• Title/Summary/Keyword: Clinical faculty

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Consecutive versus concomitant follicle-stimulating hormone and highly purified human menopausal gonadotropin: A milder response but better quality

  • Maghraby, Hassan Ali;Agameya, Abdel Fattah Mohamed;Swelam, Manal Shafik;El Dabah, Nermeen Ahmed;Ahmed, Ola Youssef
    • Clinical and Experimental Reproductive Medicine
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    • v.49 no.2
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    • pp.135-141
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    • 2022
  • Objective: This study investigated the impact of two stimulation protocols using highly purified human menopausal gonadotropin (HP-hMG) on the endocrine profile, follicular fluid soluble Fas levels, and outcomes of intracytoplasmic sperm injection (ICSI) cycles. Methods: This prospective clinical trial included 100 normal-responder women undergoing ovarian stimulation for ICSI; 55 patients received concomitant follicle-stimulating hormone (FSH) plus HP-hMG from the start of stimulation, while 45 patients received FSH followed by HP-hMG during mid/late follicular stimulation. The primary outcome was the number of top-quality embryos. The secondary outcomes were the number and percentage of metaphase II (MII) oocytes and the clinical pregnancy rate. Results: The number of MII oocytes was significantly higher in the concomitant protocol (median, 13.0; interquartile range [IQR], 8.5-18.0 vs. 9.0 [8.0-13.0] in the consecutive protocol; p=0.009); however, the percentage of MII oocytes and the fertilization rate were significantly higher in the consecutive protocol (median, 90.91; IQR, 80.0-100.0 vs. 83.33 [75.0-93.8]; p=0.034 and median, 86.67; IQR, 76.9-100.0 vs. 77.78 [66.7-89.9]; p=0.028, respectively). No significant between-group differences were found in top-quality embryos (p=0.693) or the clinical pregnancy rate (65.9% vs. 61.8% in the consecutive vs. concomitant protocol, respectively). The median follicular fluid soluble Fas antigen level was significantly higher in the concomitant protocol (9,731.0 pg/mL; IQR, 6,004.5-10,807.6 vs. 6,350.2 pg/mL; IQR, 4,382.4-9,418.4; p=0.021). Conclusion: Personalized controlled ovarian stimulation using HP-hMG during the late follicular phase led to a significantly lower response, but did not affect the quality of ICSI.

Determining Potential Link between Environmental and Clinical Isolates of Cryptococcus neoformans/Cryptococcus gattii Species Complexes Using Phenotypic and Genotypic Characterisation

  • Kenosi Kebabonye;Mosimanegape Jongman;Daniel Loeto;Sikhulile Moyo;Wonderful Choga;Ishmael Kasvosve
    • Mycobiology
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    • v.51 no.6
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    • pp.452-462
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    • 2023
  • Opportunistic infections due to Cryptococcus neoformans and C. gattii species complexes continue to rise unabated among HIV/AIDS patients, despite improved antifungal therapies. Here, we collected a total of 20 environmental and 25 presumptive clinical cryptococcal isolates from cerebrospinal fluid (CSF) samples of 175 patients enrolled in an ongoing clinical trial Ambition 1 Project (Botswana-Harvard Partnership). Identity confirmation of the isolates was done using MALDI-TOF MS and PCR. We describe the diversity of the isolates by PCR fingerprinting and sequencing (Oxford Nanopore Technology) of the intergenic spacer region. Mating types of the isolates were determined by amplification of the MAT locus. We report an unusual prevalence of 42.1% of C. neoformans × C. deneoformans hybrids Serotype AD (n = 16), followed by 39.5% of C. neoformans Serotype A (n = 15), 5.3% of C. deneoformans, Serotype D (n = 2), 7.9% of C. gattii (n = 3), and 5.3% of C. tetragattii (n = 2) in 38 representative isolates that have been characterized. Mating type-specific PCR performed on 38 representative environmental and clinical isolates revealed that 16 (42.1%) were MATa/MAT𝛼 hybrids, 17 (44.7%) were MAT𝛼, and five (13.2%) possessed MATa mating type. We used conventional and NGS platforms to demonstrate a potential link between environmental and clinical isolates and lay a foundation to further describe mating patterns/history in Botswana.

