bowel disease are those indicative of chronic inflammation, primary sclerosing cholangitis, previous dysplasia, and a family history of colorectal cancers. The pace of CRC surveillance in this population will be determined by the presence of these risk factors, and the surveillance modality is based on colonoscopy with chromoendoscopy and targeted biopsies. In the absence of staining, systematic biopsies can be performed.","PeriodicalId":508857,"journal":{"name":"Saudi Journal of Medical and Pharmaceutical Sciences","volume":"15 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141384911","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 : 2024-06-03DOI: 10.36348/sjmps.2024.v10i06.001
Wafaa Alshahrani, Nadia M. Samad, Muhammad Rehan Malik, Abdullah Abdulwahed Eid
We describe a unique case of a 60-year-old asthmatic Saudi patient who developed acute respiratory distress syndrome (ARDS) and accelerated lung fibrosis after the administration of the second dose of the COVID-19 mRNA vaccine. This patient presented to the emergency room with a four-day history of fever, shortness of breath, and cough. His hospitalization was complicated by non-ST segment elevation myocardial infarction, non-sustained ventricular tachycardia, and a lowered Glasgow Coma Scale. He was intubated at a P/F ratio of 73 mmHg and a peak inspiratory pressure of 46 cmH2O. His antibiotics had to be modified, as he had QT prolongation. Additional anti-pseudomonal, anti-anaerobe, and anti-fungal coverings were empirically given, which were later switched to colistin based on the results of a sputum culture. On ICU day 17, the patient went into cardiac arrest due to severe ARDS and septic shock. Despite attempts at resuscitation, he was unable to be revived.
{"title":"Accelerated Extensive Lung Fibrosis Post–COVID-19 Immunization in an Asthmatic Patient","authors":"Wafaa Alshahrani, Nadia M. Samad, Muhammad Rehan Malik, Abdullah Abdulwahed Eid","doi":"10.36348/sjmps.2024.v10i06.001","DOIUrl":"https://doi.org/10.36348/sjmps.2024.v10i06.001","url":null,"abstract":"We describe a unique case of a 60-year-old asthmatic Saudi patient who developed acute respiratory distress syndrome (ARDS) and accelerated lung fibrosis after the administration of the second dose of the COVID-19 mRNA vaccine. This patient presented to the emergency room with a four-day history of fever, shortness of breath, and cough. His hospitalization was complicated by non-ST segment elevation myocardial infarction, non-sustained ventricular tachycardia, and a lowered Glasgow Coma Scale. He was intubated at a P/F ratio of 73 mmHg and a peak inspiratory pressure of 46 cmH2O. His antibiotics had to be modified, as he had QT prolongation. Additional anti-pseudomonal, anti-anaerobe, and anti-fungal coverings were empirically given, which were later switched to colistin based on the results of a sputum culture. On ICU day 17, the patient went into cardiac arrest due to severe ARDS and septic shock. Despite attempts at resuscitation, he was unable to be revived.","PeriodicalId":508857,"journal":{"name":"Saudi Journal of Medical and Pharmaceutical Sciences","volume":"84 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141388874","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 : 2024-02-01DOI: 10.36348/sjmps.2024.v10i02.002
Mounia Azizi, Ali El Khand, Rabiaa Bounabe, A. Sobhi, Y. Zajjari, A. Alayoud, Souhail Mouline
Renal pathologies following viral infections have become an emerging public health problem in both developed and developing countries. Diagnostic criteria are complex. In most cases, they involve correlation between clinical, biological and histological data, with occasional recourse to molecular biology techniques. Several mechanisms are involved in the pathogenesis of virus-related nephropathy, including virus tropism in the kidney, formation of immune complexes in situ or in the bloodstream, direct cytopathogenic effects, and multiple organ failure. The hepatitis C virus is responsible for three main types of kidney disease: membranoproliferative glomerulnephritis, cryoglobulinemia and membranous nephropathy. Hepatitis B virus is associated with membranous nephropathy, membranoproliferative glomerulnethritis, and IgA nephropathy. HIV (human immunodeficiency virus) infection is associated with several glomerular and tubular kidney damage. HIVAN (HIV-associated nephropathy), a specific entity mainly affecting Africans and African-Americans, presents as a rapidly progressive glomerulonephritis rapidly progressing to the terminal stage. Infections secondary to adenovirus, cytomegalovirus, epstein-barr virus, poliomavirus and coronavirus are often responsible for acute or chronic tubulointerstitial nephritis. Treatment is mainly symptomatic, based on nephroprotection measures, rarely combined with antiviral therapy. Prophylaxis with vacci-nation, when available, remains the best means of preventing viral nephropathy.
