scholarly journals Fecal Calprotectin as early predictor for screening and relapse in pediatric chronic diarrhea in India

2021 ◽  
Vol 7 (4) ◽  
pp. 178-184
Author(s):  
Gujjarlapudi Deepika ◽  
Namburu Veeraiah ◽  
Syed Hassan Naveed ◽  
D. Nageshwar Reddy

: IBS and IBD are two abdomen ailments commonly seen in children. IBD is a life-long disorder that includes two major forms of chronic illness UC and CD, IBS may occur when the bowel is sensitive to specific foods or other triggers like stress. The aims of the study is to investigate clinical usefulness of FC as early predictor for screening and differentiating IBD and IBS and to monitor the treatment for relapse and remission in pediatric Indian population. This was hospital based observational cohort study, conducted over a period of twelve months from January 2019 to December 2019 Total 325 patients attending OPD were included in the study, in children between 1-18years in which FC was measured using commercially available CLIA kit. HB, ESR, Hscrp were also assessed, these patients were followed up. Patients were grouped asGroup I: IBS: 115(50:65M/F), Group II: 185 IBD, had Subgroup I:116 CD(48:68M/F);Group A: 62.7% presented with relapse Group B: 37.3% had disease in remission Subgroup II: 69 patients had UC(31:38 M/F); Group A: 60.9% had relapse and Group B: 39.1% in remission after follow up. Subgroup III: Others were 25(7.7%). In Study I: Levels of FC were significantly lower in patients with group I when compared to group II. In Subgroup I & Subgroup II Group A had higher FC levels when compared to group B. In Study II: A significant difference (P<0.001) and lower values of the FC, ESR, Hs-crp, frequency of stools in IBS than in CD and UC patients were observed. In Study III: FC in IBD has positive correlation (p<0.01), with the activity of the inflammatory disorder, HB, ESR, Hs-CRP and with increased frequency of diarrhea. In Study IV Fecal calprotectin value of ≥100 ug/g was diagnostic of IBD with sensitivity of 94.1%, specificity of 82.2%, PPV of 86.32%, NPV of 80.39%. The present study showed that the determination of FC assists to differentiate between IBD and IBS also useful in monitoring of remission and in early prediction of relapse in pediatric IBD.

2021 ◽  
Vol 15 ◽  
pp. 175346662110042
Author(s):  
Xiaoke Shang ◽  
Yanggan Wang

Aims: The study aimed to compare and analyze the outcomes of high-flow nasal cannula (HFNC) and noninvasive positive-pressure ventilation (NPPV) in the treatment of patients with acute hypoxemic respiratory failure (AHRF) who had extubation after weaning from mechanical ventilation. Methods: A total 120 patients with AHRF were enrolled into this study. These patients underwent tracheal intubation and mechanical ventilation. They were organized into two groups according to the score of Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II); group A: APACHE II score <12; group B: 12⩽ APACHE II score <24. Group A had 72 patients and patients given HFNC were randomly assigned to subgroup I while patients given NPPV were assigned to subgroup II (36 patients in each subgroup). Group B had 48 patients and patients given HFNC were randomly assigned to subgroup I while patients given NPPV were assigned to subgroup II (24 patients in each subgroup). General information, respiratory parameters, endpoint event, and comorbidities of adverse effect were compared and analyzed between the two subgroups. Results: The incidence of abdominal distension was significantly higher in patients treated with NPPV than in those treated with HFNC in group A (19.44% versus 0, p = 0.005) and group B (25% versus 0, p = 0.009). There was no significant difference between the HFNC- and NPPV-treated patients in blood pH, oxygenation index, partial pressure of carbon dioxide, respiratory rate, and blood lactic acid concentration in either group ( p > 0.05). Occurrence rate of re-intubation within 72 h of extubation was slightly, but not significantly, higher in NPPV-treated patients ( p > 0.05). Conclusion: There was no significant difference between HFNC and NPPV in preventing respiratory failure in patients with AHRF with an APACHE II score <24 after extubation. However, HFNC was superior to NPPV with less incidence of abdominal distension. The reviews of this paper are available via the supplemental material section.


