Pregnant women’s use and attitude toward herbal,vitamin, and mineral supplements in an academic tertiary care center,Riyadh, Saudi Arabia

Background

Herbal medicine has been widely utilized by pregnant women despite the limited available evidence regarding the safety and efficacy of that practice. The current available studies, from different countries, estimated that the use of herbal medicine during pregnancy range from 7% up to 96%. The aim of this study is to determine the prevalence, attitude, source of information, and reasoning behind the use of herbal medicine among pregnant women in Saudia Arabia.

Acute Cellular Rejection Predominated by Monocytes Is a Severe Form of Rejection in Human Renal Recipients With or Without Campath-1H (Alemtuzumab) Induction Therapy

Campath-1H has been used successfully for induction and has resulted in a low rate of acute cellular rejection (ACR) in renal transplantation in combination with various postoperative immunosuppression regimens. This study was undertaken to investigate the extent of monocyte involvement in ACR, with or without Campath-1H induction. We found that monocytes represented the majority of inflammatory cells in grades Ib or higher ACR, but not with Ia type of ACR, regardless of the status of Campath-1H induction. Cases of ACR, following Campath-1H induction, appear to demonstrate a 'pure form' of monocytic ACR, whereas monocytes were mixed with many other types of inflammatory cells in the cases of ACR in the absence of Campath-1H induction. In addition with Campath-1H induction, the cases of monocyte-predominant ACR were found to uniformly exhibit a good response to corticosteroid treatment. We conclude that monocyte-predominate ACR may represent a severe form of rejection, with or without Campath-1H treatment.     

Recombinant activated factor VII for intractable bleeding post splenectomy in a patient with myeloproliferative disorder.

Recombinant activated factor VII has been Food and Drug Administration approved to treat hemorrhages in hemophiliac patients with inhibitors and in acquired hemophilia patients. Recombinant activated factor VII use has also been considered for the management of uncontrolled bleeding in a number of congenital and acquired hemostatic abnormalities. The myeloproliferative disorders are a group of clonal hematologic diseases where, frequently, abnormal platelet function is considered a hallmark. This is the first case report addressing the clinical benefit of off-label use of recombinant activated factor VII in an attempt to control intractable bleeding in a patient with a myeloproliferative disorder after splenectomy.     

Comparison of the fertilizing capability of spermatozoa from ejaculates, epididymal aspirates and testicular biopsies using intracytoplasmic sperm injection

A prospective study was carried out to compare the fertilizing capability and pregnancy outcome following intracytoplasmic sperm injection (ICSI) using spermatozoa obtained from ejaculates, or surgically from epididymis or seminiferous tubules. A total of 77 ICSI cycles (one per patient) was included. In all, 28 patients had severe oligoasthenoteratozoospermia, 19 patients had obstructive azoospermia and 30 patients had non-obstructive azoospermia. The main outcome measures were fertilization rate per injected metaphase II oocyte and the clinical pregnancy rate per embryo transferred back to the female recipients. In patients with severe oligoasthenoteratozoospermia, the fertilization and pregnancy rates were 79 and 25 %. In patients with obstructive azoospermia, for whom epididymal spermatozoa were used, these were 75 and 28%, and in the non-obstructive group for which testicular spermatozoa were used for injection, they were 69 and 21% respectively. These rates were not significantly different in the three groups (P = 0.85 and P = 0.14 respectively), suggesting that spermatozoa from the ejaculates and epididymal or testicular biopsies are able to fertilize equally by using ICSI. Live birth per embryo transfer was significantly reduced in patients with non-obstructive azoospermia compared to the other two groups. The high abortion rate (50%) in the group in which testicular spermatozoa were used raises doubts about the developmental competence of such embryos.      

Quality of life among epileptic patients in Qassim Region,KSA

Objectives:To explore the influence of epilepsy on quality of life (QoL) among people with epilepsy in Saudi Arabia, and its association with sociodemographic and clinical characteristic aspects in the Qassim region.Methods:A cross-sectional multi-centered study done in the Qassim region from June 2018 to May 2019. A self-administered questionnaire was provided to 216 participants who attended the neurology clinic. We used a validated Arabic version of the QoL in Epilepsy (QOLIE-31) to measure the QoL.Results:The mean of the overall QOLIE-31 score was 64.23 ± 17.8. we found that employment status had a significant influence on the overall score (p<0.001) and all other QOL domains (rho ranged from -.136 for energy fatigue to -.193 for social function) Patients with focal seizures were significantly higher in emotional wellbeing (rho=-.159), seizure worry (rho=-.226), cognitive function (rho=-.166) and overall score (p=0.010) than patients with the generalized type. Monotherapy patients have higher scores in total (p<0.001) and all subscales except seizure worry and emotional wellbeing than those on polytherapy.Conclusion:Employment status, type of seizure, and AED number are the most important factors affecting Saudi patient’s QoL.

Many studies in multiple countries have tested quality of life (QoL) in epilepsy, and have highlighted areas of common concern. It has been shown that among Arabian people, epileptic patients are generally more susceptible to having higher levels of anxiety and depression.1 In Kenya, researchers have compared QoL between persons with epilepsy (PWE) and healthy people who have the same environment, social relationship, and living circumstances. These authors found that low education level, unemployment rate, unskilled employment, and low income were higher in PWE compared to their non-epileptic accompanying people.2 Despite the high prevalence rate in Saudi Arabia (6.54 per 1000),3 there has been limited research about the impact of QoL in epileptic patients. To better identify the factors that influence Saudi epilepsy patients, here we explore the influence of epilepsy on QoL among Saudi epileptic patients.     

A sticky situation: myocardial infarction in a young woman with immune thrombocytopenia on eltrombopag and a history of mediastinal radiation

Journal of Thrombosis and Thrombolysis - More recent immune thrombocytopenia (ITP) treatment strategies enhance platelet production with the use of thrombopoietin receptor agonists (TPO-RA) such as...