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   2014| September-October  | Volume 6 | Issue 5  
    Online since July 12, 2017

 
 
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ARTICLES
Complement C3 and C4 levels in recurrent aborting women with or without antiphospholipid and anticardiolipin autoantibodies
Zakarea A Yaseen Al-khayat, Nabeel Elia Waheda, Nabaz Faisal Shaker
September-October 2014, 6(5):213-218
DOI:10.4103/1947-489X.210388  
Background: Accumulating body of evidence suggests a role for the complement system in the etiology of abortion. Objectives: To evaluate levels of complements (C3, C4) in cases of abortion with or without circulating antiphospholipid (APL) and anticardiolipin (ACL) autoantibodies. Patients and Methods: A total of 103 women were enrolled in this case controlled study including 73 patients with a history of three or more abortion and 30 healthy parous women. For all, ACL, APL, C3, C4 levels were estimated. Results: The means and ranges of circulating complements (C3, C4) were as follows [C3 level: (90 ± 9; 39-115 mg/dl versus 109±16;95-138 mg/dl) in patients and controls respectively; C4 level: (18±10; 11-25 mg/dl; versus 36±7; 23-39 mg/dl) in patients and controls respectively]. The differences in the means between patients and controls were highly significant (p . 0.01). In the patients' group, according to the mean, the range of C4, C3 and the elevation of both ACL and APL, three subgroups (A, B, C) were recognizable. Group A included 21 aborting women with high levels of ACL and APL. Their complement levels (mean ± S.D; range) were as follows:[C3: (59.7±11.6; 39-65 mg/dl); C4: (14.7±5.2; 11-16 mg/dl)]. Group B included 34 aborting women with normal levels of ACL & APL. Their complement levels (mean ± S.D, range) were as follows: [C3: (88.6±19.3; 59-90 mg/dl ) and C4:(18.4±7.3; 15-21 mg/dl)]. Group C included 18 aborting women with normal levels of AC & APL and their complement levels (mean ± S.D; range) were as follows:[C3: (102.7± 15.1; 90-115 mg/dl) and C4: (21.4 ± 5.8; 17-25 mg/dl)]. The differences between the means of C3 in these subgroups were highly significant (p < 0.01), while the differences between the means of C4 between B and C were not significant. Conclusion: Low C3 & C4 levels were detected in recurrent aborting women with or without autoantibodies (APL & ACL). These data may suggest a role for these complements in the pathogenesis of recurrent pregnancy loss.
[ABSTRACT]   Full text not available  [PDF]
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CASE REPORTS
Intraoperative ventricular fibrillation arrest caused by accidental intravenous injection of epinephrine
Deyaa Baghdady Ahmed, Juniad Alam, Mahmood Talaat, Ahmed Al-Ahmary
September-October 2014, 6(5):223-226
DOI:10.4103/1947-489X.210390  
We describe a 25-year old male who experienced ventricular fibrillation (V-Fib) arrest induced by inadvertent intravenous injection of epinephrine instead of the routine reversal medication. Under general anesthesia with Desflurane inhalation, 1.5% Lidocaine containing 1:100,000 Epinephrine was injected into the nasal mucosa for septoplasty and the procedure went smoothly. Near the end of the surgery, the patient suddenly developed sinus tachycardia followed by V-Fib arrest which responded to a single shock of 300J. Sinus rhythm was restored immediately. The patient developed severe lactic acidosis and a bedside echocardiography showed global hypokinesia and normal right sided pressures. The patient was intubated and admitted to the ICU on mechanical ventilation before being weaned and extubated. Retrospectively while investigating the cause after it was discovered that epinephrine had been given as opposed to the anesthesia reversal medication. This case illustrates an unusual response to epinephrine with cardiac arrest in a healthy young male.
[ABSTRACT]   Full text not available  [PDF]
  565 71 -
VIEW POINT
Physical activity: The need of a physician's prescription
Imed Harrabi, Saad Al Ghamdi
September-October 2014, 6(5):196-198
DOI:10.4103/1947-489X.210385  
Healthcare providers are uniquely positioned to influence the sedentary epidemic trend by prescribing physical activity more frequently and more precisely. Specific written exercise prescriptions can increase patient compliance substantially. Methodical physical activity counseling, even for a short duration, will at least to some degree increase the weekly physical activity of previously sedentary patients. Frequency, intensity, timing and type are the key elements of physical activity prescription.