1995 ◽  
Vol 113 (1) ◽  
pp. 701-705
Author(s):  
Nelson Wolosker ◽  
Ruben Miguel Ayzin Rosoky ◽  
Baptista Muraco Neto ◽  
Berilo Langer

When a melito-diabetic patient presents trophic infected injury on the limb, it is essential an evaluation of the circulatory conditions for therapeutic procedures orientation. In some circumstances, although arterial pulsation is absent, there is no ischemia of tissues. In these cases, the maintenance treatment, with eventual resection of the necrosed and infected tissues may be adopted. Evolution of 70 diabetic patients with trophic injuries on extremities were submitted to a maintenance treatment. Age of patients varied from 28 to 88 years, with an average of 56.8. The most occurrence was verified in women, with 42 cases. Diabetes non-dependant on insuline (type II) was observed in 64 patients (91.5%), being the remaining 6 patients of type I. Diabetic retinopathy was observed in 14 (20%) of the patients, neuropathy in 22 (31%) and nephropathy in 8 patients (11.4%). All the patients presented arterial pulsation until the popliteal region. They were divided in 2 groups, considering trunk arteries of legs: Group I, pervial legs arteries, composed by 48 patients; Group II, occluded legs arteries, with 22 patients. In what refers to the anatomic local of the injuries, patients were classified in three groups: Group A, formed by 32 patients (45.7%), presenting injuries in one or two toes only, without affecting the metatarsic region; Group B, formed by 16 patients (22.9%), trophic injuries affecting the metatarsic region and Group C, formed by 22 patients (31.4%), injuries affecting the calcaneous region. Injuries in both of the groups were caused by mechanical traumatism. Duration of the injury in the inferior member varied from 7 to 48 days, resulting in a 12 days average. Analyzing pervicacity in trunk arterias and evolution of patients, it may be observed that there has been a significantly better result in those with all the pulses present (81.3% x 45.5%)(p<0,01). Studying the injury locals associated to the evaluation of the cases, we may observe that for injuries in the extreme digital, result is significantly better than in locals more nearly. When distal pulses are absent, there is no significant difference in the result of the treatment, being performed in distal injuries or in the more near ones (p>0,05)(Table IV).


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249252
Author(s):  
Reaz Mahmud ◽  
Mohammad Aftab Rassel ◽  
Farhana Binte Monayem ◽  
S. K. Jakaria Been Sayeed ◽  
Md Shahidul Islam ◽  
...  

Background Globally, studies have shown conflicting results regarding the association of blood groups with SARS CoV-2 infection. Objective To observe the association between ABO blood groups and the presentation and outcomes of confirmed COVID-19 cases. Design, setting, and participants This was a prospective cohort study of patients with mild-to-moderately severe COVID-19 infections who presented in the COVID-19 unit of Dhaka Medical College Hospital and were enrolled between 01 June and 25 August, 2020. Patients were followed up for at least 30 days after disease onset. We grouped participants with A-positive and A-negative blood groups into group I and participants with other blood groups into group II. Results The cohort included 438 patients; 52 patients were lost to follow-up, five died, and 381 completed the study. The prevalence of blood group A [144 (32.9%)] was significantly higher among COVID-19 patients than in the general population (p < 0.001). The presenting age [mean (SD)] of group I [42.1 (14.5)] was higher than that of group II [38.8 (12.4), p = 0.014]. Sex (p = 0.23) and co-morbidity (hypertension, p = 0.34; diabetes, p = 0.13) did not differ between the patients in groups I and II. No differences were observed regarding important presenting symptoms, including fever (p = 0.72), cough (p = 0.69), and respiratory distress (p = 0.09). There was no significant difference in the median duration of symptoms in the two group (12 days), and conversion to the next level of severity was observed in 26 (20.6%) and 36 patients (13.8%) in group I and II, respectively. However, persistent positivity of RT-PCR at 14 days of initial positivity was more frequent among the patients in group I [24 (19%)] than among those in group II [29 (11.1%)]. Conclusions The prevalence of blood group A was higher among COVID-19 patients. Although ABO blood groups were not associated with the presentation or recovery period of COVID-19, patients with blood group A had delayed seroconversion.


