ABSTRACT
Background: Brucellosis is a zoonotic disease that is widely spread across the globe, with the number of cases increasing annually. Spinal brucellosis is known to affect about half of patients with brucellosis. Nevertheless, data on the optimal antibiotic regimens for spinal brucellosis are limited. Therefore, this study aims to compare antibiotic treatment regimens for spinal brucellosis at our center in Makkah, Saudi Arabia. Methods: This is a retrospective cohort study of an 11-year period from 2010 to 2021 conducted at a single center in Makkah, Saudi Arabia. All patients with spinal brucellosis were included. Patients were excluded if the duration of the received antibiotic regimen or follow-up was poorly documented. Data analysis was conducted using RStudio (R version 4.1.1). Categorical variables of each regimen used by the patients were presented as frequencies and percentages, while numerical variables were summarized using the median and interquartile range (IQR). Results: A total of 35 patients were included; the median (IQR) age of the patients was 58.0 (48.0 to 63.0) years. The most frequently reported symptoms upon admission included low back pain (83.3%). The most frequently administered regimen was the combination of streptomycin + doxycycline + rifampicin (SDR) (20 patients, 55.6%), followed by the combination of streptomycin + rifampicin + trimethoprim/sulfamethoxazole (SRT) (eight patients, 22.2%). Overall, out of the total 35 patients who received first-line treatment, only six patients experienced therapy failure. Out of the total six patients who experienced first-line treatment failure with SDR (five patients, 83%) and SDT (one patient, 17%), surgery was indicated for three patients. Surgical intervention was deemed necessary in 12 patients (34%). Three patients chose not to undergo surgical intervention but still showed complete improvement upon completing the treatment duration. One patient experienced a postoperative complication, resulting in paraplegia. Conclusions: In this study, we found that among 35 patients, treatment failure was observed only in six patients who received triple therapy. In addition, surgical intervention was indicated in 12 patients; however, three patients refused surgery and improved ultimately after changing or extending the duration of the antibiotic regimen.
ABSTRACT
Background and Objective: Clinicians must possess a comprehensive understanding of variations in canal morphology and configuration during endodontic procedures to enhance treatment success. This study aims to assess and analyze the canal configurations of maxillary first premolars using Cone-Beam Computed Tomography within the sub-population of Western Saudi Arabia. Materials and Methods: In this cross-sectional study, following the acquisition of ethical clearance from Batterjee Medical College in Jeddah, Saudi Arabia, a retrospective examination of Cone-Beam Computed Tomography (CBCT) scans of maxillary first premolars in adult patients was conducted. The study focused on quantifying the number of canals and characterizing their configurations, with classification based on Vertucci's categorization. Results: The study examined 399 CBCT images of maxillary first premolars, revealing that type IV canal configurations were the predominant morphology (56.9%), followed by type V (24.6%). Significant gender-related disparities were observed, with females displaying a higher incidence of types I and V canals. At the same time, males exhibited a greater prevalence of types IV and VI canals. Notably, no substantial associations were discerned between canal types and age groups. Conclusion: Within the context of maxillary first premolars, type IV canal configuration emerged as the most prevalent. Gender-based distinctions were evident, with females predominantly presenting types I and V canal configurations, whereas males displayed a higher occurrence of types IV and VI canal configurations.
ABSTRACT
We report the case of a 51-year-old gentleman who underwent living renal transplantation in Pakistan for end-stage renal disease one and a half years ago. He presented to our hospital with renal artery stenosis and an extra-renal pseudoaneurysm at the anastomotic site of the transplanted kidney. This can cause graft dysfunction and hypertension due to impairment of arterial perfusion in the transplanted kidney. Treatment with percutaneous transluminal angioplasty and covered stenting of the pseudoaneurysm and stenosis improved kidney function and hypertension.
