This systematic review and meta-analysis aimed to summarize the pregnancy outcomes of women diagnosed with genital tuberculosis (GTB) who spontaneously conceived or underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) after being treated with antitubercular therapy (ATT). Publications from the PubMed, Medline, Embase, Ovid, Scopus, Web of Science, and Google Scholar databases were searched from December 20, 2021 to March 5, 2022. The outcomes are presented as pooled averages with 95% confidence intervals. The inconsistency index (I2) test was used to measure the heterogeneity between studies. The certainty of the evidence was assessed using GRADEPro (https://www.gradepro.org/). Of the numerous articles identified, 33 met the inclusion criteria and were included in this systematic review. Generally, there was a significant increase in pregnancy rates among patients who underwent IVF compared with those who underwent ATT (37.9% vs. 23.8%; p=0.02). Conversely, there was no significant difference in pregnancy rates between patients who underwent IUI and those who conceived spontaneously (18.1% vs. 23.8%; p=0.65). In cases in which no abnormalities were found on hysterosalpingography or hysterolaparoscopy, pregnancy rates were comparable between spontaneous and IVF conceptions (48.4% vs. 49.2%). There were no significant differences in pregnancy or live birth rates between patients with GTB and those with other infertility factors undergoing IVF treatment (p>0.05). ATT, which is administered during the early stages of GTB is effective in achieving pregnancy outcomes comparable to IVF. However, in patients with advanced-stage disease, IVF is a superior treatment modality, resulting in increased pregnancy rates.

This systematic review and meta-analysis aimed to summarize the pregnancy outcomes of women diagnosed with genital tuberculosis (GTB) who spontaneously conceived or underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) after being treated with antitubercular therapy (ATT). Publications from the PubMed, Medline, Embase, Ovid, Scopus, Web of Science, and Google Scholar databases were searched from December 20, 2021 to March 5, 2022. The outcomes are presented as pooled averages with 95% confidence intervals. The inconsistency index (I2) test was used to measure the heterogeneity between studies. The certainty of the evidence was assessed using GRADEPro (https://www.gradepro.org/). Of the numerous articles identified, 33 met the inclusion criteria and were included in this systematic review. Generally, there was a significant increase in pregnancy rates among patients who underwent IVF compared with those who underwent ATT (37.9% vs. 23.8%; p=0.02). Conversely, there was no significant difference in pregnancy rates between patients who underwent IUI and those who conceived spontaneously (18.1% vs. 23.8%; p=0.65). In cases in which no abnormalities were found on hysterosalpingography or hysterolaparoscopy, pregnancy rates were comparable between spontaneous and IVF conceptions (48.4% vs. 49.2%). There were no significant differences in pregnancy or live birth rates between patients with GTB and those with other infertility factors undergoing IVF treatment (p>0.05). ATT, which is administered during the early stages of GTB is effective in achieving pregnancy outcomes comparable to IVF. However, in patients with advanced-stage disease, IVF is a superior treatment modality, resulting in increased pregnancy rates.

This systematic review and meta-analysis aimed to summarize the pregnancy outcomes of women diagnosed with genital tuberculosis (GTB) who spontaneously conceived or underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) after being treated with antitubercular therapy (ATT). Publications from the PubMed, Medline, Embase, Ovid, Scopus, Web of Science, and Google Scholar databases were searched from December 20, 2021 to March 5, 2022. The outcomes are presented as pooled averages with 95% confidence intervals. The inconsistency index (I2) test was used to measure the heterogeneity between studies. The certainty of the evidence was assessed using GRADEPro (https://www.gradepro.org/). Of the numerous articles identified, 33 met the inclusion criteria and were included in this systematic review. Generally, there was a significant increase in pregnancy rates among patients who underwent IVF compared with those who underwent ATT (37.9% vs. 23.8%; p=0.02). Conversely, there was no significant difference in pregnancy rates between patients who underwent IUI and those who conceived spontaneously (18.1% vs. 23.8%; p=0.65). In cases in which no abnormalities were found on hysterosalpingography or hysterolaparoscopy, pregnancy rates were comparable between spontaneous and IVF conceptions (48.4% vs. 49.2%). There were no significant differences in pregnancy or live birth rates between patients with GTB and those with other infertility factors undergoing IVF treatment (p>0.05). ATT, which is administered during the early stages of GTB is effective in achieving pregnancy outcomes comparable to IVF. However, in patients with advanced-stage disease, IVF is a superior treatment modality, resulting in increased pregnancy rates.