1977 ◽  
Vol 39 ◽  
pp. 143-152 ◽  
Author(s):  
Z. Ceplecha

Statistical studies of the photographic data on atmospheric trajectories and orbits of meteors (from 10-4 g to hundreds of tons) point to 5 groups of bodies with different structure and composition. The following classification is proposed: Fireball group I = exceptional cases of so-called “asteroidal” bodies among Super-Schmidt (SS) and small-camera (SC) meteors 5 ordinary chondrites. Fireball group II = group A among SS and SC = carbonaceous chondrites. Group B among SS and SC = dense cometary materials with small perihelion distances (not distinguishable among fireballs). Fireball group IIIa = group C among SS and SC = regular cometary material. Fireball group IIIB = group D (above C) of SS and SC = Draconid-shower type of cometary material. Statistics of the orbits for separate groups is considered and characteristic orbits are given.


2020 ◽  
Vol 11 (3) ◽  
pp. 3478-3483
Author(s):  
Ramya S ◽  
Sureka Varalakshmi V ◽  
Uma Maheswari K ◽  
Chandan Bala R

C-reactive protein (CRP), produced by the hepatocytes is a primary inflammatory marker of T2DM. Higher levels of gamma-glutamyl transferase enzyme (GGT) and Hs CRP (High sensitive CRP)are associated with the complication of poor glycemic control.This study was aimed to find the association of Hs CRP and GGT for cardiovascular risk factors in Type 2 diabetes mellitus (T2DM)and Hypertension in the suburbs of Chennai. This study includes 57 subjects with T2DM and Hypertension (Group A) and 62 subjects with T2DM (GroupB) within the age group of 40-60 years. FBS, HbA1C, Hs CRP, GGT and blood pressure were determined. Statistical analysis was performed using Statistical Package for the SPSS 17 version. Mean values of FBS, blood HbA1C, Hs CRP and GGT were significantly higher among participants of Group A than Group B. Significant difference of FBS, HbA1C were found between the two groups. In contrast, no significant difference of GGT was found between the groups. Differences were considered statistically significant at two-sided P < 0.05. Within the group, Hs CRP shows the significance and positive correlation with FBS, SBP and DBP. Still, GGT does not show any significance in Group A. In contrast, in Group B, both Hs CRP and GGT shows the importance and positive correlation with FBS and HbA1C.It is concluded that high levels of HsCRP are associated with T2DM and Hypertension, indicating increased cardiovascular risk, and it should be included in regular monitoring of type-2 diabetic patients.


2021 ◽  
Vol 30 (04) ◽  
pp. 235-242
Author(s):  
Mariya Khalid ◽  
◽  
Mohammad Ali Chughtai ◽  
Sohrab Shaheed ◽  
Syed Nasir Shah

OBJECTIVE: The aim of this experimental study is to compare the dimensional accuracy of gypsum casts after repeated disinfection in microwave at 900 Watts, 2450 MHz (5 minutes) and immersion in 0.5% Sodium hypochlorite (10 minutes). Disinfecting casts is recommended to prevent cross infection but may cause dimensional changes. During fabrication of prosthesis, a cast may get contaminated several times so there is a need of repeated disinfection. METHODOLOGY: Sample size was 33 (11 in each group), calculated through WHO software for sample size determination by using standard deviation of 0.16 at 95% confidence interval and 80% power of study. Impressions in irreversible hydrocolloid were recorded of an acrylic cast fabricated for this study. The impressions were poured with die stone and were randomly divided into 3 groups; Group I: Microwave disinfection, Group II: Immersion disinfection in 0.5% Sodium hypochlorite, Group III: Control group. For Groups I and II, each cast was disinfected 7 times with 5 minutes interval between two disinfection cycles, after every cycle anteroposterior and mediolateral measurements were recorded using digital Vernier caliper (accuracy upto 0.01 mm). For group III, casts were rinsed with distilled water, dried in open air within temperature range of 28+/-2OC for 10 mins followed by anteroposterior and mediolateral measurements. This procedure was repeated seven times for each cast. RESULTS: Anteroposterior and Mediolateral differences of dimensional change between and within the Group A, B and C was calculated by One Way ANOVA. Inter/intra examiner reliability was taken into consideration at the time of study. Mean dimensional change in the casts were insignificant through six disinfecting cycles. However, in the seventh cycle, a significant difference (p=0.003) was observed in the anteroposterior dimension (0.03% dimensional change for Group A and 1.26 % for Group B whereas, in mediolateral dimension, dimensional change was 0.35% for Group A and 0.59% for Group B (p=0.004). Dimensional change of >0.5% was considered as the cutoff value for casts to be considered as dimensionally accurate. Casts disinfected through immersion disinfection did not produce dimensionally inaccurate casts in anteroposterior dimension after third cycle and in seventh cycle in mediolateral dimension. However, result is significant only in seventh cycle. Microwave disinfection produced dimensionally accurate casts throughout all cycles. CONCLUSION: Microwave disinfected casts remained dimensionally stable compared to immersion disinfection. KEYWORDS: Disinfection, microwave, immersion, dimensional stability, gypsum casts