Subepithelial connective tissue graft with and without the use of plasma rich in growth factors for treating root exposure

  • Lafzi, Ardeshir;Faramarzi, Masoumeh;Shirmohammadi, Adileh;Behrozian, Ahmad;Kashefimehr, Atabak;Khashabi, Ehsan
    • Journal of Periodontal and Implant Science
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    • v.42 no.6
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    • pp.196-203
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    • 2012
  • Purpose: The aim of this study was to evaluate the clinical efficiency of the subepithelial connective tissue graft (SCTG) with and without plasma rich in growth factor (PRGF) in the treatment of gingival recessions. Methods: Twenty bilateral buccal gingival Miller's Class I and II recessions were selected. Ten of the recessions were treated with SCTG and PRGF (test group). The rest ten of the recessions were treated with SCTG (control group). The clinical parameters including recession depth (RD), percentage of root coverage (RC), mucogingival junction (MGJ) position, clinical attachment level (CAL), and probing depth (PD) were measured at the baseline, and 1 and 3 months later. The data were analyzed using the Wilcoxon signed rank and Mann-Whitney U tests. Results: After 3 months, both groups showed a significant improvement in all of the mentioned criteria except PD. Although the amount of improvement was better in the SCTG+PRGF group than the SCTG only group, this difference was not statistically significant. The mean RC was $70.85{\pm}12.57$ in the test group and $75.83{\pm}24.68$ in the control group. Conclusions: Both SCTG+PRGF and SCTG only result in favorable clinical outcomes, but the added benefit of PRGF is not evident.

Prevalence, Laboratory Findings and Clinical Characteristics of Campylobacteriosis Agents among Hospitalized Children with Acute Gastroenteritis in Lebanon

  • Ghssein, Ghassan;Awada, Rana;Salami, Ali;Bahmad, Hisham F.;Awad, Ali;Joumaa, Wissam H.;Roz, Ali El
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.4
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    • pp.346-356
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    • 2021
  • Purpose: Campylobacter species are currently the most common cause of bacterial gastroenteritis. In Lebanon, Campylobacter infection occurrence is underdiagnosed owing to the lack of specific culture and rapid test kits, particularly among children. This study aimed to evaluate the prevalence, laboratory findings, and clinical characteristics of Campylobacter infection in hospitalized children with acute gastroenteritis in South Lebanon. Methods: We conducted a 6-month retrospective cohort study between January and June 2018, including 291 children aged between 1 month and 12 years, who were admitted to a tertiary healthcare center in South Lebanon. The medical files of the patients were reviewed to retrieve the required clinical information, including clinical and laboratory data. Results: The prevalence of campylobacteriosis agents in pediatric patients with acute gastroenteritis is 12.02%. Patients infected with Campylobacter had more severe acute gastroenteritis than Campylobacter-negative patients and often presented with high-grade fever, diarrhea episodes more than six times per day, diarrhea lasting for more than five days, and dehydration. Indeed, children with high-grade fever (≥38.5℃) were five times more likely to test positive for Campylobacter than those with low-grade fever. In addition, the results showed a higher Vesikari score for the majority of Campylobacter-positive patients with severe acute gastroenteritis compared to a moderate profile for Campylobacter-negative patients. Conclusion: The present study findings highlight that Campylobacter infection is frequent among children with acute gastroenteritis. Therefore, the detection of Campylobacter should be carried out for the diagnosis of human gastroenteritis in Lebanon, along with the detection of routine enteropathogens.

