Hipotiroidismo subclínico y pérdida de embarazo: una revisión de la literatura / Subclinical Hypothyroidism and Pregnancy Loss: A Literature Review

Existe una alta prevalencia de hipotiroidismo subclínico (SCH) en el embarazo. Está vinculado a una importante morbilidad y mortalidad materna y fetal. Los efectos de SCH sobre el embarazo incluyen mayores riesgos de hipertensión gestacional y ruptura prematura de membranas (PROM). Sus fetos y bebés tenían más probabilidades de sufrir de bajo peso al nacer (LBW) y retraso del crecimiento intrauterino (IUGR). El riesgo de aborto espontáneo se informa alto en varios estudios para SCH no tratado. SCH se asocia directamente con una mayor presencia de anti -cuerpos anti TPO en suero materno. La detección temprana y el tratamiento de SCH han sido testigos de mejores resultados en términos de resultado del embarazo. Esta revisión se centra para establecer la relación de una mayor prevalencia de SCH en los países en desarrollo, así como su asociación con el aumento de los cuerpos anti TPO en suero materna y sacar una conclusión que puede ayudar a reducir las razones y proporcionar una solución. Este estudio concluyó que SCH es más frecuente en los países en desarrollo, ya sea debido a la deficiencia de yodo, una disminución de la conciencia sobre este problema o menos acceso a las instalaciones médicas. Por lo tanto, se sugiere que las hembras con antecedentes de partos prematuros, IUGR anteriores o abortos involuntarios deben someterse a una detección de hipotiroidismo subclínico y niveles de anticuerpos anti TPO durante sus visitas prenatales

There is a high prevalence of subclinical hypothyroidism (SCH) in pregnancy. It is linked to significant maternal and fetal morbidity and mortality. SCH's effects on pregnancy include increased risks of gestational hypertension and premature rupture of membranes (PROM). Their fetuses and infants had been more likely to suffer from low birth weight (LBW) and intrauterine growth retardation (IUGR). The risk of miscarriage is reported high in various studies for untreated SCH. SCH is directly associated with increased presence of anti TPO anti bodies in maternal serum. Early detection and treatment of SCH have witnessed better results in terms of pregnancy outcome. This review focuses to establish the relationship of increased prevalence of SCH in the developing countries as well as its association with increased anti TPO anti bodies in maternal serum and draw a conclusion which can help narrow down the reasons and provide solution. This study concluded that SCH is more prevalent in developing countries, either due to iodine deficiency, decreased awareness about this problem or less access to medical facilities. Therefore, it is suggested that females with history of preterm deliveries, previous IUGRs, or miscarriages should undergo screening for subclinical hypothyroidism and Anti TPO antibody levels during their antenatal visits.

UNA ENCUESTA DE CONOCIMIENTOS, ACTITUDES Y MEDIDAS PREVENTIVAS TOMADAS POR ESTUDIANTES DE MEDICINA Y ODONTOLOGÍA DURANTE LA PANDEMIA DE COVID-19 EN RIAD, ARABIA SAUDÍ / A Survey of Knowledge, Attitude, and Preventive Measures Taken by Medical and Dental Students during the COVID-19 Pandemic in Riyadh, Saudi Arabia

Objetivo: Con la enfermedad del coronavirus-2019 (COVID-19) convirtiéndose en una aflicción global, es imperativo evaluar el conocimiento, la actitud y las prácticas de los incipientes profesionales de la salud ante la pandemia. Por lo tanto, este estudio tuvo como objetivo evaluar el conocimiento y la actitud de los estudiantes de medicina y odontología frente a la infección COVID-19. Además, se analizaron las medidas preventivas ejercidas por ellos durante el brote. Método: Este estudio fue un estudio prospectivo, transversal, basado en un cuestionario. Se llevó a cabo en un período de 5 meses desde el 15 de abril de 2021 hasta el 15 de septiembre de 2021. Se difundió un cuestionario autoadministrado bien diseñado y validado a través de la plataforma Google Forms a 726 estudiantes de medicina y odontología de Riyadh, Arabia Saudita, después de obtener el consentimiento informado electrónico. Resultado: De los 726 encuestados, 490 eran mujeres y 236 hombres. Según los resultados, >50% de la población del estudio siguió al Ministerio de Salud, KSA, como su fuente de información para obtener las últimas actualizaciones sobre la infección por COVID-19, el 17,8% confió en las actualizaciones de la Organización Mundial de la Salud y el 17,1% recurrió a la red social actualizaciones Se encontró que el 92,33% de los estudiantes de medicina y odontología tenían un conocimiento adecuado de la pandemia y que el 96,55% demostró una actitud positiva hacia esto. Además, el 81,84% de los participantes adoptaron buenas prácticas con respecto a la infección. Conclusión: El presente estudio estableció que los estudiantes de medicina y odontología de Riyadh, Arabia Saudita, tienen un conocimiento adecuado sobre la pandemia. Los estudiantes también mostraron una actitud positiva hacia la situación. Sin embargo, con la disminución de la tasa de infección, las medidas prácticas se han reducido.

