scholarly journals Antibodies to Histone in the Pediatric Population: A Retrospective Chart Review

2021 ◽  
Author(s):  
Charles Matthew Justice ◽  
Terry L. Moore
Keyword(s):  
Antibody Titer ◽  
Lupus Erythematosus ◽  
Pediatric Population ◽  
P Value ◽  
Diagnostic Utility ◽  
Antibody Testing ◽  
Rheumatologic Disease ◽  
Autoantibody Production ◽  
Common Diagnosis ◽  
Significant Difference

Abstract Background:Antibodies to histone have been associated in the adult literature with systemic lupus erythematosus(SLE) and drug induced lupus(DILE). Little data is available regarding the spectrum of pathology that antibodies to histone encompass in the pediatric population. Prior studies suggest an association with SLE, juvenile idiopathic arthritis(JIA), uveitis and linear scleroderma.Methods:Patient charts were reviewed that contained positive anti-histone antibody testing during a consecutive three year period. Patient diagnosis along with the presence of: anti-histone antibody titer, ANA, and the presence of other autoantibodies to SSA, SSB, Sm, RNP, dsDNA and chromatin were obtained. The frequency of SLE, JIA and DILE was further investigated in specific subsets.Results:139 individual charts were reviewed containing 41 different diagnoses. The most common diagnosis was hypermobility arthralgia with 22 patients. The most frequent rheumatologic diagnosis was JIA(non-systemic) with 19. 13 patients in this study were diagnosed with SLE and 2 with DILE. 18 patients had other autoantibody production, of these, 11 had SLE or DILE. Only one of 62 patients with a weak anti-histone antibody titer(1.0-1.5) was diagnosed with SLE. When strong titers are present(>2.5), the anti-histone antibody test was associated with a greater than 50% incidence of an underlying rheumatologic disease and ten times higher incidence of SLE than a weak titer. In regards to the frequency of SLE, there was a statistically significant difference in weak and moderate(1.6-2.5) titers(p-value 0.0113) and weak and strong titers(p-value 0.0053). Conclusion:The presence of anti-histone antibody was observed in a variety of diagnoses in the pediatric population. Overall, the presence of anti-histone antibodies appears to have poor diagnostic utility for any specific condition. However, diagnostic utility for SLE does improve with higher titers, when combined with other autoantibody positivity. Strength of titer did not appear to be a factor for JIA, but was the most frequently observed rheumatologic disease in this study.

scholarly journals Correlation between Clinical Symptoms of Coeliac Disease, Serum IgA Anti TTG and Biopsy in Pediatric Population of Northern India

2020 ◽  
Vol 8 (1) ◽  
pp. 65-68
Author(s):  
Sumit Jeena ◽  
Jaswinder Kaur ◽  
Nishant Wadhwa
Keyword(s):  
Coeliac Disease ◽  
Clinical Symptoms ◽  
Tissue Transglutaminase ◽  
Pediatric Population ◽  
Clinical Manifestations ◽  
North India ◽  
P Value ◽  
Serum Iga ◽  
Significant Difference ◽  
The Mean

Background: Celiac disease is basically an immune-mediated enteropathic condition produced by permanent sensitivity to gluten in genetically susceptible subjects. There is paucity of data in north India regarding clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population. The present study was conducted with the aim to determine the correlation between clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population of northern India.Materials and Methods: The present study was conducted in prospective including 73 pediatric patients at Department of Pediatric Gastroenterology, Institute of Child Health, Sir Gangaram Hospital, New Delhi, India. Esophagogastroduodenoendoscopy and serum anti Ig A tissue transglutaminase were performed. The characteristic scalloping of the folds were looked for in endoscopy followed by four duodenal biopsies performed from second part of duodenum and histological grading was performed as per modified marsh system. Patients with Serum IgA anti tTG>20 U/ml were confirmed to be at risk. Complete histological work up was done including hemoglobin, RBC indices and peripheral blood smear examination. The association of clinical manifestations with disease grade was also established with correlation coefficient. All the data thus obtained was arranged in a tabulated form and analyzed using SPSS software. Probability value of less than 0.05 was regarded as significant.Results: There were 4 males and 16 females with marsh grade 1 and 2 and mean age of 7.3±1.9 years. There were 5 males and 8 females with marsh grade 3a and mean age of 6.8±2.3 years. The mean weight of 18.11±3.89, height of 103.17±8.73 and BMI of 16.26±3.78 was observed amongst subjects with Marsh grade 1 and 2. The mean weight of 15.12±3.17, height of 99.28±9.19 and BMI of 15.02±3.20was observed amongst subjects with Marsh grade 3a. Diarrhoea was maximum amongst subjects with grade 3c and 4(70%) and minimum amongst Grade 1 and 2 (40%). There was a significant difference between the frequency of anemia amongst different grades as the p value was less than 0.05.Conclusion: The most common presenting signs and symptoms were diarrhea and abdominal pain. The study also concluded that the incidence of anemia increases with higher marsh grades.

scholarly journals Cyanotic congenital heart disease: Impact on growth and endocrine functions.