This systematic review and meta-analysis aimed to summarize the pregnancy outcomes of women diagnosed with genital tuberculosis (GTB) who spontaneously conceived or underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) after being treated with antitubercular therapy (ATT). Publications from the PubMed, Medline, Embase, Ovid, Scopus, Web of Science, and Google Scholar databases were searched from December 20, 2021 to March 5, 2022. The outcomes are presented as pooled averages with 95% confidence intervals. The inconsistency index (I2) test was used to measure the heterogeneity between studies. The certainty of the evidence was assessed using GRADEPro (https://www.gradepro.org/). Of the numerous articles identified, 33 met the inclusion criteria and were included in this systematic review. Generally, there was a significant increase in pregnancy rates among patients who underwent IVF compared with those who underwent ATT (37.9% vs. 23.8%; p=0.02). Conversely, there was no significant difference in pregnancy rates between patients who underwent IUI and those who conceived spontaneously (18.1% vs. 23.8%; p=0.65). In cases in which no abnormalities were found on hysterosalpingography or hysterolaparoscopy, pregnancy rates were comparable between spontaneous and IVF conceptions (48.4% vs. 49.2%). There were no significant differences in pregnancy or live birth rates between patients with GTB and those with other infertility factors undergoing IVF treatment (p>0.05). ATT, which is administered during the early stages of GTB is effective in achieving pregnancy outcomes comparable to IVF. However, in patients with advanced-stage disease, IVF is a superior treatment modality, resulting in increased pregnancy rates.

This systematic review and meta-analysis aimed to summarize the pregnancy outcomes of women diagnosed with genital tuberculosis (GTB) who spontaneously conceived or underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) after being treated with antitubercular therapy (ATT). Publications from the PubMed, Medline, Embase, Ovid, Scopus, Web of Science, and Google Scholar databases were searched from December 20, 2021 to March 5, 2022. The outcomes are presented as pooled averages with 95% confidence intervals. The inconsistency index (I2) test was used to measure the heterogeneity between studies. The certainty of the evidence was assessed using GRADEPro (https://www.gradepro.org/). Of the numerous articles identified, 33 met the inclusion criteria and were included in this systematic review. Generally, there was a significant increase in pregnancy rates among patients who underwent IVF compared with those who underwent ATT (37.9% vs. 23.8%; p=0.02). Conversely, there was no significant difference in pregnancy rates between patients who underwent IUI and those who conceived spontaneously (18.1% vs. 23.8%; p=0.65). In cases in which no abnormalities were found on hysterosalpingography or hysterolaparoscopy, pregnancy rates were comparable between spontaneous and IVF conceptions (48.4% vs. 49.2%). There were no significant differences in pregnancy or live birth rates between patients with GTB and those with other infertility factors undergoing IVF treatment (p>0.05). ATT, which is administered during the early stages of GTB is effective in achieving pregnancy outcomes comparable to IVF. However, in patients with advanced-stage disease, IVF is a superior treatment modality, resulting in increased pregnancy rates.

Background::Elevated high blood pressure is controlled by complicated, little-understood genetic and epigenetic pathways that are influenced by both heritable and environmental variables. Many adult systolic and diastolic blood pressure-related genomic loci have been identified through previous genome-wide association studies (GWAS); meanwhile, studies specifically on Asian adult populations have not been done. This study aims to comprehensively assess and summarize any gene changes that have been studied and see whether there is a possible influence between epigenetic changes and hypertension in Asian adults.Methods::This evidence-based analysis is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement and has been registered in PROSPERO under registration number [CRD42024622261]. The data were processed qualitatively to assess the risk of bias using the Newcastle-Ottawa Scale (NOS) and Agency for Health Research and Quality (AHRQ) standards as the threshold. Our study in particular shows that epigenetic modifications may play a role in hypertension, particularly in Asian individuals.Results::A total of 28 studies were selected for qualitative evaluation. In the adult Asian population, 26 publications (92.8%) reported a relationship between blood pressure and epigenetics. Every study describes a distinct gene or location associated with hypo- or hypermethylation. Elevated systolic and diastolic blood pressure was linked to variations of several single-nucleotide polymorphisms (SNPs), cytosine phosphate guanines (CPGs), and other monogenic genes.Conclusion::Alterations in epigenetic modifications in potential genes or loci are linked to systolic and diastolic blood pressure of Asian adult populations.

