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

{"title":"Evaluating the Effectiveness of Moxibustion in Hyperlipidemia: A Systematic Review and Meta-Analysis.","authors":"Mohammad A Jareebi, Abdulsalam Humedi, Asayel Darraj, Jana Alsyrawan, Alwaleed Bamanie, Salman Alghamdi, Albaraa Marzuqi, Majd Al-Matrafi, Dana Alharbi, Areej Barnawi, Jalal Abu Halimah, Aisha H Majrashi, Amani Saad Alsriha, Adhari A Alselmi, Ghadeer A Alneel","doi":"10.1159/000548187","DOIUrl":"10.1159/000548187","url":null,"abstract":"<p><p><p>Objective: Our systematic review aimed to evaluate the safety and efficacy of moxibustion (MXB) therapy for hyperlipidemia (HLP) by analyzing pre- and post-treatment outcomes.</p><p><strong>Methods: </strong>This meta-analysis of randomized controlled trials evaluated MXB therapy's effects on adult HLP patients, assessing pre- and post-treatment fasting blood sugar (FBS), apolipoprotein A-I (Apo A-I), apolipoprotein B (Apo B), and lipid profiles including total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), using a random-effects model. Results showed significant changes in these parameters, indicating MXB's potential efficacy in improving lipid metabolism and related markers.</p><p><strong>Results: </strong>The analysis includes 6 studies comprising 228 HLP patients (males: 25.43%, females: 51.75%, unknown: 22.8%). Result showed significant difference in TC (OR = 0.69 [0.13, 1.24], p = 0.02), LDL (OR = 0.42 [0.22, 0.63], p = 0.00), Apo B (OR = 0.33 [0.06, 0.60], p = 0.02), FBS (OR = 0.38 [0.05, 0.71], p = 0.02), and TG (OR = 0.35 [0.16, 0.54], p = 0.00) values in post-treatment group compared to pretreatment group. However, no significant changes was analyzed in values of HDL (OR = -0.16 [-0.38, 0.06], p = 0.16) and Apo A-l (OR = 0.01 [-0.26, 0.28], p = 0.96).</p><p><strong>Conclusion: </strong>Statistical analysis showed a positive correlation between MXB therapy and HLP. This supports the clinical application of MXB for HLP treatment. However, further high-quality studies with optimal doses in high-risk population and comprehensive safety reporting would enhance clinical applicability. </p>.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"126-143"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986558","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":"Impact of Root Canal Filling Quality on Periapical Status and Root Resorption in Orthodontically Treated Teeth: A Retrospective Radiographic Study.","authors":"Davut Çelik, Abdulrahman Neccaroğlu, Barış Başer","doi":"10.1159/000550718","DOIUrl":"10.1159/000550718","url":null,"abstract":"<p><p><p>Objective: The aims of the study were to assess the influence of root canal obturation quality on periapical status after orthodontic treatment and evaluate the association between gender and root resorption.</p><p><strong>Materials and methods: </strong>This retrospective radiographic study included 283 endodontically treated teeth from 199 patients (71 males, 128 females) treated with fixed appliances. Teeth were classified as adequate or inadequate based on the filling length, density/homogeneity, untreated canals, and coronal restoration integrity. Periapical status was assessed using the Periapical Index (PAI) on paired pre- and post-treatment panoramic radiographs. Chi-square, McNemar-Bowker, and Fisher's exact tests were used. Radiographically vital teeth from the same cohort were screened descriptively for incident periapical changes.</p><p><strong>Results: </strong>The PAI score distributions differed between the adequate and inadequate groups before (p = 0.001) and after treatment (p = 0.003). Temporal changes were not statistically significant within the groups (adequate, p = 0.236; inadequate, p = 0.148). After treatment, 26.99% of adequately filled and 60.83% of inadequately filled teeth remained or progressed to pathological PAI scores (3-5). Root resorption was more frequent in males (p < 0.05). In the vital-tooth screening, the baseline PAI was 1; three teeth developed radiolucency (PAI 4), and one developed a new radiopaque lesion.</p><p><strong>Conclusion: </strong>Inadequate obturation was associated with a higher proportion of pathological periapical outcomes after orthodontic treatment, and male gender was associated with higher root resorption. These findings support the careful preorthodontic radiographic verification of endodontic quality. </p>.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"357-363"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088818","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":"Group B <i>Streptococcus</i> and Vaginal Microbiome Dynamics in Pregnancy.","authors":"Niluka Dilrukshi, Jananie Kottahachchi, Thushari Dissanayake, Kajan Muneeswaran, Neluka Fernando","doi":"10.1159/000551477","DOIUrl":"10.1159/000551477","url":null,"abstract":"<p><p><p>Objective: This study aimed to compare the vaginal microbiome of group B Streptococcus (GBS)-positive and -negative pregnant women in selected tertiary care hospitals in Sri Lanka.