2021 ◽  
Vol 28 (10) ◽  
pp. 1477-1483
Author(s):  
Muhammad Sohail Arshad ◽  
Waqas Imran Khan ◽  
Arif Zulqarnain ◽  
Hafiz Muhammad Anwar-ul-Haq ◽  
Mudasser Adnan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pulmonary Stenosis ◽  
Tertiary Care ◽  
Cyanotic Congenital Heart Disease ◽  
P Value ◽  
Common Diagnosis ◽  
Significant Difference ◽  
The Impact

Objective: To find out the impact of Cyanotic Congenital Heart Disease (CCHD) on growth and endocrine functions at a tertiary care child healthcare facility of South Punjab. Study Design: Case Control study. Setting: Department of Pediatric Cardiology and Department of Pediatric Endocrinology, Institute of Child’s Health (ICH), Multan, Pakistan. Period: December 2018 to March 2020. Material & Methods: During the study period, a total of 53 cases of Echocardiography confirmed CCHD were registered. Along with 53 cases, 50 controls during the study period were also enrolled. Height, weight, body mass index (BMI) along with hormonal and biochemical laboratory investigations were done. Results: There was no significant difference between gender and age among cases and controls (p value>0.05). Most common diagnosis of CCHD among cases, 24 (45.3%) were Tetralogy of Fallot (TOF) followed by 9 (17.0%) transposition of the great arteries (TGA) with Ventricular Septal Defect (VSD) with Pulmonary Stenosis (PS). Mean weight of CCHD cases was significantly lower in comparison to controls (21.19+6.24 kg vs. 26.48+8.1 kg, p value=0.0003). Blood glucose was significantly lower among cases in comparison to controls (77.58+14.58 mg/dl vs. 87.25+11.82 mg/dl, p value=0.0004). No significant difference was found in between cases and controls in terms of various hormone levels studied (p value>0.05) except Insulin-like Growth Factor-1 (IGF-1) levels (p value<0.0001). Conclusion: Children with cyanotic congenital heart disease seem to have negative effects on nutrition and growth. Change in pituitary-adrenal axis is suspected while pituitary-thyroid axis seemed to be working fine among CCHD cases. Serum glucose and IGF-1 levels were significantly decreased among CCHD cases.

Treatment strategies and pregnancy outcomes in antiphospholipid syndrome patients with thrombosis and triple antiphospholipid positivity

2014 ◽  
Vol 112 (10) ◽  
pp. 727-735 ◽  
Author(s):  
Elisa Salvan ◽  
Teresa Del Ross ◽  
Maria Gerosa ◽  
Laura Andreoli ◽  
Aldo Maina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiphospholipid Syndrome ◽  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Conventional Therapy ◽  
Treatment Strategies ◽  
P Value ◽  
Pregnancy Failure ◽  
Significant Difference ◽  
Antibody Positivity

SummaryPrevious thrombosis, diagnosis of systemic lupus erythematosus (SLE) and triple antiphospholipid (aPL) antibody positivity have recently been found to be independent factors associated to pregnancy failure during conventional therapy in women with antiphospholipid syndrome (APS). This study aimed to assess the effect of various treatment strategies on pregnancy outcomes in women with APS and the risk factors for pregnancy failure. One hundred ninety-six pregnancies of 156 patients diagnosed with APS were analysed: 118 (60.2%) of these had previous thrombosis, 81 (41.3%) were diagnosed with SLE, and 107 (54.6%) had triple aPL positivity. One hundred seventy-five (89.3%) were treated with conventional therapies (low-dose aspirin [LDA] or prophylactic doses of heparin + LDA or therapeutic doses of heparin + LDA), while 21 (10.7%) were prescribed other treatments in addition to conventional therapy. The pregnancies were classified into seven risk profiles depending on the patients’ risk factors – thrombosis, SLE, and triple aPL positivity – and their single, double or triple combinations. It was possible to find significant difference in outcomes correlated to treatments only in the thrombosis plus triple aPL positivity subset, and logistic regression analysis showed that additional treatments were the only independent factor associated to a favourable pregnancy outcome (odds ratio=9.7, 95% confidence interval= 1.1–88.9, p-value<0.05). On the basis of this retrospective study, we found that APS pregnant patients with thrombosis and triple aPL positivity treated with additional therapy had a significant higher livebirth rate with respect to those receiving conventional therapy alone.

scholarly journals Randomized control trial comparing primary hip spica versus initial traction and hip spica of fracture at or below the junction of the upper and middle third of femur in children