Objective: With coronavirus disease-2019 (COVID-19) becoming a global affliction, it is imperative to assess the knowledge, attitude, and practices of budding healthcare professionals toward the pandemic. Hence, this study aimed to evaluate the knowledge and attitude of medical and dental students toward COVID-19 infection. In addition, the preventive measures exercised by them during the outbreak were analyzed. Method: This study was a prospective, cross-sectional, questionnaire-based study. It was conducted over a period of 5 months from April 15, 2021 to September 15, 2021. A well-designed and validated self-administered questionnaire was disseminated through the Google Forms platform to 726 medical and dental students of Riyadh, Saudi Arabia, after obtaining electronic informed consent. Result: Of the 726 respondents, 490 were women and 236 were men. As per the results, >50% of the study population followed the Ministry of Health, KSA, as their source of information to obtain latest updates on COVID-19 infection, 17.8% relied on the World Health Organization updates, and 17.1% resorted to social network updates. It was found that 92.33% of the medical and dental students had adequate knowledge of the pandemic and that 96.55% demonstrated a positive attitude toward it. Furthermore, 81.84% of the participants adopted good practices with regard to the infection. Conclusion: The present study established that the medical and dental students of Riyadh, Saudi Arabia, have an adequate knowledge about the pandemic. The students also displayed a positive attitude toward the situation. However, with the decline in the infection rate, the practice measures have been reduced.

Solid neuroendocrine carcinoma of the breast

Primary neuroendocrine carcinoma of the breast is a rare disease that accounts for less than 5% of all cancers arising from the breast. The tumour cells stain positively for chromogranin and synaptophysin. This report describes the occurrence of infiltrating ductal carcinoma of breast with neuroendocrine differentiated tumour in 37 year old female. Early small cell neuroendocrine cancer of the breast that is treated with surgery and adjuvant chemotherapy shows an increased disease-free survival. She is planned for anthracycline/cyclophosphamide based chemotherapy followed by etoposide/platinum based chemotherapy. As her tumour showed ER/PR positivity, she will be given hormonal therapy subsequently, however, more extensive review is required to define a standard treatment protocol for this rare neoplasm.

Vasculopathy in patients with diabetic foot using doppler ultrasound

To determine the extent of vasculopathy in patients with diabetic foot using Doppler ultrasound scanning. This descriptive study was carried out in Surgical Unit III, Civil Hospital, Karachi from January 2004 to December 2005. All patients having diabetic foot complications including abscess formation, cellulitis, ulceration and gangrene were included in the study after taking informed consent. Peripheral pulses like posterior tibial, dorsalis pedis, and popliteal arteries were checked. The presence of vasculopathy was checked with Doppler scanning of dorsalis pedis artery, posterior tibial artery, popliteal artery and veins. The data was collected on a proforma that was specially designed for this study. Out of the total 30 patients included in this study, vasculopathy was detected in 19 [63.33%] patients. The pulse was clinically weak in 10 [33.33%] and absent in 7 [23.33%] patients, while the Doppler scan revealed that in 17 [56.66%] cases the dorsalis pedis artery and in 19 [63.33%] the posterior tibial artery was involved. These findings were asymmetrical i.e. they were mostly found in the affected limb, with a male preponderance. This study shows that the vasculopathy is strong independent risk factor in the development of diabetic foot lesions. The usual symptoms and signs of lower limb ischemia may not be present and indeed may be misleading in diabetic foot disease

Infant feeding in Saudi Arabia: mothers' attitudes and practices

We conducted a nationwide cross-sectional survey of 4872 mothers [mostly Saudi] to study infant feeding patterns. Information was collected about their feeding practices with their youngest child using pre-tested questionnaires. About four-fifths of the mothers had received health education about breastfeeding, most often from medical staff; younger mothers tended to be better informed. Approximately 92% fed colostrum to the newborn, but 76.1% had introduced bottle-feeding by 3 months [48.3% cited insufficient milk as the reason for introducing the bottle]. This was significantly related to nationality and education level. Mixed feeding [breastfeeding and bottle-feeding] was popular. Solid foods tended to be introduced late and this was significantly related to nationality, age and education level

Primary cutaneous melanoma of the foot

A 97 years old lady was admitted through the clinic with the history of a painless black lesion in the sole of her left foot. She clearly remembered presence of a nevus at that site since her childhood. The lesion had started to increase in size over the last two years and as it was not painful with no discharge or itching, she decided to delay medical consultation. She had associated osteoarthritis in both knees and angina pectoris, which was well-controlled on medications. Local examination revealed a 2 cm pigmented lesion with an irregular raised surface and irregular margins in the sole of the left forefoot. No intransit lesion could be visualized and the ipsilateral inguinal lymph node were not palpable. Systemic examination did not reveal any evidence of distant metastasis. The patient underwent routine preoperative blood tests including CBC, blood sugar level, renal function profile and ECG which were all essentially normal. The radiological metastatic workup was negative for systemic disease. She underwent excision biopsy under general anaesthesia which on frozen section confirmed malignant melanoma. A wide local lesion with 1.5 cm clearance and excision upto the plantar fascia was done. A split skin graft was placed to facilitate wound closure. Her post operative course was unremarkable and she was discharged next day from hospital. The final histopathology confirmed malignant melanoma Clark level 5 with clear margins of resection

Suppurative hidradenitis

Suppurative hidradenitis is a chronic relapsing inflammatory disease originating in apocrine gland follicles, which may become chronic and often indolent due to subcutaneous extension with induration, scarring, destruction of skin appendages and sinus formation