Journal of Clinical Research and Case Studies最新文献

{"title":"Helicobacter Pylori: A Belittled Cause of Immune Thrombocytopenic Purpura (ITP) and Role of Helicobacter Pylori Eradication Therapy for Treating ITP","authors":"Richmond R Gomes","doi":"10.61440/jcrcs.2023.v1.09","DOIUrl":"https://doi.org/10.61440/jcrcs.2023.v1.09","url":null,"abstract":"Immune thrombocytopenic purpura (ITP) is an autoimmune disease characterized by production of auto antibodies against platelet surface antigens. ITP affects women more often than men and is more common in children than adults. ITP is a diagnosis of exclusion after other identifiable etiologies have been ruled out. After the first report by Gasbarrini et al. showing rising platelet counts in ITP patients following Helicobacter pylori (HP) eradication therapy, there is growing evidence that highlights the role of HP in triggering ITP. The H-pylori infection induced ITP is validated by many proposed mechanisms such as molecular mimicry due to production of auto antibodies against H-pylori surface virulent factors (CagA) and cross reactivity of these antibodies with platelet surface antigens (GP IIb/IIIa, GP Ib/IX, and GP Ia/IIa), phagocytic perturbation due to enhanced phagocytic activity of monocytes, enhanced dendritic cell numbers and response, platelets aggregation due to presence of anti- H-pylori IgG and von Willebrand factor (vWf) and finally host immune response against H-pylori virulent factors CagA and VacA leading to ITP. Eradication of Helicobacter pylori infection has been variably associated with a platelet response in patients with immune thrombocytopenic purpura (ITP). Eradication therapy is simple and inexpensive, with limited toxicity and the advantage of avoiding long-term immunosuppressive treatment for those who respond. Although the evidence and follow-up are limited, it appears reasonable to routinely screen patients with ITP for H pylori, particularly in those populations with a high background prevalence of H pylori infection.","PeriodicalId":472378,"journal":{"name":"Journal of Clinical Research and Case Studies","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136364850","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":"Exploring the Promise of Ketamine Therapy for Autism: Benefits and Brain Changes","authors":"Ryan Ward","doi":"10.61440/jcrcs.2023.v1.11","DOIUrl":"https://doi.org/10.61440/jcrcs.2023.v1.11","url":null,"abstract":"Autism is a neurodevelopmental disorder that affects communication and social interaction abilities. While there are various therapeutic options available for autism, there is growing evidence suggesting that ketamine therapy could be a promising treatment for autism spectrum disorder (ASD). Ketamine is a dissociative anesthetic that has been used for decades in anesthesia and pain management, but recently has been shown to have promising effects on a variety of psychiatric conditions, including autism. In this article, we will explore the benefits of ketamine therapy on autism and the specific changes that occur in the brain.","PeriodicalId":472378,"journal":{"name":"Journal of Clinical Research and Case Studies","volume":"252 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136364847","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":"First Tirone David’s Intervention in Mali: About a Case at the Festoc Centre in Bamako","authors":"Diarra BI, Doumbia M, Coulibaly B, Togo S, Daffe S, Doucoure O, Koita S, Ouattara MA","doi":"10.61440/jcrcs.2023.v1.13","DOIUrl":"https://doi.org/10.61440/jcrcs.2023.v1.13","url":null,"abstract":"Surgery to replace the aortic root with a valved tube, whether mechanical or biological, remains the most widely used technique for the correction of diseases affecting this aortic segment [1]. Although mechanical valves are usually used, they expose patients to the risk of thromboembolic complications associated with anticoagulation. We report on the first Tirone David procedure performed at the Festoc center in Bamako. A 60-year-old patient was referred to us for dilatation of the ascending aorta in the context of stage 3 dyspnea. Physical examination revealed a Musset’s sign and a diastolic murmur of intensity 3/6 at the aortic focus. Ultrasound revealed severe aortic insufficiency associated with dilation of the ascending aorta, with the aortic annulus measured at 23.5 mm, the sinus at 50 mm and the sino-tubular junction at 61 mm. Thoracic angioscan showed a saccular aneurysm of the initial segment of the ascending aorta. Coronary angiography was normal. Surgery was performed to replace the ascending aorta, preserving the aortic valve and re-implanting the coronary arteries. The postoperative course was marked by the onset of a haemorrhagic syndrome with pre-buffering, which prompted repeat surgery 24 hours after the first operation. The outcome was favorable, with the drains removed 48 hours later.","PeriodicalId":472378,"journal":{"name":"Journal of Clinical Research and Case Studies","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136364849","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":"Case Report of High Dose Factor rVIIa in a Child","authors":"Housam Almadani, Mohammed Zein, Saleh Alzahrani, Mohammad Almelibari, Mohammed Elhefnawy, Soltan