Home | About us | Editorial board | Search | Ahead of print | Current issue | Archives | Submit article | Instructions | Subscribe | Advertise | Contacts | Login
  Users Online: 517 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
   Table of Contents - Current issue
Coverpage
July-September 2019
Volume 9 | Issue 3
Page Nos. 89-121

Online since Monday, July 1, 2019

Accessed 3,670 times.

PDF access policy
Journal allows immediate open access to content in HTML + PDF

EPub access policy
Full text in EPub is free except for the current issue. Access to the latest issue is reserved only for the paid subscribers.
View as eBookView issue as eBook
Access StatisticsIssue statistics
RSS FeedRSS
Hide all abstracts  Show selected abstracts  Export selected to  Add to my list
ORIGINAL ARTICLES  

Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia p. 89
Abdulaziz Alobaid, Samer Ahmeed, Mohammed Abuzaid, Latifa Aldakhil, Ahmed Abu-Zaid
DOI:10.4103/ajm.AJM_188_18  
Objective: To report our single-center experience in terms of patient clinical characteristics, treatment outcomes, and chemotherapy-related toxicities in patients with low-risk gestational trophoblastic neoplasia (GTN). Materials and Methods: A retrospective cross-sectional study (2008–2013) was conducted at a tertiary health-care hospital in Saudi Arabia. Forty-four (n = 44) patients met the inclusion criteria for low-risk GTN. Methotrexate (MTX) was administered in a 5-day regimen: 0.3–0.5mg/kg intravenously (IV) daily for 5 days every 2 weeks (maximum 25mg per dose). Actinomycin D (ActD) was administered 1.25mg/m2 pulsed IV every 2 weeks. Results: The majority of patients had molar pregnancy as the antecedent event (86%), developed GTN within the first 4 months after the initial evacuation (93.2%), had human chorionic gonadotropin levels between 1,000 and 10,000 mIU/dL (36.3%), and had the World Health Organization prognostic scores from 0 to 2 (48.7%). Only 38 patients accepted treatment with chemotherapy. A total of 37 patients received first-line MTX; 34 patients of them achieved complete remission (CR, 92%). The three patients who developed MTX resistance were salvaged with sequential ActD and all achieved CR of 100%. Only one patient received first-line ActD and achieved CR. The overall survival as well as cure rate for all patients with low-risk GTN was 100%. No patient developed MTX-related hepatic toxicity or ActD-related blister formation. No severe adverse effects occurred. Conclusion: Our 5-day IV MTX regimen was highly effective in treating patients with low-risk GTN, with CR rate of 92% and no severe toxicity. Primary and sequential ActD therapy appears to be very effective.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Women’s health in Northwestern Syria: Findings from Healthy-Syria 2017 study p. 94
Abdullah Sulieman Terkawi, Basil Bakri, Amena S Alsadek, Rawaa H Alsibaee, Esraa M Alasfar, Amna H Albakour, Abdulhannan Y Aljouja, Nour A Alshaikhwais, Feras A Fares, Pamela D Flood, Hussam Jnaid, Amina A Najib, Diaa A Saloom, Noran A Zahra, Khalid A Altirkawi
DOI:10.4103/ajm.AJM_190_18  
Objectives: Since the uprising in 2011, there have been limited health-care data from inside Syria regarding women’s health. This study aimed to provide an updated account of women’s health, including pregnancy, perinatal care, childbirth, and other conditions to identify obstacles and challenges to health-care delivery in Northwestern Syria. Methods: This is a prospective data registry study, using a medical electronic records system that builds on the International Classification of Diseases, Tenth Revision (ICD-10) codes. We collected data from one medical center in Northwestern Syria during 2017. We conducted a survey to understand patients’ knowledge of and barriers limiting antenatal care (ANC). Results: We studied 7213 patients’ health status and surveyed 134 regarding ANC. Prenatal care, delivery, and miscarriage treatment represented the most common (70%) reasons for women’s health-care visits, followed by menstrual disorders (17%). From 2057 delivery records, 70% delivered vaginally and 30% required cesarean delivery. Our findings showed that 1169 (24%) of the pregnant women (4936) in 2017 were adolescents, of them 22 (0.44%) were 14 years old. Regarding ANC visits, 85% of respondents did not have a single ANC visit in the first trimester, 82% had no visits in the second trimester, and 44% had no visits in the third trimester. Thirty-one percent had no ANC visit throughout the entire pregnancy. Only 13% had postnatal care (PNC) visits. Women who live in the refugee camp are 2.7 times less likely to meet the World Health Organization (WHO) criteria for focused ANC (FANC = 4 visits) compared to those who reside in town (P < 0.001), with only 14% having met the FANC. The major barrier to ANC is related to transportation (34%), followed by factors related to the study center (29%) and knowledge and education (19%). We estimated the number of obstetrics-gynecology doctors per 1000 populations to be 0.02. Conclusions: We found a huge deficiency in ANC and PNC visits, a high adolescent birth rate, and a higher cesarean-to-vaginal delivery ratio than what is recommended by the WHO. We also found a severe shortage in the number of obstetrician-gynecologists serving this population.
[ABSTRACT]  [HTML Full text]  [PDF]  [Sword Plugin for Repository]Beta
BRIEF REPORT Top

