1
|
Murshidi R, Bani Hamad S, Al Refaei A, Shewaikani N, Shaf'ei M, Alshoubaki SN, Haddad TA, Khasawneh T, Fkheideh T, Abdallat M. A novel predictive method for risk stratification in acne patients receiving isotretinoin: an analysis of laboratory abnormalities and changes in inflammatory parameters. J DERMATOL TREAT 2024; 35:2301435. [PMID: 38186323 DOI: 10.1080/09546634.2023.2301435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 12/29/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Isotretinoin is a widely used, effective medication for moderate to severe acne. It is typically used for several months, which necessitates regular laboratory monitoring. However, consensus on the optimal assessment frequency is lacking. METHOD This is a single-center retrospective study on 1182 patients who received isotretinoin for acne at the Dermatology Clinic in Jordan University Hospital over 5 years. RESULTS Of the 1182 patients, 892 (76.57% females) met the inclusion criteria. An increase in the proportion of patients with abnormal triglycerides and total cholesterol levels from baseline to the sixth month was observed (p < 0.05). Conversely, differences in the number of patients with abnormal AST, ALT, and CBC were not found throughout treatment (p > 0.05). Moreover, there was a decrease in the neutrophil-to-lymphocyte ratio (NLR) ratio and systemic inflammatory index (SII) after the sixth month of isotretinoin treatment compared to the baseline (p = 0.012 and p = 0.021, respectively). CONCLUSIONS We found that a baseline cholesterol level of 163.9 mg/dl and a baseline triglycerides level of 85.5 mg/dL are highly specific and sensitive in detecting grade 1 abnormalities at the one-month follow-up. This novel prediction approach serves as an effective risk stratification method for isotretinoin acne patients.
Collapse
Affiliation(s)
- Rand Murshidi
- Department of Dermatology, School of Medicine, The University of Jordan, Amman, Jordan
| | - Salsabiela Bani Hamad
- Department of Dermatology, School of Medicine, The University of Jordan, Amman, Jordan
| | | | | | - Moayad Shaf'ei
- Department of Special Surgery, School of Medicine, The University of Jordan, Amman, Jordan
| | | | - Tala A Haddad
- School of Medicine, The University of Jordan, Amman, Jordan
| | | | - Taima Fkheideh
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Mahmoud Abdallat
- Department of Neurosurgery, School of Medicine, The University of Jordan, Amman, Jordan
| |
Collapse
|
2
|
Elifranji ZO, Al-Ajlouni JM, Al-Saber MG, Hammad YS, Baniatta BA, Alshoubaki SN, Jabaiti MS, Alkhatib AM, Abu awad AM, Altarazi AE, Abdin AN, Al-Ani A, Alshrouf MA. Effect of Preoperative Antianxiety Medications on Blood Pressure and Blood Loss in Total Knee Arthroplasty: A Case-Control Study. Adv Orthop 2023; 2023:6355849. [PMID: 37456533 PMCID: PMC10349676 DOI: 10.1155/2023/6355849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/14/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023] Open
Abstract
Background The increasing number of canceled operations in patients undergoing total knee arthroplasty (TKA) due to high blood pressure readings has put a considerable burden on surgeons. In this study, we aim to assess the effect of giving antianxiety drugs preoperatively on maintaining blood pressure (BP) and blood loss for patients undergoing TKA surgery. Methods This retrospective case-control study included patients who underwent total knee arthroplasty and divided them into two main groups: those who had taken a 3 mg bromazepam oral tablet at the night preoperatively and the control group. The blood pressure of patients was then measured preoperatively (baseline), in the morning of surgery, in the operating room before anesthesia, and during the surgery. The percentage of measured BP was calculated by dividing the measured BP by the baseline, then multiplying by 100. Results 301 patients were included in our study: 137 received bromazepam and 164 as a control group. The ratio of systolic BP (SBP) in the morning of surgery to the baseline (percentage of morning SBP) decreased significantly in the bromazepam group compared with the controls. The ratio of SBP, in the operating room before anesthesia (percentage of preanesthesia SBP) also decreased significantly in the bromazepam group. However, the percentage of SBP in the middle of surgery did not change significantly. In addition, there was a significant difference change from the baseline in diastolic BP and mean arterial BP between the two groups in the morning of surgery, inside the theatre, and in the middle of the operation. The bromazepam group also showed a significant decrease in blood loss. Conclusion Preoperative oral antianxiety drugs (bromazepam) helps in controlling hemodynamic changes associated with anxiety, including maintaining BP in well-controlled hypertensive and healthy patients undergoing TKA, and it plays a role in decreasing the total blood loss.
Collapse
Affiliation(s)
- Zuhdi O. Elifranji
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Jihad M. Al-Ajlouni
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Munther G. Al-Saber
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Yazan S. Hammad
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Basel A. Baniatta
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Sara N. Alshoubaki
- Medical Internship, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan
| | - Mohammad S. Jabaiti
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Ahmad M. Alkhatib
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Abdelrahman M. Abu awad
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Abdelrahman E. Altarazi
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Aseel N. Abdin
- Medical Internship, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan
| | - Abdallah Al-Ani
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11942, Jordan
| | - Mohammad Ali Alshrouf
- Medical Internship, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan
| |
Collapse
|