Hasan","doi":"10.61440/jcrcs.2023.v1.10","DOIUrl":"https://doi.org/10.61440/jcrcs.2023.v1.10","url":null,"abstract":"The maximum tolerated dose of recombinant factor VIIa without significant toxicity is not studied in a clinical trial. Separate case reports of accidental intake of high dose recombinant factor VIIa were reported. This case report describes an exposure of an infant with congenital factor VII deficiency to a high dose of recombinant factor VIIa (300 μg. /kg).","PeriodicalId":472378,"journal":{"name":"Journal of Clinical Research and Case Studies","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136364846","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":"Preliminary Results of Ventricular Septal Defect Surgery in Festoc Center in Bamako","authors":"Diarra BI, Ouattara MA, Coulibaly B","doi":"10.61440/jcrcs.2023.v1.12","DOIUrl":"https://doi.org/10.61440/jcrcs.2023.v1.12","url":null,"abstract":"Interventricular septal defects are dehiscences of the interventricular septum connecting the systemic and pulmonary circulations. The aim of this study is to report the preliminary results of the first series of intraventricular septal defects managed at the Festoc centre in Bamako. This is a mono-centric, descriptive retrospective study taking place at the FESTOC Centre in the period from 10 September 2018 to 30 April 2023. Patients of any age and sex, operated for IVC were included. Patients operated abroad were not included. We recorded 74 cases of IVC, i.e. 23.19% out of 300 cases. 61% of the patients were male, with a sex ratio of 1.56. The average age was 11 years. Symptoms were dominated by dyspnoea and recurrent bronchitis in 67.21% and 49.18% respectively. Peri-membrane and admission topography were dominant, with rates of 84% and 10%","PeriodicalId":472378,"journal":{"name":"Journal of Clinical Research and Case Studies","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136364848","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":"Clinical Epidemiological Characterization of Vaginal Infection in Pregnant. “Orlando Matos Mosquera” Polyclinic 2019-2021","authors":"Elisa Puentes Rizo M, Alejandro Aguilar Puentes, Ruben Aguilar Puentes, Mariam Machado Tejeda, Pedro Rolando López Rodríguez","doi":"10.61440/jcrcs.2023.v1.06","DOIUrl":"https://doi.org/10.61440/jcrcs.2023.v1.06","url":null,"abstract":"Introduction: Vaginal infection is a disease with a high incidence in pregnancy. It is associated with maternal-fetal complications, being early diagnosis and fundamental treatment. Objective: To clinically and epidemiologically characterize pregnant women with vaginal infection belonging to the “Orlando Matos Mosquera” Polyclinic in the period 2019-2021. Method: Observational, descriptive and cross-sectional study of pregnant women with vaginal infection. The arithmetic mean and standard deviation of the quantitative variables and the absolute frequencies and percentages in qualitative variables whose association was obtained through the Chi-square with 5% significance were obtained. Results: 245 pregnant women were analyzed. The mean age was 25 years. 42.4% were mestizo, 56.4% accompanied or single, 41.2% had an upper secondary level, and 12.7% were housewives. At least 7 out of 10 smoked or had unprotected sex. 80.8% of the examined had vaginal discharge. 75 pregnant women suffered infection by Candida albicans and the average gestational age was 18.58 ± 8.48 weeks of pregnancy, with 37.6% of vaginal infections occurring in the first trimester. 73.0% of the mixed infections had vaginal changes and 66.7% of the infections due to infrequent germs were complicated. 3 out of 10 presented premature rupture of membranes, abortion or preterm delivery. Conclusions: Adolescents and young adults, mestizos, accompanied and with a higher secondary level prevailed. Vaginal discharge as a symptom and Candida albicans infection predominated. There was an association between the variables analyzed and complications.","PeriodicalId":472378,"journal":{"name":"Journal of Clinical Research and Case Studies","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135950614","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":"Neurotransmitters of the Nervous System-Characterization and Methodological Approaches to the Study Using Monoclonal Antibodies","authors":"Maksimovich N Ye, Bon EI, Kohan NV, B Th Vihang","doi":"10.61440/jcrcs.2023.v1.05","DOIUrl":"https://doi.org/10.61440/jcrcs.2023.v1.05","url":null,"abstract":"A mediator is a physiologically active substance found in a nerve cell in a bound form, which is secreted from an excited nerve ending into the synaptic cleft and specifically acts on the receptors of the postsynaptic target cell. When a neurological stimulus reaches the end of a nerve fiber, neurotransmitters are produced, and by diffusing across the synapse, they cause the impulse to be transferred to another nerve fiber, a muscle fiber, or some other component. CNS comprises neurotransmitter indicators in the form of genes and proteins that are expressed uniquely in various cells. The major neurotransmitter indicators’ neurological, developmental, and pathological functions are demonstrated in this article.","PeriodicalId":472378,"journal":{"name":"Journal of Clinical Research and