</p><p><strong>Subjects and methods: </strong>Fifteen GBS-positive and fifteen GBS-negative women were included in the study. The composition of vaginal microbiome was profiled by sequencing 16S rRNA V3-V4 region. Microbiome diversity and variation were evaluated.</p><p><strong>Results: </strong>Alpha diversity measured by Shannon diversity and Chao 1 index differed significantly between GBS-positive and GBS-negative groups (Chao 1, p = 0.0003; Shannon, p = 0.0003), while beta diversity pairwise permutational multivariate analysis of variance (p = 0.435) showed no significant difference, indicating similar overall bacterial compositions. Gardnerella and Prevotella were more abundant in GBS-positive group, while majority of the GBS-negative group was dominated by Lactobacillus (87.9%). Lactobacillus iners was the most abundant species in both groups. Lactobacillus gallinarum, reported for the first time in Sri Lanka, was the second most common Lactobacillus species. Linear discriminant analysis effect size identified no taxa enriched in GBS-negative group, whereas GBS-positive group showed significantly higher relative abundance with several taxa with Bifidobacterium showed the highest linear discriminant analysis score (4.459). Methylocystis, though of low biological relevance, was significantly abundant in GBS-positive group (p = 0.025).</p><p><strong>Conclusion: </strong>Lactobacillus spp. were reduced in GBS-positive women, with higher abundance of other bacterial taxa suggesting that disruption of a Lactobacillus dominant vaginal microbiome may facilitate GBS colonization and potentially increase the risk of neonatal infection. </p>.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"467-476"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477836","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":"Efficacy and Safety of Procalcitonin-Guided Antibiotic Therapy versus Standard of Care for Sepsis: A Systematic Review and Meta-Analysis.","authors":"Hafsa Arshad Azam Raja, Muhammad Jibran Afridi, Fatima Asad, Khizar Yasin, Muhammad Uzair, Yasir Saleem, Hanifa Sardar, Iqra Bismil, Areej Saeed, Imtiaz Ullah, Gulmeena Riffat, Muhammad Hamza Abdullah Khan, Hamza Khan, Mohammad Ebad Ur Rehman, Farhan Ali","doi":"10.1159/000551475","DOIUrl":"10.1159/000551475","url":null,"abstract":"<p><p><p>Objectives: This systematic review and meta-analysis assesses the efficacy and safety of procalcitonin (PCT)-guided therapy compared to the standard of care in septic patients.</p><p><strong>Methods: </strong>A comprehensive literature search was performed using the Cochrane Library, <ext-link ext-link-type=\"uri\" xlink:href=\"http://ClinicalTrials.gov\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">ClinicalTrials.gov</ext-link>, Embase, and MEDLINE, covering studies from their inception to April 2025. RevMan was used to perform a random effects meta-analysis, and forest plots were used to visualize the pooled estimates. The Mantel-Haenszel method was applied to analyze dichotomous outcomes. The inverse variance method was applied to analyze continuous outcomes.</p><p><strong>Results: </strong>Sixteen randomized controlled trials, with a total of 6,885 patients, were included. PCT-guided therapy was associated with significantly improved antibiotic treatment duration (standardized mean difference [SMD] -0.81, 95% confidence interval [CI]: -1.17 to -0.45, I2 97%), duration of mechanical ventilation (SMD -0.47, 95% CI: -0.57 to -0.37, I2 0%), and antibiotic-free days (SMD 0.14, 95% CI: 0.04-0.25, I2 0%). Both groups were comparable in terms of ICU mortality, hospital mortality, 30-day mortality, 90-day mortality, ICU stay, hospital stay, new infection, and clinical recovery. PCT was associated with greater reinfection (risk ratio 1.12, 95% CI: 1.00-1.26, I2 0%).</p><p><strong>Conclusion: </strong>PCT-guided therapy was associated with shorter antibiotic treatment duration, though substantial heterogeneity was observed, while mortality outcomes were comparable between groups. Standardized PCT-based protocols are needed to improve consistency and clinical applicability. </p>.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"427-438"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470773","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.","authors":"","doi":"10.1159/000550403","DOIUrl":"10.1159/000550403","url":null,"abstract":"<p><p>The authors' accepted manuscript \"Assessment of Blood Lead Levels in Pre-School Children in Kuwait\" [Med Princ Pract. 