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The incidence of obstetric acute renal failure remains significant in developing countries. The aim of our study is to define the risk factors involved in the occurrence of ARF during pregnancy or during the immediate postpartum period and to evaluate its evolutionary profile in terms of epidemiology, etiopathogenesis, and therapeutic management over the years in Morocco. This is a retrospective study conducted in the maternal-infant resuscitation service of the Ibn Rochd University Hospital of Casablanca, over the period from January 2020 to August 2023, including 95 patients. The current incidence in our series over this period was 22.2%. The mean age of our population was 33 ± 7.74 years [18-43 years], 67.3% of patients were in the gestational period, compared to 33.7% in the immediate postpartum period. Fourteen patients were primiparous (8.6%), 27.4% had a history of miscarriage, and 10.7% had a history of pre-eclampsia. Oligo-anuria was initially identified in 24 patients. The most frequent etiology was pre-eclampsia (56.7%), followed by hemorrhage (27%) and sepsis (19.3%). The evolution was marked by recourse to hemodialysis in 62% of cases, with a maternal mortality of 26%. The existence of heart disease, the context of pre-eclampsia, and the use of diuretics and vasoactive drugs were significantly correlated with maternal survival. No factor was correlated with secondary recovery from ARF. The development of health structures and the optimization of screening strategies are the keywords for prevention.

Dentistry has much to offer in the detection and solution of crime or civil proceedings. Forensic dentistry requires an interdisciplinary knowledge of dental science, and it is the role of the Forensic Odontologist to establish a person's identity. Teeth, with their physiologic variations, pathosis record information that remains throughout life and beyond. Forensic Odontology has an important role in the recognition of abuse among children. Teeth may also be used as a weapon against children, and physical evidence such as DNA, bite marks, fingerprints may objectively link suspects to a crime and develop important investigative leads. Gender identification and sex determination by analyzing the pulp tissue in primary teeth can be regarded as an effective tool in providing valuable forensic information. The rights of children and their aspirations are of paramount importance, and the Pediatric dentist can contribute immensely to the field of Forensic Odontology in providing justice to these unfortunate children.

A 61-year-old patient with autosomal dominant polycystic kidney disease (Irazabal class 1E) in whom renal function had decreased and kidney size had increased over the past 3 years (change in serum creatinine, 1.3 mg/dL to 1.5 mg/dL; change in total kidney volume, 5632 cm3 to 7301 cm3) was treated with tolvaptan 60 mg/day. After 8 years of tolvaptan treatment, serum creatinine remained at 1.51 mg/dL, and total kidney volume was at 6812 cm3. Adequate salt intake and good weight control may have resulted in good outcomes, even in patients with treatment-resistant giant cystic kidney disease.

Touch DNA, the minute quantities of DNA deposited through skin contact, has become a valuable tool in forensic investigations. However, the recovery of touch DNA from non-porous surfaces remains a challenging task, requiring optimized collection and extraction techniques to maximize DNA yield, because non-porous surfaces have smooth, non-absorbing material properties. This review explores various non-porous surfaces such as glass, plastic, and metal, analyzing their impact on DNA recovery efficiency. Different collection methods, including swabbing, tape lifting, scrubbing, and vacuum collection methods, are evaluated to determine their effectiveness in retrieving minute amounts of DNA from these surfaces. Through a comparative analysis of existing studies, this paper identifies which collection methods work best for different non-porous surfaces and why choosing the right technique matters. Factors such as surface type, environmental conditions, and collection technique performed, time duration, and so on can affect DNA recovery, making it crucial to use the most effective approach. This review also emphasizes the need for standardized protocols to ensure consistent and reliable results in forensic investigations. Having clear guidelines can reduce errors, improve DNA analysis, and make touch DNA analysis more reliable in forensic investigations. By focusing on these aspects, this study aims to contribute to the ongoing efforts in refining touch DNA recovery strategies.

