ABSTRACT
Background and Aim: Non-alcoholic fatty liver (NAFLD) is one of the most common progressive metabolic disorders worldwide. There are increasing scientific interests nowadays for the association between vitamin D status and Non-alcoholic fatty liver. Earlier studies have revealed that vitamin D deficiency is highly prevalent in Non-alcoholic fatty liver patients that contributes to poor outcomes. Hence, the present study aimed to assess the efficacy and safety of oral cholecalciferol on Non-alcoholic fatty liver patients. Subjects and Methods: This study was conducted on 140 patients that were randomized either to group 1 that received the standard conventional therapy in addition to placebo or group 2 that received the standard conventional therapy in addition to cholecalciferol during the 4 months study period. Results: At the end of the study group 2 revealed significant decrease (p < 0.05) in the mean serum level of TG, LDL-C, TC, hsCRP as compared to their baseline results and group 1 results. Additionally, a significant improvement in the serum levels of ALT (p = 0.001) was seen in group 2 at the end of the study when compared to group 1. Whereas group 1 did not show any change in these parameters when compared to group 2 and their baseline results. Conclusion: Cholecalciferol was shown to have beneficial effects on serum ALT levels, hsCRP levels and lipid profile of NAFLD patients. Clinical Trial Registration: https://prsinfo.clinicaltrials.gov/prs-users-guide.html, identifier NCT05613192.
ABSTRACT
Introduction and importance Ewing's sarcoma is an aggressive malignancy primarily affecting skeletal system in children and young adults. CASE PRESENTATION: We report an unusual case of Ewing sarcoma in a 14-year-old boy with clinical and radiological features of rapid onset metachronous skeletal metastasis (within 4 weeks of diagnosis). CLINICAL DISCUSSION: Although the deterioration of symptoms was very rapid, it is unusual to note that in the presence of such widespread metastatic disease the lungs per se remained uninvolved. CONCLUSION: We describe a unique case of metastatic Ewing's sarcoma who showed rapid systemic disease progression with widespread skeletal metastases (and CNS involvement) but without any evidence of pulmonary involvement.
ABSTRACT
Hemodiafiltration (HDF) is not associated with lower mortality risk compared to standard hemodialysis (HD). However, there are many critical clinical outcomes in dialysis patients in addition to mortality; the impact of HDF on these other outcomes is not clear. This retrospective study included all patients referred to DaVita Clinics in the Kingdom of Saudi Arabia. High-flux HD was the initial modality in all patients. Those who did not achieve adequacy targets or those with poorly controlled phosphorus were switched to postdilution HDF using 18 to 23 L exchange per treatment. Patients dialyzing with a central venous catheter, patients who dialyzed less than 90 days at DaVita, and those with interrupted HDF were excluded. Of the 1115 patients, 215 (19%) were on HDF and 900 on high-flux HD; the median follow-up was 6 months for all patients. The HDF group showed a significant reduction in serum phosphate (P < .001), a significant increase in serum calcium (P < .012) and a significant improvement in Kt/V (P < .0001). The HDF group had significantly higher hemoglobin levels than the HD group (P = .024), with a significant reduction in weekly erythropoiesis-stimulating agent dose after starting HDF (P < .001). A modified protocol that included prolonged dialysis duration, larger-sized dialyzer, faster blood flow rates, and adding hemofiltration fluid may be helpful in achieving the recommended targets. Thus, HDF can enable the achievement of adequate dialysis care in some patients. Randomized-controlled clinical trials are necessary to confirm these findings.
Subject(s)
Hemodiafiltration/methods , Kidney Failure, Chronic/therapy , Renal Dialysis/methods , Bone Density , Equipment Design , Female , Follow-Up Studies , Humans , Male , Middle Aged , Phosphorus/blood , Quality Improvement , Retrospective Studies , Saudi Arabia , Time FactorsABSTRACT
Utilization of health Insurance services by children can be influenced by many factors, such as health care need, availability of transportation, and geographic access to care. Utilization rates may be affected by certain barriers which include: physical unavailability geographical, financial, psychological and socio-cultural or organizational barriers. This study was carried out to study the pattern of utilization of services provided by the Students' Health Insurance Programme in Alexandria by preparatory school students. A cross-sectional descriptive study was performed to identify the understudied variables. A sample of 1121 school students was included. They were from general preparatory schools (public and private) who utilized any health service within the last 6 months prior to the start of the study. A relevant questionnaire was designed for data collection through an interview with the student's parent during a visit to the school clinic. It was found that the highest percentage of public school students preferred to obtain medical services at the school physician clinic (51.2%) whereas, the highest percentage of private school students preferred to obtain medical services at a private physician (74.0%). The highest percentage of both public and private school students had knowledge regarding the time of service (47.0% and 36.5%, respectively). As regards public schools the highest mean satisfaction score was for the dimension of school physician examination (2.20+/-0.6), whereas, the highest mean satisfaction score for private school students was for the dimension of referral procedures to the specialist (2.30+/-0.5). It was concluded that accessibility barriers towards the programme could be handled through, distribution of brochures at the beginning of every scholastic year and further simplification of administrative procedures and paper work cycles adopted by the programme.