Association Between Pediatric Gastroesophageal Reflux Disease Symptom and Quality of Life Questionnaire Score, Endoscopy and Biopsy in Children with Clinical Gastroesophageal Reflux Disease: A Prospective Study

  • Fatima Safira Alatas ;Dian Wulandaru Sukmaning Pertiwi ;Muzal Kadim;Pramita Dwipoerwantoro;Hanifah Oswari ;Badriul Hegar ;Yvan Vandenplas
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.4
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    • pp.173-180
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    • 2023
  • Purpose: Gastro esophageal reflux disease (GERD) is a burdensome disease affecting many children. A clinical examination is reported to be unreliable to diagnose GERD in children. This study aimed to investigate the relationship between the Pediatric Gastroesophageal Reflux Disease Symptom and Quality of Life Questionnaire (PGSQ) and endoscopic and histopathological findings in children with symptoms suggesting GERD. Changes in the PGSQ score in children with esophagitis as response to one month therapy were recorded as secondary outcome. Methods: This is a prospective cohort study in the pediatric outpatient clinic in an Indonesian tertiary hospital. Children aged 2-17 years old with clinical symptoms suspected of GERD are included in the study. Blinded endoscopic and histopathological examination was performed in all patients before one month proton pump inhibitors (PPI) therapy. The PGSQ information was collected at inclusion and after one month PPI treatment. Results: Fifty-eight subjects were included. Esophagitis was found in 60.9% of subjects according to endoscopy and 58.6% according to histology. There was no significant relationship between the PGSQ score and endoscopic (p=0.781) nor biopsy (p=0.740) examinations. The PGSQ showed a low diagnostic value compared to endoscopy and biopsy (area under the curve [AUC] 0.477, p=0.477, 95% confidence interval [CI] 0.326-0.629 and AUC 0.474, p=0.740 (95% CI 0.321-0.627 respectively). The PGSQ improved significantly post one month of PPI treatment. Conclusion: The PGSQ cannot be used to diagnose esophagitis in children with clinical symptoms suggesting GERD. However, the PGSQ can be used to monitor the treatment response in children with esophagitis.

Clinical Characteristics of Gynecologic Cancer Patients who Respond to Salvage Treatment with Lingzhi

  • Suprasert, Prapaporn;Apichartpiyakul, Chatchawann;Sakonwasun, Choompone;Nitisuwanraksa, Pimonphan;Phuackchantuck, Rochana
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4193-4196
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    • 2014
  • Lingzhi or Ganoderma lucidum is a popular medicinal mushroom used as a health promotion herb in China and other Asian countries for thousands of years. There have many previous studies about the anti-cancer effects of lingzhi especially in vitro. The present study reports the clinical data of 5 gynecologic cancer patients who achieved stability in the disease after ingestion of lingzhi in the form of fruit body water extract and spores in a salvage setting. This report has been written to enhance the data describing the effect of lingzhi in cancer patients.

The use of extracorporeal membrane oxygenation in children with acute fulminant myocarditis

  • Heinsar, Silver;Raman, Sainath;Suen, Jacky Y.;Cho, Hwa Jin;Fraser, John F.
    • Clinical and Experimental Pediatrics
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    • v.64 no.5
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    • pp.188-195
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    • 2021
  • Acute fulminant myocarditis (AFM) occurs as an inflammatory response to an initial myocardial insult. Its rapid and deadly progression calls for prompt diagnosis with aggressive treatment measures. The demonstration of its excellent recovery potential has led to increasing use of mechanical circulatory support, especially extracorporeal membrane oxygenation (ECMO). Arrhythmias, organ failure, elevated cardiac biomarkers, and decreased ventricular function at presentation predict requirement for ECMO. In these patients, ECMO should be considered earlier as the clinical course of AFM can be unpredictable and can lead to rapid haemodynamic collapse. Key uncertainties that clinicians face when managing children with AFM such as timing of initiation of ECMO and left ventricular decompression need further investigation.

Is it too Audacious to Challenge: Roadmap for a Primetime of Clinical Pharmacy in Korea (한국 임상약학은 어디로 달려가는가?: 한국 임상약학 발전을 위한 제안서)

