Avicenna Journal of Medicine最新文献

{"title":"MPIG6B Gene-Related Myelofibrosis: A Rare Inherited Disease That Is Frequently Described in Arab Population.","authors":"Leen Jihad Attar, Almothana Alelaimat, Alaa Alshorman, Tariq N Aladily","doi":"10.1055/s-0044-1779697","DOIUrl":"https://doi.org/10.1055/s-0044-1779697","url":null,"abstract":"<p><p>The megakaryocyte and platelet inhibitory receptor gene G6P (MPIG6B) is located on chromosome 6p21.33. It encodes G6b-B; an inhibitory receptor expressed on the surface of platelets. It regulates platelets production, aggregation, and activation. We describe a case of a 31-year-old man who presented with a long history of thrombocytopenia, anemia, and hepatosplenomegaly. The patient received multiple blood transfusions and his clinical course was stable. A bone marrow biopsy showed morphologic features similar to primary myelofibrosis. Whole exome sequencing study was performed and revealed homozygous pathogenic mutation in exon 2 of MPIG6B gene (c.324C > A, p.Cys108Ter) that is the second reported case in literature. In this report, we describe the main clinical and pathologic features of this disease and review the literature of previously documented cases.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plastic Surgeon versus Orthopedic Surgeon: Where Would You go for Your Hand Injury? A Cross-Sectional Study in Saudi Arabia","authors":"Muna F. Alnaim, N. Alrabiah, Hanan Ahmed M Al Kaabi, Basem Zogel, Samar Alfaifi, Nora Ibrahim AlMssallem, B. Al-Dhafer","doi":"10.1055/s-0044-1779487","DOIUrl":"https://doi.org/10.1055/s-0044-1779487","url":null,"abstract":"\u0000 Background Hand surgery has become a well-established medical specialty in recent years, with many highly trained hand surgeons practicing in various cities throughout Saudi Arabia. It is crucial to assess the public's knowledge and awareness regarding hand surgery specialists and to identify the existence of bias in the public's perception of plastic and Orthopedic surgeons.\u0000 Methods A self-administered questionnaire was designed and disseminated to adults in Saudi Arabia via Google Forms. The questionnaire addressed participants' knowledge about which type of surgeon they would consult for various hand-related issues.\u0000 Results A total of 716 participants were surveyed. Most believed Orthopedic surgeons were more qualified for hand surgeries than plastic surgeons. Furthermore, the public seemed to feel safer with Orthopedic surgeons regarding complications. There was a misconception regarding plastic surgeons' qualifications, with only 24.4% recognizing that all plastic surgeons could perform hand surgery. The majority also held misconceptions regarding Orthopedic surgeons' qualifications for hand surgery. Gender and educational level influenced the responses, with females and those with bachelor's degrees or higher showing slightly more knowledge.\u0000 Conclusion There is a need for increased public awareness and education regarding the qualifications and capabilities of both plastic and Orthopedic surgeons in hand surgeries. Both specialties are well-trained and competent in this area, and the choice should be based on the specific needs and circumstances of the patient.","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139795886","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}

{"title":"Plastic Surgeon versus Orthopedic Surgeon: Where Would You go for Your Hand Injury? A Cross-Sectional Study in Saudi Arabia","authors":"Muna F. Alnaim, N. Alrabiah, Hanan Ahmed M Al Kaabi, Basem Zogel, Samar Alfaifi, Nora Ibrahim AlMssallem, B. Al-Dhafer","doi":"10.1055/s-0044-1779487","DOIUrl":"https://doi.org/10.1055/s-0044-1779487","url":null,"abstract":"\u0000 Background Hand surgery has become a well-established medical specialty in recent years, with many highly trained hand surgeons practicing in various cities throughout Saudi Arabia. It is crucial to assess the public's knowledge and awareness regarding hand surgery specialists and to identify the existence of bias in the public's perception of plastic and Orthopedic surgeons.\u0000 Methods A self-administered questionnaire was designed and disseminated to adults in Saudi Arabia via Google Forms. The questionnaire addressed participants' knowledge about which type of surgeon they would consult for various hand-related issues.