[ABSTRACT]   Full text not available  [PDF]
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CASE REPORTS
Ectodermal dysplasia: Features and dental management
Roqaya Bahjat, Khadiga Herwis, Ahmed Ali Musrati
September-October 2014, 6(5):219-222
DOI:10.4103/1947-489X.210389  
The current case report presents a rare clinical case of ectodermal dysplasia for a three years old Libyan child. The child's parents were concerned about the missing dentition for their child at his age, and his malnutrition as consequence of the inability to eat healthy food. Clinical and radiographic examinations were carried to confirm the diagnosis and to make the proper treatment plan. A prosthodontic treatment offered to the child and he kept under observation.
[ABSTRACT]   Full text not available  [PDF]
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ARTICLES
Uric acid in chronic heart failure; correlation with prognostic markers
Fathia Ehmouda, Hamid Elbrasai, Ali M Elneihoum
September-October 2014, 6(5):208-212
DOI:10.4103/1947-489X.210387  
Background: Chronic heart failure (CHF) is a leading cause of both morbidity and mortality worldwide. The pathophysiologic understanding of chronic heart failure (CHF) has shifted from a mere hemodynamic disorder to a much more complex approach including changes and imbalances in neurohormonal, immune, and metabolic functions. Hyperuricemia is a constant finding in CHF. Aim: To estimate the level of uric acid (UA) in patients with CHF, and to explore the possible relationship with established prognostic markers in these patients. Patients and Methods: Ninety-five patients with CHF were studied. Detailed clinical assessment, ECG, laboratory investigations and echocardiography were performed for all patients. Serum UA level >7.0 mg/dl was considered high. Results: The age range of patients was 28-85 years (median age 67). Of this group, 54 were males. The duration of the disease ranged from 113 years. In addition, 56% of patients were diabetic, 64% were hypertensive, and 74% had ischemic heart disease. 41 patients were class III New York Heart Association (NYHA) functional calcification, whereas 34 patients and 12 patients were in class II & IV respectively. The following diagnostic information was obtained: 1) blood pressure readings were 60 -123mmHg (mean=87.9±14.4). 2) atrial fibrillation (AF) was noted in 36 patients (38%) 3) left ventricular ejection fraction (EF%) was 13-68% (mean=37.9±20.1) 4) blood urea ranged from 13-197 mg/dl (mean=64.7±42.6) 5) serum creatinine was 0.4-5.5mg/dl (mean=1.4±0.9) 6) serum sodium was 119-148 (mean=134.2±5.9) 7) Elevated serum uric acid levels were found in 73% of our patients. We found a significant inverse correlation between serum uric acid level and mean arterial blood pressure (r = -0.42, p = 0.019) and with left ventricular ejection fraction (EF%) (r = -0.31, p = 0.003). We also demonstrated a direct correlation between serum UA and blood urea (r= +0.21, p= .042), serum Cr (r= +0.21, p= 0.051) and age (r=+0.37, p= 0.034). No significant differences were noted in serum UA level in different (NYHA) functional subgroups. Conclusions: High serum UA was observed in 73% of patients with CHF. The observed significant correlation between UA level and some established prognostic markers in these patients may indicate that serum UA could provide additional prognostic information in this population. We propose that such a simple marker that can be measured anywhere at a low cost to help identify high-risk patients with CHF.
[ABSTRACT]   Full text not available  [PDF]
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ABSTRACTS BOOK
Second clinical congress of the gulf chapter of the american association of clinical endocrinologists, october, 23rd-25th 2014, Abu Dhabi, United Arab Emirates
Salem A Beshyah, Ali S Al Zahrani, Aly B Khalil
September-October 2014, 6(5):235-294
DOI:10.4103/1947-489X.210392  
These are the advance abstracts of the second clinical congress of the Gulf Chapter of the American Association of Clinical Endocrinologists to be held on 23-25 of October 2014. The declared educational objectives of the congress is to give a “state of the art in endocrine practice”. To this end, the organizing committee invited international and regional key opinion leaders to meet the objectives of the congress. We present the abstracts of the congress as submitted by the authors after minimal restyling and editing to suit the publication requirements of the journal. Many major issues and topical themes with wide interests in the profession were addressed in 5 plenary lectures. A clinical practice debate was included to highlight the pros and cons of the recently published lipid lower guidelines from both sides of the Atlantic. More focused issues were included in 12 clinical practice symposia to suite the specific educational needs of the target audience subgroups. Practical issues were addressed in “Meet the Expert”-type of interactive workshops. A selection of free communications from abstracts submitted by delegates, reflecting mostly the regional epidemiology and clinical practice in diabetes care and endocrinology, were selected for presentation as either oral or poster presentations. We hope that by publishing them in this journal we extend the benefit to those who could not make it to the live presentations. The focus of this year's congress included bone health, molecular endocrinology, pituitary and adrenal disease, new advances in diabetes care, nuclear medicine in endocrinology and select topical issues in addition to many other day to day concerns in diabetes care and clinical endocrinology.
