International journal of clinical practice
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Int. J. Clin. Pract. · Aug 2021
ReviewIntraoperative Neurophysiological Monitoring (IONM) In Pediatric Neurosurgery.
Intraoperative neurophysiological monitoring (IONM) is commonly used in various surgical procedures in adults, but with technological and anaesthetic advancements, its use has extended to the paediatric population. The use of IONM in children poses a unique set of challenges considering the anatomical and physiological differences in this group of patients. ⋯ In this article, we review the use of IONM in paediatric patients undergoing various spinal and cranial neurosurgical procedures. We discuss the patient characteristics, type of surgeries, and technical and anaesthetic considerations about IONM in this population.
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Int. J. Clin. Pract. · Aug 2021
Meta AnalysisComparative risk of new-onset hyperkalemia for antihypertensive drugs in patients with diabetic nephropathy: A Bayesian network meta-analysis.
Several randomised controlled trials (RCTs) have evaluated the risk of hyperkalemia of antihypertensive drugs on diabetic nephropathy, yet the results are conflicting. We searched MEDLINE, Embase, The Cochrane Library, and Web of Science for RCTs investigating the risk of antihypertensive drugs on hyperkalemia in diabetic nephropathy from inception to May 31, 2020. Direct comparative meta-analysis showed that the proportion of patients with hyperkalemia was significantly higher in the ARB, aldosterone antagonist, renin inhibitor group than in the placebo group. ⋯ Network meta-analysis showed the risk of hyperkalemia in the ARB, aldosterone antagonist, and renin inhibitor group was higher than in the placebo group, but there was no statistical difference between the CCB, ACEI, β blocker, endothelin inhibitor, and diuretic groups than in the placebo group. The possibility of antihypertensive drugs in risk of hyperkalemia being the worst treatment was aldosterone antagonist (98.8%), followed by ARB (73.8%), renin inhibitor (63.8%), diuretic (53.1%), ACEI (46.9%), β blocker (36.8%), endothelin inhibitor (35.2%), placebo (27.1%), and finally CCB (14.3.1%). Therefore, aldosterone antagonist seems worse than other antihypertensive drugs in the risk of hyperkalemia in patients with diabetic nephropathy.
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Int. J. Clin. Pract. · Aug 2021
ReviewPotential effects of Pomegranate (Punica granatum) on Rheumatoid arthritis: A systematic review.
Taking into account the adverse impact of the drug therapy on rheumatoid arthritis (RA), adjuvant therapies without such undesirable effects have recently gained increasing interest. Several studies have examined the potential properties of pomegranate on RA with some uncertain mechanisms suggested. This review aimed to systematically review the available evidence in this regard. ⋯ This paper gives compelling evidence regarding the efficacy of pomegranate in RA and justifies the significance of further clinical researches.
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Int. J. Clin. Pract. · Aug 2021
Multicenter StudyThe effect of optical dilatation before retrograde intrarenal surgery on success and complications: results of the RIRSearch group study.
The guidelines propose optical dilatation before retrograde intrarenal surgery (RIRS), but there are currently no evidence-based studies concerning the impact of optical dilatation with semirigid ureteroscopy (sURS). The aim of this study was to evaluate the effect of optical dilatation through sURS prior to the RIRS procedure on the success and complications of RIRS. ⋯ Optical dilatation with sURS before RIRS increases surgical success by raising the rate of UAS placement and reducing the rate of intraoperative complications. We suggest that this method can be routinely applied to patients who have not been passively dilated with a JJ stent.
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Int. J. Clin. Pract. · Aug 2021
Cesarean Section Delivery From Maternal Perspective : An Exploratory Study in Jordan.
This study aims to determine females' views, experiences and attitudes regarding the caesarean section (CS) and to explore the factors that increase the prevalence of CS in Jordan. ⋯ This study indicated that Jordanian females do not have reliable sources of information about CS. This leads to lower awareness of CS and its complications, and, as expected, CS is more likely to be performed by privately insured women.