2025; https://doi.org/10.1159/000549289], by Abdur Rahman Ahmada, Muddanna Rao, Maraheb Alkhalidi, Mohammad Al Seaidan, Muna Alkhabaz, Anwar Ali, Meshari Alqallaf, Mustafa Al-Zoughool, Maryam Shehab, Armando Chamorro, Reem Jallad, and Janvier Gasana, has been retracted by the Publisher and the Editor. After peer review, the accepted, unedited manuscript was published online as Early View. Before the final Version of Record was published, it was identified that Figures 1 and 2 were the same. The authors provided a revised figure. Review of the revised manuscript resulted in the Editors' decision to rescind their original, provisional acceptance decision and reject the revised manuscript. Consequently, the authors' published accepted manuscript has been retracted.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"200"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146152203","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":"Response to the Letter on &quot;Vitamin D Supplementation Mediates a Shift toward Anti-Inflammatory Cytokine Response in Multiple Sclerosis&quot.","authors":"Suhail Al-Shammri, Arpita Chattopadhyay, Raj Raghupathy","doi":"10.1159/000549035","DOIUrl":"10.1159/000549035","url":null,"abstract":"","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"198-199"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423851","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":"Population Pharmacokinetics and Dose Optimization of Valganciclovir and Ganciclovir in Lung Transplant Recipients.","authors":"Eliška Dvořáčková, Danica Michaličková, Jakub Petrus, Eva Klapková, Alžběta Dutková, Tereza Kotowski, Andrea Zajacová, Elke H J Krekels, Jan Havlin, Robert Lischke, Ondřej Slanař","doi":"10.1159/000548942","DOIUrl":"10.1159/000548942","url":null,"abstract":"<p><p><p>Objective: The primary goal of this study was to evaluate the pharmacokinetics (PK) of ganciclovir (GCV) and its prodrug valganciclovir (VGCV) in a large cohort of lung transplant recipients. The secondary goal was to determine the probability of target attainment (PTA) for different pharmacokinetic/pharmacodynamic (PK/PD) targets.</p><p><strong>Subjects and methods: </strong>A population PK analysis was carried out using NONMEM version 7.4.0. In total, 379 GCV concentrations (194 and 185 concentrations sampled after VGCV and GCV administration, respectively) were obtained from 110 patients and were included in the analysis. Monte Carlo simulations were performed to assess PTA for (AUC_24h) >50 mg·h/L and AUC_24h of 80-120 mg·h/L.</p><p><strong>Results: </strong>Estimated glomerular filtration rate (eGFR) was found to be the only significant covariate for GCV/VGCV clearance. Standard prophylactic and therapeutic GCV/VGCV dosing regimens lead to underdosing in patients with reduced eGFR values, particularly below 60 mL/min/1.73 m2 for VGCV and 70 mL/min/1.73 m2 for ganciclovir. For patients with higher eGFR levels, PTA levels are higher (21-35% in therapy and 44-50% in prophylaxis), but the PK show substantial variability, making individual dosing difficult.</p><p><strong>Conclusions: </strong>Standard prophylactic and therapeutic ganciclovir/VGCV dosing regimen leads to underexposure in patients with low eGFR but may be appropriate for patients with higher eGFR values. However, substantial variability in ganciclovir/VGC exposure makes it challenging to achieve efficacy targets in individuals. For this reason, therapeutic drug monitoring (TDM) should be considered. Our model can be integrated into TDM software and, alongside a TDM sample, be used for dosing guidance. </p>.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"169-180"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145295037","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":"Oral Manifestations in Children with Celiac Disease: Part I - Prevalence of Dental Enamel Defects and Recurrent Aphthous Stomatitis and Their Association with Disease-Related Factors.","authors":"Sibel Acar, Ertugrul Sabah, Maşallah Baran, Çiğdem Ömür Ecevit, Murat Sezak, Sema Aydoğdu","doi":"10.1159/000550261","DOIUrl":"10.1159/000550261","url":null,"abstract":"<p><p><p>Objectives: Celiac disease (CD) is an immune-mediated disorder triggered by gluten, often presenting with oral manifestations: dental enamel defects (DEDs) and recurrent aphthous stomatitis (RAS). This study aimed to determine the prevalence of DEDs and RAS in children with CD and to identify the clinical, serological, and histopathological factors associated with their etiology.