Medical principles and practice : international journal of the Kuwait University, Health Science Centre最新文献

{"title":"Unravelling the High-Hemoglobin-F Sickle Cell Disease Phenotype: Studies among Kuwaiti Patients.","authors":"Adekunle Adekile","doi":"10.1159/mpp/adpag027","DOIUrl":"https://doi.org/10.1159/mpp/adpag027","url":null,"abstract":"<p><p>HbF concentration influences the clinical phenotype of sickle cell disease (SCD) and the prevailing management approach involves pharmacological or genetic stimulation of HbF expression. Understanding how HbF affects the disease's progression, in the context of other potential modifiers, is vital. Kuwaiti patients with SCD predominantly carry the Arab/Indian haplotype, and their average spontaneous HbF concentration varies from ∼15-30%. Our team has conducted a series of clinical studies on these patients between 1994 and 2024 to understand their clinical course; some of these studies are summarized here. Most patients show no symptoms before age 4 or 5, when their HbF level is about 30%. Splenic function remains intact in childhood and in 60-80% of adult patients, which may explain the rarity of severe bacterial infections. Other less common complications include stroke, leg ulcers, and priapism. Most patients do not develop cerebral vasculopathy, as shown by normal transcranial Doppler studies. However, osteonecrosis of the femoral head is relatively common, affecting about 25% of children and over 50% of adults. The factors that predispose to this complication remain unclear. While the overall phenotype in pediatric patients is generally mild, the disease becomes quite severe in adults, indicating that subclinical inflammatory events accumulate over time. The pattern observed in our patients provides insight into what to expect in those treated with HbF inducers or gene therapy. Indeed, increasing HbF alone is not a cure for SCD. The greatest benefit of elevated HbF is seen in younger patients, making early intervention crucial.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032899","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":"Diagnostic Accuracy of Abdominal Ultrasound in Pediatric Patients with Signs and Symptoms of Intussusception.","authors":"Atef Ali Hamdan Khattab, Mohamed Sherif Mohamed El-Sharkawy, Abdullah Mohammad Ali Khattab, Abdelrahman Nihad Ahmad Barakat, Abdelrahman Abdallah Mahmoud Almasri, Fahad Amin Al Atawi","doi":"10.1159/mpp/adpag026","DOIUrl":"https://doi.org/10.1159/mpp/adpag026","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic performance of abdominal ultrasonography, specifically its positive predictive value, in children younger than 36 months presenting with suspected intussusception to the emergency department of a major tertiary care center in Saudi Arabia, and to describe the associated clinical and sonographic features.</p><p><strong>Methods: </strong>This retrospective study reviewed the medical records and radiological findings of 150 pediatric patients aged less than 36 months who presented with suspected intussusception to the emergency department in a major tertiary care center in Saudi Arabia between 2005 and 2015. Ultrasound was used as the initial diagnostic modality, and findings were confirmed using contrast enema, computed tomography scan, or intraoperative findings when applicable.</p><p><strong>Results: </strong>Out of 150 suspected cases, 36 patients(24.0%) were confirmed to have intussusception. All 36 ultrasound-positive cases were subsequently confirmed by contrast enema, computed tomography, or surgery, giving a positive predictive value of 100% (36/36). Because the 114 ultrasound-negative patients were classified on the basis of clinical course rather than an independent reference standard, sensitivity, specificity, and negative predictive value could not be validly estimated and are not reported. Vomiting and bloody stool were significantly associated with confirmed diagnosis; no significant association was found with gender.</p><p><strong>Conclusion: </strong>In this single-center retrospective cohort, a positive abdominal ultrasound reliably predicted confirmed intussusception, supporting its established role as the first-line imaging modality for suspected pediatric intussusception. Although this regional data add local confirmation but, given the retrospective design and the absence of an independent reference standard for ultrasound-negative cases, it should be interpreted with caution.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027466","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":"Comparative Efficacy of Three Single-File Reciprocating Systems in Reducing Intracanal Enterococcus faecalis Biofilms.","authors":"Berna Kuloglu, Bulem Üreyen Kaya, Emel Sesli Çetin, Tugba Ayvalik Ruzgarkesen","doi":"10.1159/mpp/adpag025","DOIUrl":"https://doi.org/10.1159/mpp/adpag025","url":null,"abstract":"<p><strong>Objectives: </strong>Chemomechanical preparation is essential to disrupt endodontic biofilms and reduce microbial loads to levels compatible with periradicular tissue healing. This study aimed to compare the bacterial reduction efficacy of three reciprocating single-file systems-WaveOne Gold, One Reci, and R-Motion-against Enterococcus faecalis in root canals.