2017 ◽  
Vol 13 (2) ◽  
pp. 80-91
Author(s):  
Pashupati Chaudhary ◽  
AR Bajracharya ◽  
A Joshi ◽  
B Sharma ◽  
R Bose ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Femoral Shaft ◽  
Wound Dehiscence ◽  
P Value ◽  
Chi Square ◽  
Spica Casting ◽  
Femur Fractures ◽  
Fractures In Children ◽  
Group I ◽  
Significant Difference

Background: The debate regarding optimal management of femoral shaft fractures in the pediatric population is still far from resolved. While some consensus exists in the treatment of this injury in children younger than the age of six, opinion still widely divided in children six to 11 years.Objective: The aim of study was to compare the outcome of primary hip spica versus initial traction and hip spica of fracture of shaft of femur at or below the junction of the upper and middle third in children in terms of deformity and fracture healing.Method: A RCT study was carried out in the departments of Orthopedics, B.P.Koirala Institute of Health Sciences, Dharan, Nepal from March 2004 to January 2006. Forty five patients were included in the study in which 22 patients included in early spica casting (group I) and 23 patients in traction with spica casting (group II). The functional outcomes were assessed with Pearson’ Chi-square test, Independent samples test and union was assessed radiologically.Result: There was no statistically significant difference in time of union; all of them united in 8-10 weeks follow up. No significant overall difference in terms of deformity was noted in the two groups(p value-0.306).There was significant difference in terms of hospital stay in both the groups(p value<0.05).Conclusion: The study showed that there is significant advantage in primary hip spica cast for the treatment of isolated , closed femur fractures in children ages less than 10 years and weight less than 80 pounds(45kg) which allowed us to treat these fractures without any worry of wound dehiscence, pin site infections, avascular necrosis of the femoral head.Health Renaissance 2015;13(2): 80-91

scholarly journals Comparison of Sympathetic Skin Response (SSR) between Electrical and Acoustic Stimuli in a Healthy Pediatric Population

2021 ◽  
Vol 13 (3) ◽  
pp. 520-529
Author(s):  
Sara Cavaliere ◽  
Giovanna Bertini ◽  
Cesarina Cossu ◽  
Maria Bastianelli ◽  
Simonetta Gabbanini ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Acoustic Stimulus ◽  
Sympathetic Skin Response ◽  
Electrical Stimulus ◽  
P Value ◽  
Literature Report ◽  
P Values ◽  
Acoustic Stimuli ◽  
Significant Difference ◽  
Skin Response

Data in the literature report that latency and morphology in the cutaneous sympathetic skin response (SSR) do not change according to the type of stimulus delivered, unlike the amplitude which shows greater values in relation to the intensity of the physical impact caused in patient. Since the acoustic stimulus represents a method better tolerated by the pediatric patient, the aim of this study is to evaluate the presence or absence of significant differences in SSR between electrical and acoustic stimuli. The SSR was performed for each child of 18 recruited in this study, deriving from the palm of the hand and the sole of the foot and initially delivering an electrical stimulus at the level of the median nerve at the wrist. Two acoustic stimuli were subsequently delivered with the aid of audiometric headphones. Our results show no significant differences for the amplitude values obtained (p values > 0.05). For the latency there was a statistically significant difference (p-value = 0.001) for the left hand, subsequently not confirmed by the comparison performed between the two sides (p-values = 0.28 and 0.56). If these preliminary data are confirmed by a larger sample, the acoustic stimulus could be introduced in a standardized protocol for performing SSR in pediatric patients.

Comparison of Covid-19 IgG Anti-Spike Antibody Titer after Vaccination with Sputnik V in Seropositive and Naïve Vaccinees

2021 ◽  
Vol 35 (4) ◽  
pp. 1-5
Author(s):  
Hajra Farooq
Keyword(s):  
Single Dose ◽  
Antibody Titer ◽  
Immunological Response ◽  
Severe Infection ◽  
P Value ◽  
Igg Antibody ◽  
Policy Makers ◽  
Significant Difference ◽  
Antibody Titers ◽  
Study Participants

Introduction: Immunity to SARS-CoV-2 has shown to reduce the risk of having a severe infection and initiate a good degree of disease protection. Studies assessing the antibody titer after vaccination can be very helpful to see whether previously infected individuals have better immunological response as compared to uninfected or antibody naïve individuals. Aims & Objectives: Comparison of Anti-spike IgG antibody among vaccinees with or without previous exposure to COVID-19. To determine whether single dose regimen can produce significant antibody titer amongst previously infected cases and design vaccine dosage regimens accordingly. Place and duration of study: This study was conducted at Chughtai Institute of Pathology from April 2021 to June 2021. Material & Methods: Blood samples were collected from 83 adult male and female vaccinees at baseline, 3 weeks after the first dose and finally 7 days after the second dose. Previously infected individuals’ record was noted separately. Samples were immediately analyzed using Abbott SARS-CoV-2 IgG II quant two step immunoassay. Data was analyzed using SPSS 23.0. A p-value of <0.05 was considered significant.Results: Majority of the candidates (57 %) were females and on analysis it was found that 42% of the patients were seropositive whereas 58% of the patients were antibody naïve before receiving the first dose of vaccine. There was a significant difference between mean antibody titer of seropositive and seronegative study participants at day 0, day 21 and finally on day 28 (p value <0.001) with seropositive individuals having higher antibody titers even after first vaccine shot. Conclusion: Post vaccination immunological response was higher in seropositive individuals as compared to the antibody naïve and this finding can help the policy makers to design a single dose vaccine regimen for the former category.

