The Spectrum of Glomerulonephritis in Saudi Arabia: The Results of the Saudi Registry

Only few studies regarding glomerulonephritis, with relatively small numbers of patients, have so far been published from different centers in Saudi Arabia, and have reported conflicting results regarding the patterns, even in the same city. The possible reasons for these differences include the small number of patients in the different studies, differences in the indications for renal biopsies, referral bias, geographical differences, and, sometimes, the non-availability of the necessary diagnostic facilities in the reporting centers. In order to overcome these problems, a registry for glomerulonephropathy was attempted in Saudi Arabia. Six large referral hospitals from different regions of Saudi Arabia participated in this registry. Biopsy reports and clinical information of 1294 renal biopsies were obtained. There were 782 renal biopsies due to glomerulonephritis (GN) accounting for 77.2&#x0025; of the total biopsies. Five hundred eighty seven <i> (72.6&#x0025;) </i> were primary glomerulonephritidis. Focal and segmental glomerulosclerosis (FSGS) (21.3&#x0025;) and membrano-proliferative glomerulonephritis (MPGN) (20.7&#x0025;) were the most common types found in the primary glomerulonephritidis. Membranous glomerulonephritis (MGN) was present in only 10.6&#x0025; of the cases. IgA nephropathy was found in <i> 6.5&#x0025; </i> of the cases. Of the secondary glomerulo-nephritides, systemic lupus erythematosus (SLE) was the most common indication for biopsy <i> (57.0&#x0025;) </i> and amyloidosis was found in only <i> 3.2&#x0025; </i> of the biopsies. In conclusion, FSGS and MPGN were the most common forms of primary glomerulonephritis in adult patients in Saudi Arabia. MGN was not as common as in the western world. SLE was the commonest cause of secondary GN. Amyloidosis was not as common as in other Arab countries. There is a need for more centers from Saudi Arabia to join this national GN registry. Similar registries can be established in different Arab countries, which all would, hopefully, lead to a Pan-Arab GN registry

ANTICOAGULANTS AND THROMBOLYTICS IN PREGNANCY, A SYSTEMATIC REVIEW

Background: In the developed countries, pulmonary thromboembolism associated with pregnancy (VTE) continues to be the principal cause of direct maternal death. Despite thorough treatment and preventative recommendations from several national authorities, reductions in mortality due to VTE have been negligible. Anticoagulation is still the cornerstone of prenatal care and has to be given to all patients with proven or high-risk PE. The preferred medication is low molecular weight heparin (LMWH), which has a known pharmacodynamic profile. Despite the massive utilization of these drugs there is actually little evidence supporting their efficiency in recurrent pregnancy loss reduction. Objectives: The study aims to summarize current evidences regarding the usage of anticoagulants and thrombolytics in Pregnancy. Methods: For article selection, the PubMed database and EBSCO Information Services were used. All relevant articles relevant with our topic and other articles were used in our review. Other articles that were not related to this field were excluded. The data was extracted in a specific format that was reviewed by the group members. Conclusion: A common cause of maternal death, pulmonary embolism-related fatalities still occur often in pregnant women with pulmonary embolism. One-third of pregnant women with pulmonary embolism and hemodynamic failure were reported to undergo systemic thrombolysis. There is an urgent need to improve prevention and care techniques for this vulnerable patient population. LMWHs are widely used for several different purposes as well as for the treatment and prevention of VTE during pregnancy and puerperium. Although the medicine has been found to be both safe and effective, there is no scientific proof to support its usage for all indications. In pregnant women with thrombophilia who are at high risk of developing these issues, prenatal prophylactic dalteparin does not prevent venous thromboembolism, pregnancy loss, or placenta-mediated pregnancy difficulties and is linked to an increased risk of mild bleeding. Enoxaparin may not offer any meaningful benefits to people suffering from recurrent abortion. However, in one study, the miscarriage rate was significantly lower when enoxaparin was used compared with untreated controls