Introduction: Bronchoscopy could lead to local spread of pre-existing infection, spread of infection from one patient to another if the bronchoscope is disinfected inadequately, or, isolation of microorganisms from bronchoscopic specimens in a patient who is clinically not infected, i.e., pseudo-infection. This study is one such investigation of an outbreak of bronchoscopic pseudo-infections in a tertiary care hospital.Materials and methods: Bronchoalveolar lavage (BAL) samples were inoculated onto MacConkey Agar and 5% Sheep Blood Agar and incubated at 37 °C overnight. The growths obtained on culture media were processed for identification and antimicrobial susceptibility on Vitek 2 Compact as per manufacturer’s instructions. To investigate the outbreak, 5 mL - 10 mL of sterile water was flushed through the channels of disinfected bronchoscope and collected in a sterile container. The samples were centrifuged and inoculated onto MacConkey Agar and 5% Sheep Blood Agar. The growths obtained were further processed similarly as the BAL samples were processed. Environmental swabs collected from the bronchoscopy unit were also processed as the procedure mentioned above.Results: Bronchoalveolar lavage of 3 patients in a period of 1 week were contaminated with multidrug resistant Klebsiella pneumoniae. Two out of five bronchoscope fluid samples were also contaminated with Klebsiella pneumoniae. Among the swabs collected from bronchoscope unit, Klebsiella pneumoniae was isolated from the detergent box of the endowasher. Conclusion: The risk of propagation of infection via a bronchoscope can be evaded by proper reprocessing and improving the sterilization practices. 

Objective: Comparison of visual field progression in patients with Primary Open-angle Glaucoma (POAG) and Pseudo Exfoliative Glaucoma (PEXG).Methods and materials: This is a 2-year longitudinal prospective study including 60 glaucomatous eyes with VA CF ≥ 3 m, IOP ≥ 20 mmHg, CDR ≥ 0.6 and those with Shaffer’s grade 3 or above were categorized as POAG along with signs of Pseudo exfoliative material as PEXG.Patients on anti-glaucoma medications and those who have undergone cataract and glaucoma surgeries are also included in this study. 24-2 visual field test was performed using Humphrey Field Analyzer & the progression was assessed based on 3 parameters- Mean Deviation (MD), Visual Field Index (VFI) & Guided Progression Analysis (GPA).Results: The difference in MD & VFI was higher in PEXG (-5.77 dB) (10.88%) than in POAG (-1.56 dB) (7.17%) respectively & was significant statistically (t - test, p = < 0.001). The GPA showed fast progression in 53.30% of cases in PEXG, 13.30% in POAG (Chi-square, p = < 0.001) about 63.30% of POAG & 46.70% of PEXG showed slow- moderate progression, but 23.30% of POAG subjects had no progression.Conclusion: Compared to POAG, the study showed that PEXG had frequent & faster visual field worsening. Therefore, PEXG patients require more stringent management & treatment than those with POAG.

Introduction: Cognitive impairment is defined as a new deficit in at least two areas of cognitive functioning. These may include disturbances in memory, executive functioning, attention or speed of information processing, perceptual motor abilities, or language. It has been shown that cognitive impairment is associated with the severity of kidney disease. Methods: The study was a descriptive research design, with participants purposively sampled from the general chronic kidney disease population which included haemodialysis and peritoneal dialysis patients at Steve Biko Academic Hospital in Pretoria, Gauteng Province, South Africa. Hundred and fifty-one participants (76 hemodialysis & 75 peritoneal dialysis patients), 58% were males, and 42% were females aged 19-61 years. To establish the prevalence of cognitive impairment by testing the level of cognition the Mini-Mental State Examination was utilized to provide a brief screening test to quantitatively assess the cognitive abilities and cognitive changes of patients while on dialysis. Results: Ninety-nine percent (99%) of the recruited population reported no cognitive impairment, irrespective of dialysis modality, demographic characteristics, and socio-economic status. Conclusion: Despite the findings highlighting that the majority of the chronic kidney disease population at Steve Biko Academic Hospital reported no cognitive impairment, it is crucial to increase awareness of the potential effects of cognitive impairment on daily activities, quality of life, and treatment adherence. Early detection and management of cognitive impairment can significantly impact the quality of life and adherence to treatment among these patients. Further research is needed to understand the prevalence and impact of cognitive impairment in different populations and to develop effective interventions for its prevention and management.