\u0000 Results A total of 716 participants were surveyed. Most believed Orthopedic surgeons were more qualified for hand surgeries than plastic surgeons. Furthermore, the public seemed to feel safer with Orthopedic surgeons regarding complications. There was a misconception regarding plastic surgeons' qualifications, with only 24.4% recognizing that all plastic surgeons could perform hand surgery. The majority also held misconceptions regarding Orthopedic surgeons' qualifications for hand surgery. Gender and educational level influenced the responses, with females and those with bachelor's degrees or higher showing slightly more knowledge.\u0000 Conclusion There is a need for increased public awareness and education regarding the qualifications and capabilities of both plastic and Orthopedic surgeons in hand surgeries. Both specialties are well-trained and competent in this area, and the choice should be based on the specific needs and circumstances of the patient.","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139855731","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}

{"title":"A Systematic Review and Meta-Analysis of the Outcomes of Laparoscopic Cholecystectomy Compared to the Open Procedure in Patients with Gallbladder Disease.","authors":"Debajit Kumar Roy, Rahaman Sheikh","doi":"10.1055/s-0043-1777710","DOIUrl":"https://doi.org/10.1055/s-0043-1777710","url":null,"abstract":"<p><p><b>Background</b>  Conflicting evidence regarding the laparoscopic versus open cholecystectomy outcomes in scientific literature impacts the medical decision-making for patients with gallbladder disease. This study aimed to compare a range of primary and secondary outcomes between patients receiving laparoscopic cholecystectomy and those with open intervention. <b>Methods</b>  Articles published from 1993 to 2023 were explored by utilizing advanced filters of PubMed Central/Medline, Web of Science, CINAHL, JSTOR, Cochrane Library, Scopus, and EBSCO. The gallbladder disease was determined by the presence of one or more of the following conditions: 1) Gangrenous cholecystitis, 2) acute cholecystitis, 3) chronic gallbladder diseases, and 4) cholelithiasis. The primary end-point was mortality, while the secondary outcome included (1) bile leakage, 2) common bile duct injury, 3) gangrene, 4) hospital stay (days), 5) major complications, 6) median hospital stay (days), (7) pneumonia, 8) sick leaves (days), and 9) wound infection. <b>Results</b>  Statistically significant reductions were observed in mortality (odds ratio [OR]: 0.30, 95% confidence interval [CI]: 0.30, 0.45, <i>p</i>  < 0.00001), mean hospital stay duration (mean difference: -2.68, 95% CI: -3.66, -1.70, <i>p</i>  < 0.00001), major complications (OR: 0.35, 95% CI: 0.19, 0.64, <i>p</i>  = 0.0005), post/intraoperative wound infection (OR: 0.29, 95% CI: 0.16, 0.51, <i>p</i>  < 0.0001), and sick leaves (OR: 0.34, 95% CI: 0.14, 0.80, <i>p</i>  = 0.01) in patients who underwent laparoscopic cholecystectomy compared with those with the open intervention. No statistically significant differences were recorded between the study groups for bile leakage, common bile duct injury, gangrene, median hospital stay days, and pneumonia ( <i>p</i>  > 0.05). <b>Conclusions</b>  The pooled outcomes favored the use of laparoscopic cholecystectomy over the open procedure in patients with gallbladder disease. The consolidated findings indicate the higher impact of laparoscopic cholecystectomy in improving patient outcomes, including safety episodes, compared with open cholecystectomy.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Intensive Care Unit Admissions in Patients Presenting with Coronavirus Disease 2019.","authors":"Lahib Douda, Heraa Hasnat, Jennifer Schwank, Sarien Nassar, Nancy M Jackson, Jeffrey C Flynn, Joseph Gardiner, Dawn P Misra, Abdulghani Sankari","doi":"10.1055/s-0043-1778068","DOIUrl":"https://doi.org/10.1055/s-0043-1778068","url":null,"abstract":"<p><p><b>Background</b>  Increased mortality rates among coronavirus disease 2019 (COVID-19) positive patients admitted to intensive care units (ICUs) highlight a compelling need to establish predictive criteria for ICU admissions. The aim of our study was to identify criteria for recognizing patients with COVID-19 at elevated risk for ICU admission. <b>Methods</b>  We identified patients who tested positive for COVID-19 and were hospitalized between March and May 2020. Patients' data were manually abstracted through review of electronic medical records. An ICU admission prediction model was derived from a random sample of half the patients using multivariable logistic regression. The model was validated with the remaining half of the patients using c-statistic. <b>Results</b>  We identified 1,094 patients; 204 (18.6%) were admitted to the ICU. Correlates of ICU admission were age, body mass index (BMI), quick