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   Table of Contents - Current issue
Coverpage
April-June 2020
Volume 10 | Issue 2
Page Nos. 61-92

Online since Wednesday, April 1, 2020

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ORIGINAL ARTICLES  

Update on the etiology, classification, and management of glomerular diseases p. 61
Mohammad Tinawi
DOI:10.4103/ajm.ajm_136_19  
In this brief review, the reader will find a timely update regarding some of the most commonly encountered glomerular diseases. The review will include an update on the etiology with a focus on new genetic and molecular discoveries. New classifications will be elucidated, and management will be updated in broad strokes. Illustrative pathology slides will be used as appropriate. It is critical for the reader to realize from the outset that terminology such as focal segmental glomerulosclerosis and crescentic glomerulonephritis represent a pattern of injury rather than a specific disease. Whenever possible, the specific etiology and pathogenesis of a given pattern should be sought. It is also important to know that the same disease or mechanism can cause multiple patterns of injury, whereas the same pattern of injury can be the result of multiple disease or mechanisms.
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How to read a published clinical trial: A practical guide for clinicians p. 68
Mohamad B Sonbol, Belal M Firwana, Talal Hilal, Mohammad Hassan Murad
DOI:10.4103/ajm.ajm_186_19  
Over the last 5 years, there have been more than 140 new drug approvals in the field of Oncology alone, all based on newly published clinical trials. These approvals have led to an ongoing change in clinical practice, offering new therapeutic options for patients. Therefore, it is important for healthcare providers to be able to appraise a clinical trial and determine its validity, understand its results, and be able to apply such results to their patients. In this guide, we provide a simplified approach tailored to practicing clinicians and trainees. The same concepts and principles apply to other medical specialties.
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Technology’s role in promoting physical activity and healthy eating in working rural women: A cross-sectional quantitative analysis p. 76
Sharon S Laing, Muhammad Alsayid, Katheryn Christiansen, Kathleen Shannon Dorcy
DOI:10.4103/ajm.ajm_175_19  
Aims: This exploratory study evaluated sociodemographic predictors of healthy eating and physical activity (PA) in a sample of working rural women and their access to and interest in using technology for health promotion. Settings and Design: This study is a cross-sectional quantitative analysis. Materials and Methods: A 32-item questionnaire was administered to a convenience sample of N = 60 women, working at a regional healthcare facility in the Pacific Northwest. Statistical Analysis: Descriptive statistics characterized PA and healthy eating, barriers and support for PA and healthy eating, and perceived role of technology for health promotion. Chi-square tests for categorical variables evaluated relationships between PA and healthy eating support with behavioral engagement. Results: Only 23% and 25% followed recommended PA and fruit and vegetable consumption guidelines. Those likely to engage in preventive care had higher income and education. Fewer respondents reported barriers to PA than for healthy eating (47% vs. 57%), and those reporting barriers were likely to have lower income and less than a high-school education. Sixty percent reported social support for PA and only 52% for healthy eating. A significant relationship was evident between PA support and PA engagement (P = 0.015). Eighty-two percent used mobile phones to look up health information and 29% did so daily. Almost two-thirds (62%) reported likelihood of using online health information boards to support healthy eating and 45% for PA. Conclusion: Working rural women benefit from PA and healthy eating guidance. Attention to sociodemographic predictors may support a tailored digital healthcare approach to promote wellness in this community.
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CASE REPORTS Top

Xanthoma disseminatum with extensive respiratory involvement effectively treated with cladribine: A case report p. 83
Heba Al-Tarcheh, Shahed Tish, Salloum Salloum, Ahed Haj Ibrahim
DOI:10.4103/ajm.ajm_177_19  
Xanthoma disseminatum (XD) is a rare and benign proliferative systemic disease that usually affects the skin and mucosal membranes with variable extent. Extensive systemic involvement can be associated with higher morbidity. There is paucity in the literature describing this rare pathological entity, and the ideal management remains controversial. In this article, we report our experience with cladribine in treating a case of XD. We documented the clinical and pathological manifestations of a 24-year-old woman who was initially diagnosed with rheumatoid arthritis. She presented to our institute with respiratory compromise and was found to have XD affecting skin, mucosal membranes, joints, and bone marrow. The patient received six cycles of cladribine for 6 months, during which she showed a remarkable response in relation to the respiratory lesions. Her hemoglobin also normalized and inflammatory markers gradually decreased to reach normal values. However, her skin lesions did not respond to treatment but no new lesions appeared. With our experience with cladribine, we believe that it could be a promising treatment option for XD. However, more work has to be conducted to determine the efficacy and safety in the long term.
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Mediastinal lymphoma-induced superior vena cava syndrome and chylopericardium in a pregnant lady: A case report p. 89
Omar S Obeidat, Bayan A Baniissa, Zakaria W Shkoukani, Abdullah N Alhouri
DOI:10.4103/ajm.ajm_51_19  
Mediastinal malignancies are a commonly identified etiology in superior vena cava syndrome (SVCS), and despite the known management of chemotherapy, radiotherapy, or a combination of both, this can prove to be a dilemma during pregnancy. Reported cases of SVCS management during pregnancy are scarce. Chylopericardium is a rare entity with a myriad of causes, the most common of which is a primary idiopathic origin. Initial management depends on the presence or absence of cardiac tamponade. Long-term therapy is a matter of serious debate, with some opting for conservative treatment, and others favoring a more invasive surgical approach. Cases reporting the occurrence of chylopericardium in association with pregnancy are also limited. In this report, we discuss the case of a 28-year-old pregnant woman who had both SVCS and chylopericardium as a result of a mediastinal lymphoma.
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