Overprescription of antibiotics in patients with community-acquired pneumonia in the intensive care unit p. 107
Rorak Hooten, Jose Luis Marquez, Kady Goldlist, Rafael Urcis, Matthew Adams, Kathryn R Matthias, David E Nix, Mayar Al Mohajer
DOI:10.4103/ajm.AJM_189_18  
Purpose: We aimed to assess factors associated with therapy failure in patients with community-acquired pneumonia in the intensive care unit (ICU). Methods: Electronic charts of patients with International Classification of Diseases, Ninth Revision, codes of pneumonia who were admitted to the ICU at a tertiary academic medical center in Southern Arizona were reviewed. Results: Antipseudomonal coverage and anti-methicillin-resistant Staphylococcus aureus (MRSA) coverage were often prescribed (58.4% and 54.1%, respectively). Antipseudomonal coverage was rarely necessary as pseudomonal pneumonia was found in only one case (0.9%). Antipseudomonal and anti-MRSA coverage was not associated with improved outcomes. Conclusion: Overprescription of antibiotics in this population remains a significant problem. More work is needed to further limit unnecessary antibiotic use.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

Sweet hydrothorax: a common presentation of a rare condition p. 111
Mohamad Alhoda Mohamad Alahmad, Rahil Kasmani
DOI:10.4103/ajm.AJM_131_18  
Sweet hydrothorax is a known, yet rare, complication of peritoneal dialysis. It can be life-threatening. This case is about a 70-year-old lady who presented with acute respiratory failure due to massive right-sided hydrothorax that developed insidiously over 3 months of starting peritoneal dialysis. Thoracentesis and technetium scan confirmed the diagnosis. Treatment was successful with hemodialysis.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Late presentation of anomalous left coronary artery arising from pulmonary artery with acute coronary syndrome p. 115
Monika Bhandari, Pravesh Vishwakarma, Akshyaya Pradhan, Rishi Sethi
DOI:10.4103/ajm.AJM_186_18  
Congenital anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is associated with early infant mortality and adult sudden death. The use of advanced cardiac imaging has resulted in an increase in the number of diagnosed ALCAPA cases, especially in the adult population, sometimes even asymptomatic. The extent of collateral circulation that develops between the right coronary artery (RCA) and left coronary artery (LCA) determines the outcomes. We present a case of hitherto undiagnosed case of ALCAPA, with first presentation as acute coronary syndrome (ACS) in young male.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Focal seizure as a manifestation of serotonin syndrome: case report p. 119
Eyad Almallouhi, Mohamad Rahwan, Helen Dainton, Leonardo Bonilha
DOI:10.4103/ajm.AJM_7_19  
Serotonin syndrome is a life-threatening condition. Seizure is one of the complications of serotonin syndrome that may delay diagnosis and complicate management. We report a patient who had a focal seizure with abnormal electroencephalogram in the setting of serotonin syndrome with no prior history of epilepsy or seizure-provoking factors (fever, electrolyte abnormalities, specific medication combinations, and specific medication overdosing). Recognition of seizure as a symptom of serotonin syndrome is important for early treatment and avoidance of long-term consequences. Treatment of serotonin syndrome is mostly supportive. However, a short course of antiepileptics may be needed if these patients develop seizures.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
  Feedback 
  Subscribe 

Subscribe this journal
Submit articles
Most popular articles
Joiu us as a reviewer
Email alerts
Recommend this journal