Sequential Organ Failure Assessment (qSOFA) score, arterial oxygen saturation to fraction of inspired oxygen ratio, platelet count, and white blood cell count. The c-statistic in the derivation subset (0.798, 95% confidence interval [CI]: 0.748, 0.848) and the validation subset (0.764, 95% CI: 0.706, 0.822) showed excellent comparability. At 22% predicted probability for ICU admission, the derivation subset estimated sensitivity was 0.721, (95% CI: 0.637, 0.804) and specificity was 0.763, (95% CI: 0.722, 0.804). Our pilot predictive model identified the combination of age, BMI, qSOFA score, and oxygenation status as significant predictors for ICU admission. <b>Conclusion</b>  ICU admission among patients with COVID-19 can be predicted by age, BMI, level of hypoxia, and severity of illness.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disadvantaged Patients, Health Care Providers, and Natural Disaster Preventive Planning.","authors":"Ahmed Alnajar","doi":"10.1055/s-0043-1778069","DOIUrl":"https://doi.org/10.1055/s-0043-1778069","url":null,"abstract":"","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Sarcomas of the Larynx: A Case Series of Four Different Histopathologic Types","authors":"Ala S. Abu-Dayeh, Khaled A. Murshed, Adham Ammar, M. Petkar","doi":"10.1055/s-0043-1775997","DOIUrl":"https://doi.org/10.1055/s-0043-1775997","url":null,"abstract":"Abstract Primary laryngeal sarcomas are rare. Their nomenclature and classification are similar to soft tissue counterparts; however, there are notable differences between clinical presentation, behavior, treatment, and follow-up. There is sparse information regarding the clinical features, biologic behavior, and treatment modalities of laryngeal sarcomas. To increase our understanding about these tumors, we describe herein an additional series of four cases of different pathologic types of laryngeal sarcomas, including low-grade chondrosarcoma, leiomyosarcoma, well-differentiated liposarcoma, and undifferentiated pleomorphic sarcoma. Our main aim is to upsurge awareness about the morphologic variations of laryngeal sarcomas, to avoid potential pitfalls during histopathologic examination. It is essential to ensure that correct diagnosis, subclassification, and grading are achieved for proper guidance of treatment and clinical follow-up at multidisciplinary team meetings.","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584560","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}

{"title":"Nasoenteric Tube Placement in Patients with Esophageal Varices: A Review of the Current Evidence and Society Guidelines","authors":"Osama Qasim Agha, Muhammad Alsayid, Justin Reynolds","doi":"10.1055/s-0043-1776338","DOIUrl":"https://doi.org/10.1055/s-0043-1776338","url":null,"abstract":"Abstract Esophageal varices are a common complication of portal hypertension and variceal bleeding can be associated with significant morbidity and mortality. Hospitalized patients with cirrhosis might require nasoenteric tube (NET) placement, commonly for nutritional support and/or medication administration. However, the fear of causing massive variceal bleeding among clinicians might lead to hesitancy or complete avoidance of NET placement in patients who either have a known history of esophageal varices or are at risk to have them. Several experts and society guidelines addressed this concern with variable recommendations and degrees of evidence. In this article, we present an extensive review of the literature and latest society guidelines that address the safety of NET placement in patients with esophageal varices.","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138626565","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}

{"title":"Inpatient Outcomes for Myocarditis-Related Heart Failure","authors":"Mohammad Alabbas, Cheryl Gibson, Abdulrahman Morad, Mohammad Alhoda Mohammad Alahmad","doi":"10.1055/s-0043-1776141","DOIUrl":"https://doi.org/10.1055/s-0043-1776141","url":null,"abstract":"Abstract Background Heart failure (HF) is one of the leading causes of hospitalizations among adults, accounting for high rates of morbidity and mortality in the United States. Myocarditis is a less common etiology of HF, and its outcomes are less well understood. Methods We used the Nationwide Readmissions Database from 2016 to 2019, extracting adult patients with a primary diagnosis of HF who were admitted between January and November of each year studied. We excluded patients with missing data on event time or length of stay. Inpatient outcomes were compared between cases of HF without myocarditis and