在发达国家和发展中国家，病毒感染引起的肾脏病变已成为一个新出现的公共卫生问题。诊断标准十分复杂。在大多数情况下，它们涉及临床、生物和组织学数据之间的相关性，偶尔也会求助于分子生物学技术。病毒相关肾病的发病机制有多种，包括病毒对肾脏的滋养作用、原位或血液中免疫复合物的形成、直接的细胞致病作用以及多器官功能衰竭。丙型肝炎病毒主要导致三种类型的肾病：膜增生性肾小球肾炎、冷球蛋白血症和膜性肾病。乙型肝炎病毒与膜性肾病、膜增生性肾小球肾炎和 IgA 肾病有关。艾滋病毒（人类免疫缺陷病毒）感染与多种肾小球和肾小管损害有关。HIVAN（艾滋病毒相关性肾病）是一种主要影响非洲人和非裔美国人的特殊疾病，表现为快速进展的肾小球肾炎，并迅速发展到晚期。继发于腺病毒、巨细胞病毒、天疱疮病毒、脊髓灰质炎病毒和冠状病毒的感染通常会导致急性或慢性肾小管间质性肾炎。治疗主要是对症治疗，以肾保护措施为基础，很少与抗病毒治疗相结合。如果有疫苗，使用疫苗预防仍是预防病毒性肾病的最佳方法。
{"title":"Renal Injury During Viral Infections","authors":"Mounia Azizi, Ali El Khand, Rabiaa Bounabe, A. Sobhi, Y. Zajjari, A. Alayoud, Souhail Mouline","doi":"10.36348/sjmps.2024.v10i02.002","DOIUrl":"https://doi.org/10.36348/sjmps.2024.v10i02.002","url":null,"abstract":"Renal pathologies following viral infections have become an emerging public health problem in both developed and developing countries. Diagnostic criteria are complex. In most cases, they involve correlation between clinical, biological and histological data, with occasional recourse to molecular biology techniques. Several mechanisms are involved in the pathogenesis of virus-related nephropathy, including virus tropism in the kidney, formation of immune complexes in situ or in the bloodstream, direct cytopathogenic effects, and multiple organ failure. The hepatitis C virus is responsible for three main types of kidney disease: membranoproliferative glomerulnephritis, cryoglobulinemia and membranous nephropathy. Hepatitis B virus is associated with membranous nephropathy, membranoproliferative glomerulnethritis, and IgA nephropathy. HIV (human immunodeficiency virus) infection is associated with several glomerular and tubular kidney damage. HIVAN (HIV-associated nephropathy), a specific entity mainly affecting Africans and African-Americans, presents as a rapidly progressive glomerulonephritis rapidly progressing to the terminal stage. Infections secondary to adenovirus, cytomegalovirus, epstein-barr virus, poliomavirus and coronavirus are often responsible for acute or chronic tubulointerstitial nephritis. Treatment is mainly symptomatic, based on nephroprotection measures, rarely combined with antiviral therapy. Prophylaxis with vacci-nation, when available, remains the best means of preventing viral nephropathy.","PeriodicalId":508857,"journal":{"name":"Saudi Journal of Medical and Pharmaceutical Sciences","volume":"18 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139685320","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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