Familial hypocalciuric hypercalcemia (FHH) is one of the rare reasons for hypercalcemia. FHH is an autosomal dominant disease that is inheritable. The most common calcium sensitive receptors (CaSR) develop because of the inactivation of. In addition, they also develop due to the function loss of AP2S1 and GNA11. The FHH sickness is characterized by hypercalcemia, hypocalciuria, the regular or increased level of the parathyroid hormone, and normal renal function. The symptoms of hypercalcemia are usually not observed. It is often diagnosed by calculating the calcium/creatine clearance ratio of a 24-hour urine sample, and then genetically looking at it. FHH is usually a benign disorder, and when symptomatic and rarely complications develop, calcimimetics are used or parathyroidectomy can be performed. In conclusion, FHH is a benign and genetically transmitted, moderate cause of hypercalcemia. It is rare and usually asymptomatic.

Background: Absence of nocturnal decrease in Blood Pressure (BP) (“non-dipping”) has been shown to be a strong and independent predictor of cardiovascular events, target organ damage, cardiovascular sequela and cardiovascular mortality. Obstructive Sleep Apnea (OSA) has been associated with non-dipping with an estimated prevalence of approximately 50%, but factors associated with non-dipping in OSA patients remain poorly understood. In this study, we examined clinically relevant variables associated with non-dipping in OSA.Methods: Patients (n = 35) undergoing overnight valuation for OSA, laboratory-based polysomnography, structured clinical interviews, and comprehensive metabolic and anthropometric evaluations, and ambulatory BP monitoring for 24 hours. Patients were classified into a) dipping BP group or b) non-dipping BP group, based on (a) a nocturnal systolic BP decrease of 10% - 20% or (b) a systolic BP decrease of < 10%. Results: Patients had moderate and severe OSA (AHI = 34.8 ± 29.1), and 42.9% demonstrated a non-dipping BP pattern. The severity of OSA measures did not differ between dipping group and non-dipping group. However, Wake after Sleep Onset (WASO) and chronicity of insomnia predicts non-dipping BP independent of demographics, sleep stages, anthropometrics, metabolic measures, or arterial stiffness. Conclusion: These findings contribute to a better understanding of the cardiovascular impacts of OSA and indicate that sleep quality should be incorporated into clinical assessments and management of OSA patients.

Introduction: Pleomorphic Carcinoma (PC) is a subset of poorly differentiated non–small cell lung cancer that is diagnostically challenging because it is a rare malignancy of the lung. It shows varying dual-cell components; spindle or giant cells and epithelial cells.Method: We report a case of 68-year-old non-smoking female who presented with cough, fever, pain in the left side of chest & weight loss of recent onset and an abnormal shadow on her chest X-ray. Computed tomography of chest revealed a well defined heterogeneously enhancing cavitatory soft tissue lesion in the posterior basal segment of the left lower lobe with mediastinal lymphadenopathy.Results: Fine needle aspiration cytology& percutaneous lung biopsy confirmed poorly differentiated malignant tumor. Patient underwent a left lower lobectomy. A diagnosis of PC was confirmed after Immunohistochemistry (IHC). Mutation analysis revealed an EGFR exon 21 mutation within the tumor cells. The patient is on Gefitinib based chemotherapy and has remained disease-free for three years post-surgery.Conclusion: PC of the lung is a rare pathological entity. Definite diagnosis may only be made on a resected tumor along with the use of IHC. Surgical resection is the main modality of the treatment. Such rare cases should be documented to establish an optimal management plan and to provide a further insight to targeted therapy.