myocarditis-associated HF (MAHF). Survey procedures were applied. Propensity scores as covariates were used in survey-weighted models to estimate the population average treatment effect on the treated using SAS 9.4. Results We included 4,454,272 HF-related weighted admissions for which 4,605 patients (0.1%) had a concurrent diagnosis of myocarditis. Overall, patients with MAHF, compared with HF without myocarditis, were younger (mean age: 53 years vs. 72 years, p < 0.001) with fewer women (45 vs. 48%), respectively. Patients with MAHF had more inpatient complications including cardiac arrest, cardiogenic shock, and use of mechanical circulatory support (p < 0.001) despite having fewer comorbidities such as diabetes, hypertension, and renal disease. Patients with MAHF had longer mean lengths of stay (9.2 vs. 5.5 days, p < 0.001). In-hospital mortality during index admission was significantly higher in MAHF at 3.9% compared with 2.8% for HF without myocarditis (p < 0.001). Myocarditis was a key predictor of inpatient mortality adjusting for risk factors. Conclusion Myocarditis-related HF is associated with increased inpatient mortality, resource utilization, and prolonged hospitalization.","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135872933","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}

{"title":"Role of Multidisciplinary Team Meetings in the Diagnosis and Management of Diffuse Parenchymal Lung Diseases in a Tertiary Care Hospital","authors":"Mohammad Ayaz Khan, Nahid Sherbini, Sami Alyami, Abdullah Al-Harbi, Suliman Alrajhi, Reem Abdullah, Dhafer AlGhamdi, Rajkumar Rajendram, Hana Bamefleh, Hamdan Al-Jahdali","doi":"10.1055/s-0043-1776063","DOIUrl":"https://doi.org/10.1055/s-0043-1776063","url":null,"abstract":"Abstract Background Decisions on the management of interstitial lung diseases (ILD) and prognostication require an accurate diagnosis. It has been proposed that multidisciplinary team (MDT) meetings for ILD (ILD-MDT) improve these decisions in challenging cases of ILD. However, most studies in this field have been based on the decisions of individual clinicians and there are few reports on the outcomes of the ILD-MDT approach. We therefore describe the experience of the ILD-MDT meetings at our institution. Methods A single-center retrospective review of the electronic health care records of patients discussed in the ILD-MDT meetings at our institution from February 2016 to January 2021 was performed. At out institution, at each ILD-MDT meeting, the referring pulmonologist presents the clinical history and the results of all relevant investigations including serology, blood gas analyses, lung function tests, bronchoscopy, and bronchoalveolar lavage. A radiologist then describes the imaging including serial computed tomography (CT) scans. When available, the findings on lung biopsy are presented by a pathologist. Subsequent discussions lead to a consensus on the diagnosis and further management. Results The study included 121 patients, comprising 71 (57%) males and 76 nonsmokers (62.8%), with a mean age of 65 years (range: 25–93 years). The average number of comorbidities was 2.4 (range: 0–7). Imaging-based diagnoses were usual interstitial pneumonia (UIP)/chronic hypersensitivity pneumonitis (CHP) in 32 (26%) patients, UIP in 20 (17%) patients, probable UIP in 27 (22%) patients, nonspecific interstitial pneumonia in 11 (9%) patients, and indeterminate interstitial lung abnormalities (ILA) in 10 (8%) patients. The most common consensus clinical diagnosis after an ILD-MDT discussion was chronic hypersensitivity pneumonitis/idiopathic pulmonary fibrosis in 17 patients (14%), followed by idiopathic pulmonary fibrosis and connective tissue disease associated interstitial lung disease in 16 patients (13%), CHP in 11 patients (9.1%), and ILA in 10 patients (8.4%). Only a 42 patients (35%) required surgical lung biopsy for confirmation of the diagnosis. Conclusion This study describes the characteristics of the patients discussed in the ILD-MDT meetings with emphasis on their clinical, radiological, and laboratory data to reach a diagnosis and management plan. The decisions on commencement of antifibrotics or immunosuppressive therapy for patients with various ILDs are also made during these ILD-MDT meetings. This descriptive study could help other health care professionals regarding the structure of their ILD-MDT meetings and with discussions about diagnostic and care decisions for diffused parenchymal lung disease patients.","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135327422","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}