2020 ◽  
Vol 20 (4) ◽  
pp. 440-447 ◽  
Author(s):  
Adel A. Hagag ◽  
Mohamed S. El Frargy ◽  
Hoassam A. Houdeeb

: Sepsis is unusual systemic reaction to an ordinary infection, and it probably represents a pattern of response by the immune system to the injury. Vitamin D is a fat-soluble steroid hormone that contributes to the maintenance of normal calcium homeostasis and skeletal mineralization. Vitamin D has an important role in the regulation of both innate and adaptive immune systems. Aim of the Work: The current study aimed to evaluate the therapeutic value of vitamin D supplementation as an adjuvant therapy in neonates with sepsis. Subjects and Method: This study included 60 neonates with sepsis who were randomly divided into 2 equal groups; group I: 30 neonates with sepsis who received antibiotic only, Group II: 30 neonates with sepsis who received antibiotic therapy and vitamin D. This study also included 30 healthy neonates as a control group. For all patients and controls, serum level of 25 (OH) vitamin D and highly sensitive C reactive protein (hs-CRP) were immunoassayed. Results: There is no significant difference between groups I, II and controls regarding weight, gestational age, sex and mode of delivery. There were significant differences between groups I and II in sepsis score and hs-CRP after 3, 7, 10 days of treatment (p values for sepsis score were 0.009, 0.006, 0.004 respectively and for hs-CRP were 0.015, 0.001, 0.001 respectively). There was a significant difference in immature /total (I/T) ratio after 7, and 10 days of treatment (p value= 0.045, 0.025, respectively,) while there was no significant difference in immature /total (I/T) ratio after 3 days of treatment (p value = 0.624).Serum 25(OH) vitamin D levels were significantly lower in neonates with sepsis (group I and II) than the controls (p value < 0.05, while there were no significant differences between the three groups considering serum calcium and phosphorus levels (P =1.000, 1.000, respectively). Isolated organisms from blood culture in neonates with sepsis (group I and group II) were most commonly B- hemolytic streptococci, E-coli, hemophilus influenza and staphylococcus aurous. There was a significant negative correlation between hs-CRP and serum 25 (OH) vitamin in group II on entry (r = - 0.832 and P value = 0.001) and after 2 weeks (r = - 0.590 and P value = 0.021). ROC curve of specificity and sensitivity of 25 (OH) vitamin D level in prediction of early-onset neonatal sepsis showed that cutoff value of vitamin D was ≤20 ng/ml, sensitivity was 100%, specificity was 73%, positive predictive value was 73%, negative predictive value was 100% and accuracy was 87. Conclusion and Recommendation: Serum 25 (OH) vitamin D levels of neonates with the early onset neonatal sepsis were significantly lower than the healthy controls. Vitamin D supplementation improved sepsis score and decrease high levels of hs-CRP; this reflects the role of vitamin D as a target therapy for neonatal sepsis. Further studies are warranted to confirm the therapeutic value of vitamin D in neonatal sepsis.


2007 ◽  
Vol 35 (03) ◽  
pp. 447-453 ◽  
Author(s):  
Jianzhu Liu ◽  
Yoo-Teak Lee ◽  
Sang-Eun Lee ◽  
Jung-Yeon Lee ◽  
Duck-Hwan Kim

