From the Editor
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Ahmad Husari
Editor, Middle-East Journal of Internal Medicine
Director, American University of Beirut Sleep Disorders Center
Director, American University of Beirut outpatient clinical care services
Assistant Professor
Division of Pulmonary and Critical Care Medicine
American University of Beirut Medical Center
Beirut Lebanon
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This is the first issue of MEJIM this year. The topics in this issue vary from obstetrics to oncological cardiology.
A paper from Jordan assessed the efficacy of using intra cervical Foley catheter induction of labour among pregnant women with and without previous caesarean section, and their neonatal outcome at King Hussein Medical Centre. The study was conducted in the labor department of King Hussein Medical Center (KHMC) using a data sheet including patient questionnaire to review demographic characteristics of patients , indication for induction of labor and results of inductions regarding outcome, success rate and neonatal outcome. The most prevalent age group of induced patients was (25 -34 years) which accounts for (54.5%) followed by (16-24) which accounts for (30.5%), 15% only were between the age of 35 and 45. Intra cervical Foley's catheter was the most common used method for induction of labour, where more than half of the Patients used this method ( 54.5) followed by prostaglandin(23.0%). Artificial rupture of membranes followed by oxytocin or seeping of membranes was the least used methods with each method accounting for around 10 %. The authors concluded that induction of labor in still one of the biggest indications for admissions to labor ward causing a lot of worries to both the patients, their family and the health care providers.

Another paper looked at the role of power Doppler ultrasonography in detection of subclinical hyperuricemia in patients with Non-Hodgkin's Lymphoma. The authors studied 100 NHL patients (divided into 2 groups depending on the presence of the double contour (DC) sign detected by PDUS and 100 controls in a cross sectional study. Demographic, clinical and serological data were evaluated. PDUS was done to all patients and controls. There was a statistically significant difference between the two groups regarding the presence of subclinical hyperuricemia in group (1)(p=0.008) who had higher s. creatinine and gouty nephropathy (p=0.002and p=0.001 respectively). The authors concluded that PDUS can detect subclinical hyperuricemia and subsequent inflammatory arthritis in NHL patients; also it serves as a non-invasive, bedside tool.
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A paper fom Kirkuk looked at the Agreement Between Direct Smear Microscopy and GeneXpert MTBIRIFI in Diagnosis of Pulmonary Tuberculosis Among Patients Attending Consultary TB Clinic, Kirkuk. A cross sectional study recruited 958 patients presented to chest and respiratory diseases clinic for the period from 4th of December till 30th June 2014 for detection of Mycobacterium tuberculosis by direct smear microscopy. Out of these 321 samples were tested by gene Xpert; they were stratified according to site of disease to 249 pulmonary and 72 extra pulmonary cases. The authors stressed that tuberculosis is one of the deadliest diseases causing morbidity and mortality worldwide, as it infects 9 million and kills 3 million annually, yet one third of the world population is infected with TB. This study was planned to compare the accuracy of PCR with direct sputum smear among patients attended TB Clinic in Kirkuk. It was found that the percentage of direct smear positive was 3.03% while that for PCR was 11.5%. The percentage of Rifampin resistance was (10.8%) among positive cases. The authors concluded that GeneXpert/MTB/RIF is superior to direct AFB in detecting Mycobacterium tuberculosis , by time and detecting resistance in less than 2 hours.

Early And Late Outcome For Single Versus Double Stenting For Bifurcational Coronary Artery Lesions. Although stent placement with dedicated techniques has been suggested to be a useful therapeutic modality for treating bifurcation lesions, limited information is available if stent placement on the side branch and on the parent branch provides any advantage over a simpler strategy of stenting the parent vessel and balloon angioplasty of the side branch. The purpose of this study is to evaluate two different techniques of stent placement in bifurcation lesions of coronary artery disease. Between January 2010 and January 2012, we treated a total of 92 patients with bifurcation lesions with two strategies, stenting the parent vessel and balloon angioplasty of the side branch (group A, n=70) or stenting both vessels (group B, n=22). Angiograms were analyzed by quantitative angiography, and clinical follow-up was obtained for six months. Stent placement on both branches resulted in a lower residual stenosis in the side branch. Acute procedural success was similar in the two groups(100%). At the six-months follow-up, the angiographic restenosis rate and the target lesion revascularization rate were similar in the two groups, but repeated percutaneous coronary intervention done for symptomatic patients with de novo lesions in other arteries. There was no difference in the incidence of six-months total MACE. The authors concluded that for the treatment of true bifurcation lesions, a complex strategy of stenting both vessels provided no advantage in terms of procedural success and late outcome versus a simpler strategy of stenting only the parent vessel.