Percutaneous needle aspiration versus catheter drainage in treating hepatic abscess

Aim of the study: was to investigate the effectiveness of Percutaneous Needle Aspiration in comparison to continuous catheter drainage in the treatment of hepatic abscesses

Methods: A review of the scientific literature [From 1980 to October 2017] MEDLINE, EMBASE, SCOPUS, Current Contents, Cochrane Library, and Clinicaltrials.gov were searched to identify randomized controlled trials that investigated thoroughly the Percutaneous Needle Aspiration Versus Catheter Drainage in the treating of hepatic abscess and clearly met the inclusion criteria and the study primary endpoints [success rate, total resolution and mortality]. Identification of papers and data extraction were performed by independent researchers

Results: the search yielded six eligible RCTs covering 348 patients. The meta-analysis showed that outcomes in patients treated with PCD were superior to those in patients treated with PNA in terms of success rate [RR: 0.79, 95% CI=0.64-0.97; P = 0.04], days to achieve a 50% reduction in abscess cavity size [SMD: ?1.076, 95% CI 0.63-1.51; P < 0.00001] and overall clinical improvement [SMD: 0.71, 95% CI 0.35-1.09; P =0.0001]. On the other hand, no significant difference was notable in the duration of hospitalization [SMD: -0.15, 95% CI -2.03 to 1.72, P = 0.84] or procedure-related complications [RR: 0.48, 95% CI 0.13-2.58; P = 0.39]

Conclusion: The results of the present meta-analysis and systematic review indicated that PCD and PNA can be less safe and less invasive methods for the treatment of hepatic abscesses yet PCD is suggested to be more advantageous and superior to PNA

Overview of risk factors of diabetic macular edema treatment prognosis

Background: Diabetes mellitus [DM] is just one of the world's fastest growing chronic conditions as well as a leading cause of acquired vision loss, diabetic macular edema [DME] is a disease linked to diabetes. Some individuals with diabetes will certainly get a kind of retinopathy-a problem of the retina in the eye. Diabetic retinopathy could progress as well as result in DME [additionally referred to as retinal swelling] that might impact your vision, and is among the most usual reasons for blindness

Objective: In this review we discuss about the most dangerous risk factors during treatment and in daily life, which can worsen the treatment prognosis

Methods: PubMed and Embase database were searched up to July, 2018 for relevant studies that discussing the risk factors of glaucoma

Result: It is clear that the variety of people affected by DM is expanding greatly, as is the variety of patients with problems from DM. Fortunately; the eye symptoms of DME can be identified and managed prior to considerable vision loss happens if patients with DM undergo routine eye tests and much better manage their systemic condition

Conclusion: Close collaboration in between doctors and also ophthalmologists is important in the managing of patients with diabetic retinopathy and also DME. To make certain very early medical diagnosis as well as treatment all diabetic person patients should be screened for diabetic person retinopathy. Control of blood pressure, serum lipids, and also renal function are very important treatments focused on prevention of visual impairment associated with diabetic retinopathy and DME

Relationship between renal failure and hypertension among patients in riyadh, saudi arabia

Background: chronic kidney disease [CKD] is common in Saudi although there are few data on the prevalence of this disorder. Therefore, we initiated a multicenter screening study to identify the prevalence and staging of CKD in 712 patients with known hypertension in four hospitals in Riyadh, Saudi Arabia

Method: we measured estimated glomerular filtration rate by the six-variable modification of diet in renal disease equation and proteinuria by the protein/creatinine ratio. All the subjects studied were Saudis

Results: of the 712 patients studied, the median age was 59 years [range 19-90 years] and 560 [78.7%] of the patients were female. The mean duration of hypertension was 4 years [range 0.1-50]. The overall prevalence of CKD was 46.9% [95% CI: 43.2-50.7%]; 19.1% had CKD stages 1-2 and 27.8% had CKD stages 3-5. There was no difference in age between patients with or without CKD [p = 0.12]. The overall prevalence of proteinuria was 28.9% [95% CI: 25.6-32.4%]; 14.7% of subjects had preexisting diabetes mellitus and their prevalence of CKD [55%; 95% CI: 42.4-62.2] did not differ from those without diabetes [46%; 95% CI: 41.9-50.0, p = 0.133]

Conclusion: CKD is common in hypertensive patients in Riyadh, Saudi Arabia with a prevalence of 46.9%. This provided justification for the inclusion of this group in CKD screening programs in Saudi

Review on liver cirrhosis complications and treatment

Background: cirrhosis is a late stage of scarring [fibrosis] of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. The liver carries out several necessary functions, including detoxifying harmful substances in your body, cleaning your blood and making vital nutrients. Cirrhosis occurs in response to damage to your liver. Each time your liver is injured, it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function

Objective of the Study: review and evaluate the best practices in diagnosis, complications and management of cirrhosis, and novel clinical and scientific developments

Methods: electronic search in the scientific database from 1966 to 2017- [Medline, Embase, the Cochrane Library as well as NHS center websites were searched for English Publications obtained from both reprint requests and by searching the database. Data extracted included authors, country, and year of publication, age and sex of patients, epidemiology, geographical distribution, pathophysiology, risk factors, clinical manifestations, investigations and types of surgical treatment

Results: there is sufficient body of evidence suggesting that cirrhosis is a pathological diagnosis with no laboratory cutoff values for the diagnosis of cirrhosis. However, it can still be diagnosed clinically, by history, physical examination laboratory analyses and ancillary testing such as ultrasonography. Early diagnosis has proven to give relevantly better case management results while late detection can only hardly manage the symptoms accompanied with cirrhosis

Conclusion: Screening for chronic liver disease is a key factor for early detection of signs for liver damage, which can be performed inexpensively and easily with clinical history-taking, measurement of transaminase concentrations, upper abdominal ultrasonography, and transient elastography [where available]. Abnormal findings should prompt specific diagnostic testing to determine the etiology of the underlying disease. In most patients, the dynamic process of progressive fibrosis, which could ultimately lead to cirrhosis, can be interrupted by the timely recognition of the risk, followed by appropriate treatment