Wernicke’s encephalopathy in hyperemesis gravidarum: A systematic review

Background. In daily practice, healthcare practitioners face many challenges in ethical and professional decision making. Currently, little is known on the ethical and professional deliberations and weighing benefits against risks in daily complementary and alternative medicine (CAM) practice. The aim of this study was to combine the Utrecht method and the Analytic Hierarchy Process (AHP) in deliberations, weighing benefits against risks of using ginger for a pregnant woman suffering nausea and vomiting of pregnancy (NVP) along with other comorbidities. Methods. A hypothetical case was constructed using the twelve tips for constructing dilemma case-based assessment. Three CAM practitioners, two physicians, three pharmacists, and two patients were recruited, and the Utrecht and the AHP methods were combined and used to deliberate and weigh benefits against risks of using ginger for the presented case. Results. Responses from the ten panelists were obtained. Priority ratings showed significantly higher scores (p-value < 0.001) for alleviating symptoms of NVP (30.7%  ± 16.6%) compared to other potential benefits. Increasing the risk of bleeding was given significantly higher (p-value < 0.0001) weight scores (24.7%  ± 13.5%) than other potential side effects. Potential risk of spontaneous abortion and risk of impairment of fetal development were given higher (p-value < 0.001) weight scores than risk of fetal hypoglycemia. When benefits were compared against side effects and risks to the fetus and pregnancy, potential benefits were given higher (p-value < 0.001) weight scores (72.3%  ± 5.2%). Conclusions. Considering the anticipated benefits and risks, a shared decision was made to use ginger in the case presented. The woman should also be informed of the potential side effects and risks of using ginger. The use of this combined method might promote openness and transparency in making shared decisions for healthcare providers and patients.

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Combining and Using the Utrecht Method and the Analytic Hierarchy Process to Facilitate Professional and Ethical Deliberation and Decision Making in Complementary and Alternative Medicine: A Case Study among a Panel of Stakeholders

We report two cases of Wernicke-Korsakoff syndrome (WKS) secondary to hyperemesis gravidarum. Oral thiamine was administered (intravenous unavailable locally). However, both the patient's condition improved in the first 48 h and progressively over a month. Initially, WKS is missed due to rare feature of full classical triad of symptoms, especially in nonalcoholics.

What can go wrong in hyperemesis gravidarum: Wernicke-Korsakoff syndrome in Bulawayo, Zimbabwe.

Background:Wernicke-Korsakoff syndrome (WKS) is a triad of ophthalmoplegia, ataxia and memory deficits due to thiamine insufficiency resulting from under- or untreated Wernicke’s encephalopathy (WE...

Wernicke-Korsakoff Syndrome in Hyperemesis Gravidarum: A Case Report and Literature Review.

Submitral valve aneurysms are a rare but well-known pathology. These aneurysms should be considered as a differential diagnosis in young individuals who present with symptoms of heart failure and mitral regurgitation.

Submitral valve aneurysm in Bulawayo, Zimbabwe: A case report

A gastric phytobezoar is an uncommon finding The most frequent symptoms are dyspepsia, abdominal pain, nausea, and vomiting (Gastroenterology Report, 7, 2019, 74) It is an important differential to remember in patients with risk factors for developing phytobezoars because phytobezoars can be managed conservatively in most cases

Case report-An unusual diagnosis of a gastric phytobezoar in a middle-aged woman.

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What can go wrong in hyperemesis gravidarum: Wernicke-Korsakoff syndrome in Bulawayo, Zimbabwe.

Submitral valve aneurysm in Bulawayo, Zimbabwe: A case report

Case report-An unusual diagnosis of a gastric phytobezoar in a middle-aged woman.