Laser hair removal in a patient with polycystic ovarian syndrome and vitiligo

It is well recognized that vitiligo displays the Koebner phenomenon. However, the impact of this phenomenon on hair removal in these patients has little been considered. This is a challenging case of a woman with hirsutism and vitiligo who opted to have laser hair removal treatment.     

Comparable Reproductive Outcomes of ICSI for Couples with Unexplained Infertility and Couples with Male Factor Infertility

Objective

The aim of this study was to compare intra-Cytoplasmic Sperm Injection (ICSI) outcomes (fertilization rate, embryo quality, pregnancy rate, and live birth rate) for couples with unexplained infertility and couples with male factor infertility, and if the quality of semen is related to ICSI outcomes.

Risk for postpartum hemorrhage,transfusion, and hemorrhage-related morbidity at low,moderate, and high volume hospitals

Objective: The objective of this study was to characterize risk for and temporal trends in postpartum hemorrhage across hospitals with different delivery volumes.

Study design: This study used the Nationwide Inpatient Sample (NIS) to characterize risk for postpartum hemorrhage from 1998 to 2011. Hospitals were classified as having either low, moderate or high delivery volume (≤1000, 1001 to 2000,?>2000 deliveries per year, respectively). The primary outcomes included postpartum hemorrhage, transfusion, and related severe maternal morbidity. Adjusted models were created to assess factors associated with hemorrhage and transfusion.

Results: Of 55,140,088 deliveries included for analysis 1,512,212 (2.7%) had a diagnosis of postpartum hemorrhage and 361,081 (0.7%) received transfusion. Risk for morbidity and transfusion increased over the study period, while the rate of hemorrhage was stable ranging from 2.5 to 2.9%. After adjustment, hospital volume was not a major risk factor for transfusion or hemorrhage.

Discussion: While obstetric volume does not appear to be a major risk factor for either transfusion or hemorrhage, given that transfusion and hemorrhage-related maternal morbidity are increasing across hospital volume categories, there is an urgent need to improve obstetrical care for postpartum hemorrhage. Those risk factors are able to discriminate women at increased risk supports routine use of hemorrhage risk assessment.     

Biomarkers for evaluation of treatment response in classical Hodgkin lymphoma: comparison of sGalectin‐1, sCD163 and sCD30 with TARC

Soluble Galectin‐1 (sGal‐1, also termed LGALS1), soluble CD163 (sCD163) and soluble CD30 (sCD30) have been reported to be elevated in plasma or serum of patients with classical Hodgkin lymphoma (cHL). We aimed to determine the clinical utility of these biomarkers for evaluation of treatment response compared to thymus and activation regulated chemokine (TARC, also termed CCL17). Plasma or serum samples were prospectively collected among 103 newly diagnosed cHL patients before and after treatment. Levels of sGal‐1, sCD163, sCD30 and TARC were correlated with disease characteristics and clinical treatment response. Elevated plasma levels of sGal‐1, sCD163, sCD30 and TARC were found in 67%, 21%, 91% and 93% of cHL patients respectively. Mean plasma levels of sGal‐1 and sCD30 decreased after treatment but sCD163 did not decrease after treatment. There was no correlation with change of these markers and clinical treatment response in individual patients. TARC levels strongly correlated with disease characteristics and metabolic volume. TARC remained high in 6 out of 7 non‐responsive patients and dramatically decreased in 95 out of 96 responsive patients. In summary, elevated pre‐treatment levels of sGal‐1, sCD163, sCD30 and TARC can be found in patients with cHL. However, only plasma TARC accurately reflects disease activity and correlates with clinical treatment response.     

Rate of cultivable subgingival periodontopathogenic bacteria in chronic periodontitis

Although microbiological studies have identified more than 400 bacterial species in periodontal pockets, only a limited number have been implicated as periodontal pathogens. The purpose of this study was to investigate the incidence of cultivable subgingival periodontopathogenic bacteria in chronic periodontitis. Bacterial samples were collected with sterile paper points from the deepest periodontal pockets ((5 mm) of 203 patients: 92 males and 111 females, aged 35-55 years. The samples were cultured under anaerobic and capnophilic conditions using selective and non-selective media. Isolates were characterized to species level by conventional biochemical tests and a commercial rapid test system. The isolates were Actinobacillus actinomycetemcomitans (26.8%), Porphyromonas gingivalis (21.9%), Capnocytophaga sputigena (16.7%), Eikenella corrodens (13.2%), Prevotella intermedia (10.5 %), Prevotella disiens (3.1%), Peptostreptococcus micros (2.9%), Capnocytophaga gingivalis (2.2%), Prevotella corporis (1.8%), Peptostreptococcus magnus (1.3%) and Fusobacterium nucleatum (0.4%). No periodontopathogenic bacterial growth was observed in 14 of the samples (6.2%). The number of samples associated with monobacterial growth and polybacterial growth were 74.9% and 18.2% respectively. It is concluded that the bacterial composition associated with a number of patients' samples is quite complex, and that some of cultivable anaerobic and capnophilic bacteria act as periodontal pathogens in chronic periodontitis.     

Identification and treatment of individuals with attention-deficit/hyperactivity disorder and substance use disorder: An expert consensus statement

Attention-deficit/hyperactivity disorder (ADHD) often co-occurs with substance use (SU) and/or substance use disorder (SUD). Individuals with concurrent ADHD and SU/SUD can have complex presentations that may complicate diagnosis and treatment. This can be further complicated by the context in which services are delivered. Also, when working with young people and adults with co-existing ADHD and SU/SUD, there is uncertainty among healthcare practitioners on how best to meet their needs. In February 2022, the United Kingdom ADHD Partnership hosted a meeting attended by multidisciplinary experts to address these issues. Following presentations providing attendees with an overview of the literature, group discussions were held synthesizing research evidence and clinical experience. Topics included: (1) A review of substances and reasons for use/misuse; (2) identification, assessment and treatment of illicit SU/SUD in young people and adults with ADHD presenting in community services; and (3) identification, assessment and treatment of ADHD in adults presenting in SU/SUD community and inpatient services. Dis-cussions highlighted inter-service barriers and fragmentation of care. It was concluded that a multimodal and multi-agency approach is needed. The consensus group generated a table of practice recommendations providing guidance on: identification and assessment; pharmacological and psychological treatment; and multi-agency interventions.     

Publication productivity and citation analysis of the Medical Journal of Malaysia: 2004 - 2008

We analysed 580 articles (original articles only) published in Medical Journal of Malaysia between 2004 and 2008, the resources referenced by the articles and the citations and impact received. Our aim was to examine article and author productivity, the age of references used and impact of the journal. Publication data was obtained from MyAIS database and Google Scholar provided the citation data. From the 580 articles analyzed, contributors mainly come from the hospitals, universities and clinics. Contributions from foreign authors are low. The useful lives of references cited were between 3 to 11 years. ISI derived Impact factor for MJM ranged between 0.378 to 0.616. Journal self-citation is low. Out of the 580 sampled articles, 76.8% have been cited at least once over the 5 years and the ratio of total publications to citations is 1: 2.6.