  • Min, Bo-kyung
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.2
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    • pp.182-187
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    • 2011
  • The Korean pharmacy education has been facing extraordinary challenges. Clinical pharmacy has been embraced into mainstream in the new curriculum since its introduction in Korea. Although these changes are positive to provide our graduates adequate knowledge and skills to meet international standards of pharmacy education, current preparedness is far from desired goals. Thus, faculty members and clinical pharmacy experts from diverse walks are tirelessly committed to develop clinically oriented educational sites. However, it is important to recognize that pharmacy practice, research, and education should be aligned with the $Profession^{\circ}{\Phi}s$ vision. Most faculty members in clinical pharmacy were unexceptionally expected to tackle educational challenges with new curriculum. All academicians must profess throughout their career. Fundamental component in academic career is research accomplishments. The prosperity of clinical pharmacy inevitably goes with research. Clinical researchers in Korea are underprivilaged over basic scientists due to less funding opportunity, administrative support, and research resources. Clinical pharmacy researchers should further overcome poor recognition among other healthcare professionals and government. Aggressive networking and support and awareness of pharmacy oriented clinical research from the Korean college of clinical pharmacy would nurture clinical pharmacy research. With research progress, clinical pharmacy would be prerogative in Korean pharmacy advance.

Thailand Consensus on Helicobacter pylori Treatment 2015

  • Mahachai, Varocha;Vilaichone, Ratha-Korn;Pittayanon, Rapat;Rojborwonwitaya, Jarin;Leelakusolvong, Somchai;Kositchaiwat, Chomsri;Mairiang, Pisaln;Praisontarangkul, Ong-Ard;Ovartlarnporn, Buncha;Sottisuporn, Jaksin;Pisespongsa, Pises;Maneerattanaporn, Monthira;Sony, Ravin;Sirinthornpunya, Siam;Chaiyamahapurk, Orawan;Wiwattanachang, Olarn;Sansak, Inchaya;Harnsomboon, Piyathida;Chitapanarux, Taned;Chuenrattanakul, Surapon
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2351-2360
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    • 2016
  • Management of Helicobacter pylori infection is an important aspect of many upper gastrointestinal tract diseases, such as chronic gastritis, peptic ulcer disease, gastric cancer and mucosa-associated lymphoid tissue (MALT) lymphoma. The Thailand Consensus on H. pylori treatment 2015 consisted of 22 national experts who took active roles, discussed all important clinical information and investigated clinical aspects in four workshops, focuising on: (1) Diagnosis (2) Treatment (3) Follow-up after eradication and (4) H. pylori infection and special conditions. Experts were invited to participate on the basis of their expertise and contribution to H. pylori works and/or consensus methodology. The results of each workshop were taken to a final consensus vote by all experts. Recommendations were developed from the best evidence and availability to guide clinicians in management of this specific infection associated with variety of clinical outcomes.

Interferon-γ and Interleukin-10 Gene Polymorphisms are not Predictors of Chronic Hepatitis C (Genotype-4) Disease Progression

  • Bahgat, Nermine Ahmed;Kamal, Manal Mohamed;Abdelaziz, Ashraf Omar;Mohye, Mohamed Ahmed;Shousha, Hend Ibrahim;ahmed, Mae Mohamed;Elbaz, Tamer Mahmoud;Nabil, Mohamed Mahmoud
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.5025-5030
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    • 2015
  • Immunoregulatory cytokines have an influence on hepatitis C virus (HCV) infection outcome. This study aimed to determine whether single nucleotide polymorphisms (SNP) in IFN- ${\gamma}$ and IL-10 genes are associated with susceptibility and/or are markers of prognosis regarding chronic hepatitis C outcomes. IFN ${\gamma}$ (+874T/A) and IL-10 (-1082G/A) genotypes were determined in 75 HCV genotype 4 patients with different disease severities (chronic hepatitis, n=25, liver cirrhosis and hepatocellular carcinoma (HCC) on top of liver cirrhosis, n=50) and 25 healthy participants using allele-specific polymerase chain reaction. No statistical differences in allele or genotype distributions of IFN ${\gamma}$ and IL-10 genes were detected between patients and controls or between patientgroups. No significant difference in the frequency of IL-10 SNP at position -1082 or IFN-${\gamma}$ at position +874T/A was found between chronic HCV genotype 4 and with progression of disease severity in liver cirrhosis or HCC. In conclusion; interferon-${\gamma}$ and interleukin-10 gene polymorphisms are not predictors of disease progression in patients with chronic hepatitis C (Genotype-4).