</p><p><strong>Methods: </strong>Sixty-two human premolars were inoculated with E. faecalis and instrumented using one of the three reciprocating systems. Intracanal bacterial loads were quantified via colony-forming units (CFUs) before and after chemomechanical preparation. Additionally, five specimens from each group were analyzed via scanning electron microscopy (SEM) to qualitatively assess biofilm disruption. Data were analyzed using one-way analysis of variance (ANOVA) with the significance level set at p < 0.05.</p><p><strong>Results: </strong>All three reciprocating systems demonstrated a comparable reduction in intracanal microbial loads (p > 0.05) from a mean baseline of approximately 6.78 log₁₀ CFU. The mean log-based relative percentage reductions percentage reductions ranged from 36.8% (WaveOne Gold) to 40.0% (R-Motion). SEM analysis revealed the persistence of residual biofilm across all experimental groups.</p><p><strong>Conclusions: </strong>Despite variations in instrument design and metallurgy, the three evaluated reciprocating systems demonstrated comparable efficacy in reducing intracanal E. faecalis populations.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019424","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":"Epidemiological and Clinical Characteristics of Interstitial Lung Diseases in Kuwait: A 9-Year Single-Center Observational Prospective Study.","authors":"Mousa Elias Khadadah, Abdulaziz Taleb Muqim, Ali H Ziyab, Mahmoud M Elhosiny","doi":"10.1159/mpp/adpag005","DOIUrl":"10.1159/mpp/adpag005","url":null,"abstract":"<p><strong>Objective: </strong>The data on epidemiological features of interstitial lung diseases (ILD) in the Gulf region are scarce. The aim of this study was to describe the baseline clinical and epidemiological characteristics of ILD patients in a single specialized expertise center in Kuwait.</p><p><strong>Subjects and methods: </strong>This prospective, observational registry evaluated 167 patients newly diagnosed with ILD via a multidisciplinary team approach between November 2016 and October 2025. The demographics, exposures, comorbidities, and physiological data were systematically collected. Appropriate parametric and nonparametric descriptive statistics were applied to summarize and compare clinical variables across ILD subtypes.</p><p><strong>Results: </strong>Majority of the patients were male (60.5%), with a mean age of 58.7 years (SD ± 13.2). Idiopathic pulmonary fibrosis (IPF) was the most frequent subtype (34.1%), followed by connective tissue disease-related ILD (CTD-ILD; 23.4%) and hypersensitivity pneumonitis (HP; 20.4%). The environmental and occupational exposures were documented in 41.3% and 10.2% of the cohort, respectively, with environmental exposure predominant in the HP group (76.5%). Overall, gastroesophageal reflux disease was the most prevalent comorbidity (in 58.1% of cases). Patients with HP demonstrated the poorest baseline lung function compared to other subtypes, with a mean predicted forced vital capacity of 59.2% (SD ± 14.4).</p><p><strong>Conclusion: </strong>This 9-year prospective study provides the first real-world ILD dataset from Kuwait. IPF, CTD-ILD, and HP are the predominant clinical phenotypes. Knowledge of comprehensive exposure histories is vital for diagnostic evaluation to identify manageable HP before irreversible fibrosis develops.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019470","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 Predictors of Postpartum Persistent Hypothyroidism in Gestational Hypothyroidism: A Cohort Study.","authors":"Büsra Çetintulum Aydin, Seher Irem Sahin, Ece Çiftçi Öztürk, Hüseyin Öztürk, Hayriye Esra Ataoglu","doi":"10.1159/mpp/adpag024","DOIUrl":"https://doi.org/10.1159/mpp/adpag024","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether gestational timing, biochemical severity, treatment response, or metabolic parameters predict postpartum persistent hypothyroidism and to evaluate the contribution of thyroid autoimmunity.</p><p><strong>Material and methods: </strong>This single-center retrospective cohort study included pregnant women newly diagnosed with hypothyroidism in an internal medicine outpatient clinic. Recorded variables included demographic characteristics, gestational age at diagnosis, baseline thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels, follow-up thyroid function tests, fasting glucose, oral glucose tolerance test results, gestational diabetes diagnosis, and thyroid function at six weeks postpartum. Patients were categorized into early (≤13 weeks), mid (14-27 weeks), and late (≥28 weeks) diagnosis groups. Associations between gestational timing, treatment response, glycemic parameters, and postpartum persistent hypothyroidism were analyzed.