Variety Of Systemic Complications Research Articles

Periodontitis to Placenta

Introduction: Surprising how a small part of our body, the mouth, can alter and result in a variety of systemic complications if not taken care of. The primary factor for maternal and newborn morbidity and mortality is thought to be periodontitis. Gynecologists have a crucial role in educating their patients about the need of keeping good dental health because it can improve the success of pregnancies and reduce mouth pain. Objective: The objective of this study was to understand the awareness of gynecologists practicing in Pune, Maharashtra, about periodontal status and its outcome in pregnant women. Materials and Methods: A questionnaire-based study was conducted on 60 gynecologists. We evaluated people's knowledge of the negative effects of female sex hormones on periodontal health. Results: Eighty percent were aware of the correlation between periodontal health and female sex hormones. 56.7% agreed that periodontal microorganisms can pass through the placenta and harm the fetus. 76.7% were unaware that the possibility of prenatal growth restriction has increased. Most participants did not motivate pregnant women for an oral health checkup. Conclusion: It can be inferred that gynecologists are not aware of the connection between mouth findings and worse pregnancy outcomes.

Therapeutic potential of flavonoid-rich plants in the treatment of arterial hypertension and diabetes mellitus: focus on antioxidant role

Introduction: Chronic non-communicable diseases are the main causes of morbidity and mortality today, among them, Arterial Hypertension (SAH) and Type 2 Diabetes Mellitus (T2DM), which are responsible for a variety of systemic complications. Both conditions share, in their pathophysiology, the state of oxidative stress, justifying the possible use of antioxidant components, such as flavonoids. Objectives: To characterize and describe the therapeutic potential of the main medicinal plants of popular use, rich in flavonoid-type antioxidant constituents, in the treatment of hypertension and diabetes. Methodology: An integrative literature review study, developed from a survey in PubMed, MEDLINE and LILACS databases. Results: From the survey, the following plants used for hypertension stood out: Hibiscus sabdariffa, Allium sativum L., Phyllathus amarus, Ginkgo biloba and Matricaria chamomilla. As for diabetes, the following stand out: Syzygium cumini L., Caesalpinia sappan, Andrographis paniculata and Curcuma longa L. Conclusion: The results showed that the use of medicinal plants rich in flavonoids can serve as an important ally in the prevention, control and treatment. of SAH and T2DM, acting mainly against the state of oxidative stress, a common pathophysiological mechanism in both diseases, and thus preventing the occurrence of complications resulting from this state.

A Reasonable Outcome with Systemic Corticosteroids in a Case of Ibuprofen Induced Stevens-Johnson Syndrome

Both Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are idiosyncratic severe mucocutaneous reactions, usually to drugs or infections, characterized by blistering and epithelial sloughing. Although rare, SJS and TEN are destructive diseases; in serious cases the acute phase may be followed by a variety of systemic complications, including multiorgan failure and death. Ibuprofen is a universal antipyretic and analgesic non-steroidal antiinflammatory drug which is widely used in practice and considered as relatively safe. Hereby we introduce an Ibuprofen induced SJS case in a 14-year-old Somalian female with chief complaint of extensive skin rashes accompanied by ulceration, mild fever and difficulty in swallowing for two days. Soon after the patient was diagnosed as Ibuprofen associated SJS, she was treated with systemic corticosteroids in addition to general measures. The sign and symptoms started to resolute as soon as the second day of approval and at the seventh day the patient was discharged from the hospital. It was noteworthy that the findings of SJS/TEN appeared in relatively shorter time after the usage of accused drug compared to the previous knowledge, as well as it was remarkable. In addition, it is noticeable, that easily accessible drugs such as ibuprofen, which are frequently used in children, are not as innocent as it is thought. Moreover that is important to inform and closely follow the patients for the development of delayed drug hypersensitivity reactions.

Mesenchymal stem cell dysfunction in diabetes.

Diabetes mellitus (DM) is a chronic disease that results in a variety of systemic complications. Recently, stem cell-based therapies have been proposed as potential modalities to manage DM related complications. Mesenchymal stem cell (MSC) based therapies are often considered as an ideal stem cell-based treatment for DM management due to their immunosuppressive characteristics, anti-inflammatory properties and differentiation potential. While MSCs show tremendous promise, the underlying functional deficits of MSCs in DM patients is not well understood. Using the MEDLINE database to define these functional deficits, our search yielded 1826 articles of which 33 met our inclusion criteria. This allowed us to review the topic and illuminate four major molecular categories by which MSCs are compromised in both Type 1 DM and Type II DM models which include: (1) changes in angiogenesis/vasculogenesis, (2) altered pro-inflammatory cytokine secretion, (3) increased oxidative stress markers and (4) impaired cellular differentiation and decreased proliferation. Knowledge of the deficits in MSC function will allow us to more clearly assess the efficacy of potential biologic therapies for reversing these dysfunctions when treating the complications of diabetic disease.