The present study was conducted in order to clarify the anti-emetic effect of oculo-acupuncture (OA) on dogs with xylazine-induced vomiting, and also to compare the anti-emetic effect of OA and body acupuncture (AP). Twelve dogs induced to vomit by xylazine were selected from total 29 mongrel dogs in preliminary experiment and were used as subjects in this study. This study was comprised of two experiments. In experiment 1, the anti-emetic effects of OA on dogs were examined in the stomach/spleen region (experimental group I), the zhongjiao region (experimental group II), and the stomach/spleen region plus the zhongjiao region (experimental group III) using 12 dogs induced to vomit for one week interval repeatedly. On the other hand, needle acupuncture (AP) (BL20 + BL21, experimental group A) and OA (stomach/spleen and zhong jiao regions) combined with needle AP (BL20 + BL21) (experimental group B) were examined using 6 vomiting dogs, for one week interval repeatedly in experiment 2. As a result, the vomiting rates of experimental group I (50%, p < 0.05), experimental group II (58.3%) and experimental group III (41.6%, p < 0.01) were lower than that of control (100%), respectively in experiment 1. The vomiting rates of both experimental group A (50%, p < 0.05) and experimental group B (50%, p < 0.05) were lower than that of control (100%) in experiment 2. The starting vomiting time in experimental groups was similar to that of the control groups in experiment 1 and 2. This study demonstrated that OA had anti-emetic effects on dogs with xylazine-induced vomiting and OA in the stomach/spleen region plus the zhongjiao region was the most effective in anti-emesis among the experimental groups. In addition, body AP and OA combined with body AP had a similar anti-emetic effect on dogs with xylazine-induced vomiting.


2021 ◽  
Vol 2 (2) ◽  
pp. 216-224
Author(s):  
Sheenam Markan ◽  
Gurvanit Kaur Lehl

Aim: To compare the post-operative pain after the use of rotary and conventional root canal instruments in single and multiple visit root canal treatment Materials and Method: 168 patients requiring Root Canal Treatment [RCT] in maxillary and mandibular 1st molar were involved in the study. On the basis of vitality and radiographic features two groups were made, multiple visit (Group A n=72), single visit (Group B n=96). Then the patients were randomly divided into 4 subgroups. Subgroup I n=36 (multiple visit conventional RCT), Subgroup II n=36 (multiple visit rotary RCT), Subgroup III n=48 (single visit Conventional RCT) and Subgroup IV n=48 (single visit rotary RCT). In subgroup I & Subgroup III Canal preparation was done with stainless steel K files in step back manner. In subgroup II & Subgroup IV, rotary Protaper Next was used. Irrigation was done with 3 % NaOCl and Ethylenediamine tetraacetic acid (EDTA) alternatively followed by obturation. The postobturation pain was recorded at 6hr, 12hr, 24hr, 1 week using visual analogue scale. Statistical Analysis was done using Tukey HSD Post Hoc Test and ANOVA Test. Results: Within 24 hours there was statistically significant difference between the groups (p< 0.05) but after 7 days no statistically significant difference was there (p>0.05). Conclusion: Patients in the groups either in single and multiple visit experience less postobturation pain if the canal preparation was done with the rotary files at all the time intervals (6hrs, 12hrs, 24hrs ) but after 7 days no statistical difference was found.


Author(s):  
Dr. Sundaresan Balagopal ◽  
Dr. Bahavathi Ananthan Hemasathya ◽  
Dr. Ramasamy Saravanan Saravanan Gayathri ◽  
Dr. M. Anisha Anisha Sebatni ◽  
Dr. Vasudevan Navabharathy

Aim: The aim of the study was to evaluate the shear bond strength of composite to dentin with 2 different dentin bonding agents after dry dentin is rewetted with a desensitizer. Materials and Methods: Sixty human mandibular molars were taken and the occlusal surface was ground to expose flat dentinal surface.  The samples were divided into two major groups Group I and Group II based on the bonding agent used. In Group I Gluma Bond5 was used and in Group II Adper Single Bond 2 was used.  Each major group is subdivided into three subgroups a, b and c with ten samples each.  Sub Group ‘a’ is moist dentin group. Sub Group ‘b’ is dry dentin group, Sub Group ‘c’ is rewetted dentin group. The desensitizer used is GLUMA Desensitizer. All these samples were thermocycled and the shear bond test was performed using Instron Universal Testing Machine. Results: Dry dentin rewetted with GLUMA Desensitizer followed by GLUMA Bond5 showed highest shear bond strength than that of other subgroups. The data was analysed using ANOVA and Tukeys honestly significant test. Conclusion: Desensitizer used as a rewetting agent increases the shear bond strength of composite on dry dentin. Keywords: Glutaraldehyde, rewetting.


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