</p><p><strong>Results: </strong>Fifty-eight women were included. Trimester-specific TSH targets were achieved in 32/58 (55.2%) at the first follow-up and 42/58 (72.4%) at the second follow-up. Early diagnosis, baseline TSH, levothyroxine dose, gestational timing, and glycemic indices were not associated with TSH normalization or postpartum persistent hypothyroidism (all p > 0.05). Postpartum persistent hypothyroidism developed in 14/58 women (24.1%). Thyroid autoantibody positivity was associated with persistence (p = 0.006) and remained independently associated with postpartum persistent hypothyroidism in multivariable analysis (odds ratio 9.78, 95% confidence interval 2.10-44.30; p = 0.020). TSH target achievement was not associated with reduced hyperglycemia.</p><p><strong>Conclusions: </strong>Thyroid autoimmunity emerged as the principal determinant of postpartum persistent hypothyroidism, supporting antibody-based risk stratification. Gestational timing, treatment response, and metabolic indices were not significantly associated with postpartum thyroid outcomes.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979272","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":"Hepatic Immunomodulatory Effect of Belatacept on the TNF-α/IL-6 Pro-Inflammatory Axis and Its Impact on Regulation of MiRNA-146a in Hepatic Injury.","authors":"Doaa Khalid Ibrahim, Yassir Mustafa Kamal Al-Mulla Hummadi, Huda Jaber Waheed","doi":"10.1159/mpp/adpag021","DOIUrl":"10.1159/mpp/adpag021","url":null,"abstract":"<p><strong>Objective: </strong>Acute liver injury is associated with a systemic cytokine release that determines the clinical prognosis. Although there are many hepatoprotective drugs, their unique immunomodulatory profiles are still unclear. This study evaluates the therapeutic potential of Belatacept versus Prednisolone on miRNA-146a expression and the pro-inflammatory cytokine cascade in a rat model of Concanavalin A-induced hepatic damage.</p><p><strong>Materials and methods: </strong>The animal model of liver injury was induced in adult male Wistar rats by dividing them in 4 groups: normal controls, liver injury, prednisolone, and belatacept-treated groups. The serum levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were used to determine the systemic inflammation and were measured by enzyme-linked immunosorbent assay. RT-qPCR was used to quantify the expression of hepatic miRNA-146a. Statistical significance was established by using one-way ANOVA (p < 0.05).</p><p><strong>Results: </strong>TNF-α and IL-6 levels in serum increased significantly, in response to inducing hepatic damage (p < 0.05). Alongside this, a notable dysregulation of miRNA-146a was detected. Belatacept treatment successfully inhibited the cytokine systemic response, bringing IL-6 down to levels that were statistically more significant than those attained by prednisolone (p < 0.01), while TNF-α reduction was comparable in both groups (p > 0.05). Additionally, Belatacept treatment effectively upregulates miRNA-146a levels, achieving a restoration profile which was statistically more significant than prednisolone (p < 0.01).</p><p><strong>Conclusion: </strong>These findings show that belatacept has stronger immunomodulatory action when compared with standard therapy. Belatacept is a promising new treatment option for liver-driven systemic inflammation which acts by inhibiting the TNF-α/IL-6 axis and modulating miRNA-146a.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946509","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":"Retraction Statement: Proactive Prevention of Postpartum Hypothyroidism: The Critical Role of Community-Based Diet and Micronutrient Supervision.","authors":"","doi":"10.1159/mpp/adpag020","DOIUrl":"10.1159/mpp/adpag020","url":null,"abstract":"<p><p>The authors' accepted manuscript \"Proactive Prevention of Postpartum Hypothyroidism: The Critical Role of Community-Based Diet and Micronutrient Supervision\" [Med Princ Pract. 2026; https://doi.org/10.1159/000553308] by Yiyun Xu and Qingzhao Xie has been retracted.After peer review, the accepted, unedited manuscript was published online as Early View. Before the final Version of Record was published, the authors requested to change the authorship of this manuscript. The justification for this change was found not to be satisfactory by the Editors and as a consequence, they have rescinded their original acceptance decision. Consequently, the published author's accepted manuscript has been retracted.The authors were informed about this decision.