[ABSTRACT]   Full text not available  [PDF]
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ARTICLES
Lipid profiles of hemodialysis patients in the jenin district of Palestine
Jamal Qasem Abumwais, Omer Fadul Idris
September-October 2014, 6(5):199-207
DOI:10.4103/1947-489X.210386  
Objectives: We aimed to 1) compare the lipid profiles in hemodialysis patients and healthy controls, 2) find out if there are any differences in lipid profiles between diabetic and non-diabetic patients on hemodialysis and 3) investigate the effects of age, sex, and duration of dialysis on the lipid profiles in hemodialysis patients. Settings: The study was conducted in the hemodialysis unit in Jenin district at The Martyr Dr. Khalil Sulaiman Hospital of Jenin city for one calendar year. Patients and Methods: Seventy one patients who were not receiving any lipid lowering therapy were included; of these 26 had diabetes. Age-matched 98 healthy persons served as controls. Total cholesterol, triglycerides, HDL-cholesterol, and LDL-cholesterol levels were determined and two atherogenic indices (i.e. TC/HDL-C and LDL-C/HDL-C ratios) were calculated for patients and controls. Independent sample T-test, Pearson's correlation factor, one way ANOVA, and LSD multiple comparison test was used to test the significance of the results. P values < 0.05 were considered as significant. Results: The results showed that hemodialysis patients have a significantly higher triglycerides and VLDL-C levels and lower HDL-C levels compared to controls. There were no statistically significant differences in total cholesterol or LDL-C levels, on the other hand, hemodialysis patients have a significantly higher TC/HDL-C and LDL-C/HDL-C ratios compared to controls. The lipid profile of diabetic hemodialysis patients is generally similar to the lipid profile of non-diabetics except that diabetic hemodialysis patients have a significantly lower HDL-C levels and a significantly higher TC/HDL-C and LDL-C/HDL-C ratios compared to non-diabetics reflecting the additional impact of diabetes on lipid profile. The lipid profile of hemodialysis patients seems to be independent of age, sex, or duration of dialysis. Conclusions: Hemodialysis patients, particularly those with diabetes, have an adverse lipid profile. This is likely contributing to the increased mortality rates. Further studies are needed to ascertain the cardiovascular abnormalities and elucidate the causes of death among hemodialysis patients specifically in our population. Abbreviations: TC: total cholesterol; TG: triglycerides; HDL-C: high density lipoprotein cholesterol, VLDL-C: very low density lipoprotein cholesterol;
[ABSTRACT]   Full text not available  [PDF]
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PATHOLOGY CORNER
The morphologic identification of common organisms that may look alike in the general pathology practice: A brief review
Jenna Boué, Basil M Kahwash, Sean Kirby, Samir B Kahwash
September-October 2014, 6(5):227-234
DOI:10.4103/1947-489X.210391  
Surgical Pathologists often rely on morphologic features in identifying organisms in their general practice. The aim of this paper is to provide a brief practical and illustrated reference, comparing the morphologic features of organisms commonly encountered in the general practice of pathology. This comparison will focus on pairs of organisms that may look alike, resulting in diagnostic difficulties. These paired look–alike organisms include: Histoplasma Capsulatum versus Pneumocystis, Falciparum Malaria versus Babesia Microti, Pseudohyphae (of Candida) versus True Fungal Hyphae (of Aspergillus), Septate Hyphae (as in Aspergillus) versus Aseptate Hyphae (as in Mucor), Fungal Hyphae versus Artifact, and Antibiotic-Altered Bacteria versus Other organisms. Key distinguishing morphologic features are compared to help avoid diagnostic pitfalls.
[ABSTRACT]   Full text not available  [PDF]
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