</p><p><strong>Materials and methods: </strong>Ninety-seven children (6-19 years) with biopsy-confirmed CD and 31 age-matched healthy controls were involved in the study. The CD cohort was stratified by age at diagnosis (<5 years and >5 years) and disease status (newly diagnosed). Data on clinical findings, human leukocyte antigen typing, and biochemical parameters were collected retrospectively. All intestinal biopsies were reevaluated according to the Marsh classification. A single, blinded examiner performed oral examinations to diagnose DEDs and RAS.</p><p><strong>Results: </strong>The prevalences of DEDs (63.9% vs. 16.1%) and RAS (27.8% vs. 22.5%) were significantly higher in the CD group than in controls (p < 0.05). The severity of DEDs was negatively correlated with serum calcium levels (p = 0.022) and positively correlated with the severity of intestinal damage (p < 0.05). A later age at diagnosis was also associated with a higher prevalence of DEDs. RAS was most prevalent in newly diagnosed, untreated patients (47%, p = 0.016) and showed significant remission following a gluten-free diet (p < 0.001).</p><p><strong>Conclusion: </strong>DEDs and RAS are significant and common oral manifestations in children with CD. The strong association between DED severity and the degree of intestinal histopathology suggests shared pathogenic pathways. These oral findings can serve as important noninvasive clinical markers in the early detection of undiagnosed CD. </p>.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"255-262"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879878","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":"Comparative Effectiveness of Mycophenolate Mofetil and Tacrolimus as a Second-Line Therapy for Autoimmune Hepatitis: A Systematic Review and Meta-Analysis.","authors":"Fahd Almalki, Sarah T Alarmati, Razan N Shata, Lama K Almatrfi, Salma A Binmahfoodh, Hana T Alomayri, Ghida'a S Qurban, Juri A Alzahrani, Lamar J Maddawi, Shatha M Alharbi, Raghad F Bahakeem, Rawan S Azooni, Hassan Alwafi, Widya Normma Insani","doi":"10.1159/000548894","DOIUrl":"10.1159/000548894","url":null,"abstract":"<p><strong>Objective: </strong>Autoimmune hepatitis (AIH) is a chronic immune-mediated liver disease that usually responds to corticosteroids ± azathioprine (AZA). However, some patients are intolerant or refractory to first-line therapy and require second-line immunosuppression. Mycophenolate mofetil (MMF) and tacrolimus (TAC) are commonly used alternatives, although comparative evidence is limited. This systematic review and meta-analysis evaluated the efficacy and safety of MMF and TAC in adult AIH patients who failed first-line therapy.</p><p><strong>Methods: </strong>A systematic search of six databases identified 16 eligible studies (n = 705), including retrospective cohorts and one case series. Study quality was assessed using the Newcastle-Ottawa Scale and the MMS (methodological quality and synthesis of case series and case reports) tool.</p><p><strong>Results: </strong>Biochemical remission was achieved in 56% of MMF-treated patients, rising to 66% with ≥6-month follow-up. TAC showed a pooled remission rate of 66%, increasing to 67% when defined by transaminase normalization. MMF was particularly effective in AZA-intolerant patients, while TAC showed better outcomes in steroid-refractory patients. Adverse events differed: MMF was most often associated with gastrointestinal intolerance, whereas TAC was linked to tremor, hypertension, diabetes, and renal impairment. However, statistical analysis showed wide confidence intervals, and there was considerable heterogeneity across studies.</p><p><strong>Conclusion: </strong>Both MMF and TAC are effective second-line therapies for AIH. MMF appears safer and better tolerated in AZA-intolerant patients, while TAC showed a modest advantage in efficacy over mycophenolate in steroid-refractory cases. Given the limitations of current evidence, including small sample sizes, heterogeneity, and lack of randomized controlled trials, treatment choice should be individualized until higher quality data are available.</p>","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"210-226"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282569","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":"Response to the Letter by Sah and Kumbhalwar on \"Population Pharmacokinetics and Dose Optimization of Valganciclovir and Ganciclovir in Lung Transplant Recipients\".","authors":"Eliška Dvořáčková, Danica Michaličková","doi":"10.1159/000550867","DOIUrl":"10.1159/000550867","url":null,"abstract":"","PeriodicalId":520708,"journal":{"name":"Medical principles and practice : international journal of the Kuwait University, Health Science Centre","volume":" ","pages":"498-499"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129230","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}