CLINICAL STATUS AND CHEMILUMINESCENT ACTIVITY OF NEUTROPHILS IN PATIENTS WITH ADVANCED PURULENT PERITONITIS IN THE DYNAMICS OF POSTOPERATIVE PERIOD

The aim of this study was to evaluate the clinical condition and to study the chemiluminescent activity of granulocytes of patients with widespread purulent peritonitis in the dynamics of post-operative treatment. The severity of the patients was determined by the SAPS scale, the presence of systemic inflammatory response syndrome was assessed by the criteria of the ACCP/SCCM. Severity and prognosis of the disease was evaluated using the Mannheim peritonitis index and the index of abdominal cavity. The severity of multiple organ failure at admission to the hospital and in postoperative period dynamics were determined by the scale of the SOFA. The study of lucigenin- and luminal-dependent chemiluminescence of neutrophils in peritonitis were taken on admission to the hospital, and on the 7th, 14th and 24th day of the postoperative period. There were a variety of systemic complications (tertiary peritonitis, perforation of hollow organs, abscesses of the abdominal cavity and other) in patients with widespread purulent peritonitis 2nd severity in 96,2% of cases. The mortality rate among patients amounted to 22.2%. It was found in the study of neutrophils chemiluminescent activity that intensity of the “respiratory burst” in pre- and postoperative periods in patients with peritonitis is defined mainly by the synthesis level of secondary reactive oxygen species. The level of synthesis of superoxide radicals by neutrophils in a state of relative dormancy, increased by 14 days after the operation and is reduced to the reference level to the 21st day. In the preoperative period and before the end of the observation level of synthesis of secondary reactive oxygen species by neutrophils of patients with peritonitis was increased, but is on the background of the slow activation of enzymes, providing a “respiratory burst”. Trend towards normalization of neutrophils chemiluminescent activity in the blood of patients with peritonitis by the end of the observation period (24th day of the postoperative period).

Hyaline vascular type of unicentric Castleman’s disease with proliferation of glomerular endothelial cells

Castleman’s disease (CD) is a lymphoproliferative disorder of uncertain etiology. It can be classified histopathologically as hyaline vascular (HV) or plasma cell (PC) type; and clinically as unicentric or multicentric. Multicentric CD mostly manifests as the PC type and is often associated with a variety of systemic complications, although renal complications are uncommon. We present here a case of HV type, unicentric CD with a variety of systemic and renal complications, including the proliferation of glomerular endothelial cells. Various cytokines are thought to be involved in the etiology of this disease, especially interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF), which are the main cytokines inducing systemic complications. It has been reported that most PC types and/or multicentric types of CD show increasing levels of serum IL-6 and VEGF, as well as systemic symptoms. Although the current case showed high serum IL-6 and VEGF levels as well as systemic symptoms, the pathological and clinical type were of the HV type and unicentric type, respectively. After immunosuppressive therapy, the serum levels of IL-6 and VEGF returned to the normal range, and systemic complications, including renal involvement, also improved. We report the possibility of pathogenesis via the serum and the pathology of this rare case.

Age and causes of death in adult-onset myotonic dystrophy.

Myotonic dystrophy is a relatively common type of muscular dystrophy, associated with a variety of systemic complications. Long term follow-up is difficult because of the slow progression. The objective of this study was to determine survival, age at death and causes of death in patients with the adult-onset type of myotonic dystrophy. A register of myotonic dystrophy patients was set up in Southern Limburg (the Netherlands), using data longitudinally collected over a 47-year period (1950-97). Survival for 180 patients (from the register) with adult-onset type myotonic dystrophy was established by the Kaplan-Meier method. The median survival was 60 years for males and 59 years for females. Survival of the patients was also estimated from the age of 15 years to the ages of 25, 45 and 65 years and compared with the expected survival of age- and sex-matched birth cohorts from the normal Dutch population. The observed survival to the ages of 25, 45 and 65 years was 99%, 88% and 18% compared with an expected survival of 99%, 95% and 78%, respectively. Thus, survival to the age of 65 in patients with adult-onset myotonic dystrophy is markedly reduced. A weak positive correlation between the CTG repeat length and younger age at death was found in the 13 patients studied (r = 0.50, P = 0.08). The cause of death could be determined in 70 of the 83 deceased patients. Pneumonia and cardiac arrhythmias were the most frequent primary causes of death, each occurring in approximately 30%, which was far more than expected for the general Dutch population. In addition, we assessed mobility in the years before death in a subgroup of 18 patients, as a reflection of the long-term physical handicap in myotonic dystrophy patients. Half of the patients studied were either partially or totally wheelchair-bound shortly before their death.

Acute Pancreatitis

In order to recognize acute pancreatitis in the setting of the acute abdomen, the surgeon must be thoroughly familiar with the numerous etiologies of the disease. No specific test is available to diagnose acute pancreatitis. CT scanning is arguably the most useful single tool, but surgical judgment is critical. Most cases of acute pancreatitis resolve spontaneously without sequelae, but the spectrum of the disease also includes highly lethal forms associated with a variety of systemic complications. Operative intervention is indicated when other, more rapidly fatal, abdominal processes cannot be reliably excluded and when local complications develop.