Case Studies","volume":"460 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135950616","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":"Asparagine Synthetase Deficiency Causing Recurrent Microcephaly: A Rare Case Report","authors":"Naiknaware Sachin Vijay","doi":"10.61440/jcrcs.2023.v1.04","DOIUrl":"https://doi.org/10.61440/jcrcs.2023.v1.04","url":null,"abstract":"Asparagine synthesise deficiency is rare autosomal recessive Nero- metabolic inborn error of metabolism. It mainly presents as triad of congenital microcephaly, severe developmental delay and axial hypotonia followed by spastic quadriplegia. It can manifest as microcephaly, intractable seizures and progressive cerebral atrophy. This disorder can only be diagnosed by genetic testing. Recessive mutations in ASNS are responsible for severe neurological phenotype characterised by progressive microcephaly and developmental delay.","PeriodicalId":472378,"journal":{"name":"Journal of Clinical Research and Case Studies","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135950613","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":"Determining the Necessary Amount and Dosage of Using Antioxidants in the Pregnant Women with Obesity to Prevent Adverse Outcomes Arise from Oxidative Stress","authors":"Behzad Saberi","doi":"10.61440/jcrcs.2023.v1.03","DOIUrl":"https://doi.org/10.61440/jcrcs.2023.v1.03","url":null,"abstract":"Normal gestational development depends on adequate nutrients and oxygen transportation in the circuit of mother-placenta-fetus. In the obese mothers, fetal growth alterations and increased risk of Large for gestational age delivering are relevant to excess in the nutrient supply. Obese mothers have also an increased risk for Small for gestational age deliveries. Small for gestational age and Large for gestational age are associated with perinatal complications like stillbirth and later complications during life span. Placental overgrowth along with increased amounts of nutrients and oxygen flux, would result in Large for gestational age newborns which during the life span, such Large for gestational age children would present themselves with more Oxidative stress and Insulin resistance in comparison with Appropriate for gestational age children.","PeriodicalId":472378,"journal":{"name":"Journal of Clinical Research and Case Studies","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135950617","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":"Efficacy of Adding Midazolam to Bupivacaine (0.5%) on the Duration of Spinal Anesthesia in Unilateral Inguinal Hernia Surgery","authors":"Hamid Kayalha, Mohammad Movahed, Asghar Karbord, Ali Alizadeh","doi":"10.61440/jcrcs.2023.v1.02","DOIUrl":"https://doi.org/10.61440/jcrcs.2023.v1.02","url":null,"abstract":"Introduction: Inguinal hernia is the most common type of abdominal hernia which is 7 times more common in men than women. Surgical treatment is performed under general or local anesthesia (spinal or epidural). Neuraxial anesthesia has a greater advantage than general anesthesia. Today, spinal block anesthetics with local drug anesthetics along with adjuvant drugs is widely used for surgery. Midazolam is one of these adjuvants whose spinal injection, in addition to its appropriate analgesic effect, enhances the effect of local anesthetics. Aim: The aim of this study was to determine the effect of intrathecal midazolam (1 mg) to bupivacaine (0.5%) on the quality and timing of sensory block, motor block and hemodynamic changes during of inguinal herniation surgery. Materials and Methods: 64 patients with ASAI / II criteria (30-70 years old) were randomly divided into two groups of 32 patients under spinal anesthesia for inguinal herniation surgery. The anesthesiologist and the patient did not know the status of the studied drugs. Group 1 received 0.5 ml of bupivacaine 0.5% + 0.2 ml of normal saline and group 2 received 3 ml of bupivacaine 0.5% + 0.2 ml of midazolam (1 mg). The return time of sensory block and the return time of motor block, the time of the first request for analgesics, the degree of satisfaction and the hemodynamic status were compared between these group. Results: The return time of sensory block in group 1 was 124.81 ± 16.15 minutes and in group 2 was 193.18± 34.53 minutes, which was statistically significant and in group 2 the return time of sensory block was longer (001 ≤. ˂P). reaction block return time: in group 2: (140.43 ± 27.46) minutes, group: 1 (107.78 ± 13.82) minutes were shorter and statistically significant (P≤ .001). The time of the first analgesic request by patients in group 1 was 157.87 ±16.32 minutes and in group 2, 264.59 ± 50.17 minutes, which was statistically significant (P ≤ .001). Satisfaction index and hemodynamic changes were not significant between groups (P ˃ 0.05). Conclusion: Addition of 1 mg of midazolam in spinal anesthesia with bupivacaine 0.5% increased of the duration of analgesia and the time of first request for analgesia without changing the hemodynamic status in patients with inguinal herniation surgery.","PeriodicalId":472378,"journal":{"name":"Journal of Clinical Research and Case Studies","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135950615","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}