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946515","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":"Letter to the Editor Regarding the Article \"Evaluating the Predictive Value of the Endothelial Activation and Stress Index in Determining the Severity and Prognosis of Acute Pulmonary Embolism\".","authors":"Ramazan Amanvermez, Fatih Çalışkan","doi":"10.1159/mpp/adpag022","DOIUrl":"10.1159/mpp/adpag022","url":null,"abstract":"","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946476","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":"Sustained Low-Efficiency Dialysis versus Intermittent Hemodialysis in Critically Ill Patients with Severe Acute Kidney Injury.","authors":"Xixi Wang, Juan Li, Xiaowei Sun, Jiang Zhu, Zijing Yuan, Xiumei Zhang","doi":"10.1159/mpp/adpag017","DOIUrl":"10.1159/mpp/adpag017","url":null,"abstract":"<p><strong>Objective: </strong>The objectives of the study were to compare clinical efficacy, hemodynamic stability, and 90-day renal outcomes between sustained low-efficiency dialysis (SLED) and intermittent hemodialysis (IHD) in medical intensive care unit (MICU) patients with severe acute kidney injury (AKI).</p><p><strong>Methods: </strong>This observational cohort study evaluated 300 patients with KDIGO Stage-2 or 3 AKI (SLED: n = 160; IHD: n = 140). Outcomes included MICU mortality, discharge renal recovery, stay duration, intradialytic complications, and 90-day renal preservation.</p><p><strong>Results: </strong>Baseline characteristics were comparable. No significant differences emerged between SLED and IHD regarding MICU mortality (33% vs. 39%, p = 0.272) or renal recovery at discharge (61% vs. 54%, p = 0.223). However, SLED demonstrated superior safety, significantly lowering intradialytic hypotension (21% vs. 41%, p < 0.001) and the need for new vasopressors (11% vs. 22%, p = 0.011), while minimizing mean arterial pressure drops (12.12 ± 3.9 vs. 19 ± 6.36 mm Hg, p < 0.001). SLED achieved shorter median MICU stays (14 vs. 16 days, p < 0.001). At 90-day, SLED survivors exhibited significantly lower renal replacement therapy dependence (11% vs. 24%, p = 0.014), reduced chronic kidney disease progression (26% vs. 34%, p = 0.044), and higher glomerular filtration rate (55.93 ± 7.69 vs. 45.86 ± 9.29 mL/min/1.73 m2, p < 0.001).</p><p><strong>Conclusions: </strong>While short-term mortality is similar, SLED dramatically mitigates intradialytic hemodynamic instability compared to IHD. By minimizing circulatory insults, SLED significantly improves 90-day parenchymal renal recovery and minimizes long-term dialysis dependence among AKI survivors.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898851","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":"Bedside Spirometry, Dyspnea Severity, and Inflammatory Markers for Predicting Noninvasive Ventilation Requirement in Acute Exacerbation of Chronic Obstructive Pulmonary Disease.","authors":"Nazlı Gönülduru, Erdem Çevik","doi":"10.1159/mpp/adpag018","DOIUrl":"10.1159/mpp/adpag018","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the association of bedside spirometry, dyspnea severity, and inflammatory markers with noninvasive mechanical ventilation (NIMV) requirement in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).</p><p><strong>Subjects and methods: </strong>This prospective observational study included adults presenting to the emergency department (ED) with AECOPD. Bedside forced expiratory volume in 1 s (FEV₁% predicted) and peak expiratory flow (PEF% predicted) were measured before treatment. Dyspnea was assessed using the Visual Analog Scale (VAS). Neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation (SII) index, eosinophil-to-basophil ratio (EBR), arterial pH, and arterial partial pressure of carbon dioxide (PaCO₂) were obtained. Spirometry and VAS were repeated at 3 h. The primary outcome was NIMV requirement during ED observation. Secondary outcomes included intensive care unit (ICU) admission. Mortality was analyzed descriptively because of limited events.</p><p><strong>Results: </strong>Among 211 patients, 91 (43.1%) required NIMV. NIMV requirement was associated with lower baseline and third-hour FEV₁% and PEF% and higher VAS scores. Higher NLR and SII index were associated with ICU admission. Seven (3.3%) patients died within 30 days and had higher NLR and SII index values and lower EBR. In multivariable analysis including arterial pH and PaCO₂, the PaCO₂ was found to be independently associated with NIMV requirement.</p><p><strong>Conclusion: </strong>Lower FEV₁% and PEF% values and greater dyspnea severity were associated with NIMV requirement, whereas inflammatory markers were associated with ICU admission and showed an association with 30-day mortality. Bedside spirometry may also provide complementary information alongside clinical assessment and arterial blood gas analysis in patients with AECOPD.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898811","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}