Medical principles and practice : international journal of the Kuwait University, Health Science Centre
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Review
Recurrent spontaneous miscarriage is still a challenging diagnostic and therapeutic quagmire.
Recurrent spontaneous miscarriage (RSM), affecting 1-2% of women of reproductive age seeking pregnancy, has been a clinical quagmire and a formidable challenge for the treating physician. There are many areas of controversy in the definition, aetiology, investigations and treatment of RSM. This review will address the many factors involved in the aetiology of RSM which is multifactorial in many patients, with antiphospholipid syndrome (APS) being the most recognized aetiological factor. ⋯ The challenges faced by the treating physician are even more overwhelming regarding the decision of what should be the most appropriate therapy offered to patients with RSM. Our review will cover the diverse modalities of therapy available including the role of preimplantation genetic testing using recent microarray technology, such as single nucleotide polymorphism and comparative genomic hybridization, as well as preimplantation genetic diagnosis; the greatest emphasis will be on the treatment of APS, and there will be important comments on the management of patients presenting with idiopathic RSM. The controversial areas of the role of natural killer cells in RSM, the varied modalities in the management of idiopathic RSM and the need for better-planned studies will be covered as well.
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To assess N51I, C59R and S108N polymorphisms of dihydrofolate reductase (dhfr) and A437G and K540E of dihydropteroate synthase (dhps) genes of P. falciparum isolates recovered from pregnant women with asymptomatic malaria in a coastal setting in Nigeria. ⋯ This study revealed the emergence of the K540E mutation among the parasite population in Lagos. However, it supports the implementation of the intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine with continuous effectiveness monitoring in the study area.
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We aimed to ascertain the factors potentially contributing to the manifestation of pressure ulcers (PU) due to poor nutritional status in a nonselected hospitalized population. ⋯ Poor nutritional status, limited autonomy in everyday activities and artificial nutrition seemed to confer noteworthy prognostic value regarding PU development in the acute-care setting.
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Comparative Study
A microcomputed tomography-based comparison of root canal filling quality following different instrumentation and obturation techniques.
With a microcomputed tomography (microCT) imaging device, we aimed to quantitatively evaluate root canal fillings after commonly used endodontic procedures and also tested the suitability of microCT for this purpose. ⋯ MicroCT was a useful tool for 3D quantitative evaluations of these root canal fillings. None of the root canal instrumentation and filling methods ensured void-free obturation. CL condensation produced mainly i-voids. With Th compaction, internal s-voids were particularly common, but there were mainly i-voids in the apical part.
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Comparative Study
Evaluation of pulmonary and extrapulmonary tuberculosis in immunocompetent adults: a retrospective case series analysis.
It was the aim of this study to evaluate the demographic factors and clinical features of extrapulmonary tuberculosis (EPTB) compared to those of pulmonary tuberculosis (PTB) among adult immunocompetent patients. ⋯ There was a high incidence of EPTB in our study. Early diagnosis of EPTB is crucial for treatment, and atypical presentations of TB should be kept in mind for immunocompetent patients living in endemic areas. Females especially should be investigated for EPTB.