Background::Elevated high blood pressure is controlled by complicated, little-understood genetic and epigenetic pathways that are influenced by both heritable and environmental variables. Many adult systolic and diastolic blood pressure-related genomic loci have been identified through previous genome-wide association studies (GWAS); meanwhile, studies specifically on Asian adult populations have not been done. This study aims to comprehensively assess and summarize any gene changes that have been studied and see whether there is a possible influence between epigenetic changes and hypertension in Asian adults.Methods::This evidence-based analysis is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement and has been registered in PROSPERO under registration number [CRD42024622261]. The data were processed qualitatively to assess the risk of bias using the Newcastle-Ottawa Scale (NOS) and Agency for Health Research and Quality (AHRQ) standards as the threshold. Our study in particular shows that epigenetic modifications may play a role in hypertension, particularly in Asian individuals.Results::A total of 28 studies were selected for qualitative evaluation. In the adult Asian population, 26 publications (92.8%) reported a relationship between blood pressure and epigenetics. Every study describes a distinct gene or location associated with hypo- or hypermethylation. Elevated systolic and diastolic blood pressure was linked to variations of several single-nucleotide polymorphisms (SNPs), cytosine phosphate guanines (CPGs), and other monogenic genes.Conclusion::Alterations in epigenetic modifications in potential genes or loci are linked to systolic and diastolic blood pressure of Asian adult populations.

Background: Myasthenia gravis is an autoimmune disorder which affects the neuromuscular junction, resulting in muscle weakness and respiratory complications. Recurrent myasthenic crises may necessitate mechanical ventilation due to respiratory failure.Case Report: We present a 21-year-old female with myasthenia gravis who experienced recurrent myasthenic crises requiring mechanical ventilation. She underwent plasma exchange therapy and inspiratory muscle training (IMT) program to improve respiratory function. Gradual ventilator adjustments and a structured IMT protocol led to significant improvements in oxygenation and carbon dioxide elimination. The patient met the weaning criteria, including the PaO2/FiO2 ratio and rapid shallow breathing index, and was successfully extubated after 12 days of mechanical ventilation. Conclusion This case highlights the importance of a multidisciplinary approach in managing myasthenic crises and suggests that IMT may expedite weaning from mechanical ventilation.

Background: Myasthenia gravis is an autoimmune disorder which affects the neuromuscular junction, resulting in muscle weakness and respiratory complications. Recurrent myasthenic crises may necessitate mechanical ventilation due to respiratory failure.Case Report: We present a 21-year-old female with myasthenia gravis who experienced recurrent myasthenic crises requiring mechanical ventilation. She underwent plasma exchange therapy and inspiratory muscle training (IMT) program to improve respiratory function. Gradual ventilator adjustments and a structured IMT protocol led to significant improvements in oxygenation and carbon dioxide elimination. The patient met the weaning criteria, including the PaO2/FiO2 ratio and rapid shallow breathing index, and was successfully extubated after 12 days of mechanical ventilation. Conclusion This case highlights the importance of a multidisciplinary approach in managing myasthenic crises and suggests that IMT may expedite weaning from mechanical ventilation.

Background: The management of cleft lip and palate aims at improving the patient’s aesthetic and functional outcomes. Delaying primary repair can disrupt the patient’s functional status. Long-term follow-up is essential to evaluate the need for secondary repair or revision surgery. This article presents the epidemiology of cleft lip and palate, including comprehensive patient characteristics, the extent of delay, and secondary repair at our institutional center, the Bandung Cleft Lip and Palate Center, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia. Methods: This retrospective study aimed to determine the epidemiology and recurrence rates of cleft lip and palate at the Bandung Cleft Lip and Palate Center, Indonesia, from January 2007 to December 2021. The inclusion criteria were patients diagnosed with cleft lip and/or palate. Procedures such as labioplasty, palatoplasty, secondary lip and nasal repair, and alveolar bone grafting were performed, and data on recurrence were available. Results: In total, there were 3,618 patients with cleft lip and palate, with an age range of 12 months to 67 years. The mean age was 4.33 years, and the median age was 1.35 years. Males predominated over females in all cleft types (60.4%), and the cleft lip was on the left side in 1,677 patients (46.4%). Most cases were unilateral (2,531; 70.0%) and complete (2,349; 64.9%), and involved a diagnosis of cleft lip and palate (1,981; 54.8%). Conclusion Delayed primary labioplasty can affect daily functioning. Primary repair for patients with cleft lip and palate may be postponed due to limited awareness, socioeconomic factors, inadequate facilities, and varying adherence to treatment guidelines. Despite variations in the timing of primary cleft lip repair (not adhering to the recommended protocol), only 10% of these patients undergo reoperation. Healthcare providers should prioritize the importance of the ideal timing for primary repair in order to optimize physiological function without compromising the aesthetic results.