Acute fatty liver disease of pregnancy (AFLP) is a rare life‐threatening medical emergency unique to pregnancy. It is characterized by progressive microvesicular fatty infiltration of maternal hepatocytes, but the exact etiology has yet to be elucidated. AFLP typically manifests in late third trimester or immediately postpartum and seldom during second trimester. Prompt delivery, irrespective of gestational age or severity, is crucial for arresting the insult and permitting recovery. We hereby report a 21‐year‐old Lebanese second‐gravid woman at 20 weeks' gestation diagnosed with AFLP depending on clinical features and compatible laboratory studies (score of 8 on Swansea criteria), in spite of early occurrence. A review and analysis of early AFLP (second trimester) compared to late (third trimester) was also presented. AFLP appearing during second trimester is as serious as the disease manifesting in late third trimester, with similar diagnostic difficulties, less association with hypertension, but with greater hesitation of obstetricians to affect prompt delivery and higher adverse perinatal outcome due to added effect of premature delivery in second trimester.
Despite the frequent alarms that have been published about the adverse effects of antibiotic use and misuse, physicians prescribe to patients approximately fifty percent of unnecessary antimicrobials. In an attempt to decrease the emergence of antimicrobial resistance and increase awareness, a team approach is required to address this prescribing phenomenon in a feasible manner.
A retrospective study was done at a one-hundred-forty-bed hospital with a representative sample size of 368 patients. Patient data was collected and analyzed by a stewardship team. The overall antibiotic inappropriate rate was 45.8%, which is relatively high and consistent with the findings of other studies mentioned in the literature.
This study aimed to provide baseline epidemiological data on the use of antibiotics in a Lebanese hospital and has revealed several notable patterns of antibiotic prescribing practices among Lebanese physicians such as the use of antimicrobial drugs example penicillin was consistently high. Strong correlations were identified between the type of attending physician and antibiotic appropriateness. These findings will be important in constructing an antimicrobial stewardship program to reduce antibiotic misuse.
Background: Mortalities due to super-infections and allergic reactions are taking place as a result of antibiotic use and misuse which in turn has led to bacterial resistance towards different antimicrobial agents.
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