scholarly journals Prevalence Ratio of Otitis Media with Effusion in Laryngopharyngeal Reflux

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Mahastini Karyanta ◽  
Siswanto Satrowiyoto ◽  
Dian Paramita Wulandari
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Laryngopharyngeal Reflux ◽  
Pediatric Population ◽  
Clinical Manifestations ◽  
Prevalence Ratio ◽  
P Value ◽  
Cross Sectional ◽  
Significant Difference ◽  
Considerable Morbidity

Background. Otitis media with effusion (OME) in adults is less prevalent than in the pediatric population but still causes considerable morbidity. It has been suggested that laryngopharyngeal reflux (LPR) may have a role in the aetiology of adult OME. Reflux advances to the laryngopharynx and, subsequently, to other regions of the head and neck such as oral cavity, nasopharynx, nasal cavity, paranasal sinuses, and even middle ear with clinical manifestations being asthma, sinusitis, and otitis media. Objective. To determine the prevalence ratio of otitis media with effusion in laryngopharyngeal reflux. Methods. Observational analytic with cross sectional design. Result. 9 of 28 subjects experienced OME in LPR group, and 2 of 28 subjects in non-LPR group. Statistically there was significant difference between the two groups with p-value 0.02 and with 95% confidence interval range of 1.066-18.990. Conclusion. The prevalence ratio of otitis media with effusion in laryngopharyngeal reflux group is 4.5 times that in non-laryngopharyngeal reflux group.

scholarly journals Serum Complement Protein C3a Level is Associated With Anti dsDNA Ab in Systemic Lupus Erythematosus: a Brief Report

2021 ◽  
Author(s):  
Yao-Hua Cai ◽  
Jun Deng ◽  
Zhao-Lin Chen ◽  
Heng Mei ◽  
Liang Tang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Complement Protein ◽  
Systemic Lupus ◽  
Laboratory Procedure ◽  
Autoantibody Production ◽  
Wide Range ◽  
Significant Difference

Abstract Objective. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is characterized by complement dysfunction and a wide range of autoantibody production. However, data about the relation between C3a and anti-ds DNA Ab in SLE are scarce. Methods.Thirteen SLE patients, diagnosed on the basis of SLICC classification criteria (6 patients positive for anti-Sm Ab, 7 patients positive for anti-dsDNA Ab) were enrolled in the present study. Serum levels of C3a, C1q were quantified by Western Blotting. Clinical, biochemical, serological and other markers of disease activity (anti-SM, anti-dsDNA) were measured by standard laboratory procedure.Results.Serum C3a levels were significantly higher in anti-dsDNA Ab (+) patients compared to anti-Sm Ab (+) patients (p < 0.01). And serum C3a levels positively correlated with SLE Disease Activity Index (SLEDAI) (p < 0.05, r = 0.6134). Interestingly, C3a was slightly correlated positively with D-Dimer, but no significant difference was found (p = 0.0983, r = 0.4783).Conclusion.C3a level is relative to SLE disease activity and may be a promising biomarker for monitoring thrombophilia in SLE.

A comparative study between Levobupivacaine alone and in combination with Dexmedetomidine in caudal analgesia of hernia repair in pediatrics

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed K Kamar ◽  
Hala G Awad ◽  
Hanan Mahmoud F Awad ◽  
Mohammed M Maarouf
Keyword(s):  
Hernia Repair ◽  
Pediatric Population ◽  
P Value ◽  
General Anesthesia Group ◽  
Caudal Anesthesia ◽  
Analgesic Regimen ◽  
Caudal Analgesia ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background Inguinal hernia repair is one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimen provides safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery. Aim of the Work to examine the effect of Dexmedetomidine as an adjuvant to Levobupivacaine in caudal anesthesia, mainly its effect in enhancing and prolonging post-operative analgesia. Patients and Methods The study was conducted on 50 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. Patients were divided randomly into two groups, each group consisted of 25 patients. After preoperative assessment and obtaining baseline vital data, all patients received general anesthesia. Group A: Patients in this group received caudal anesthesia with Levobupivacaine 0.25% at a dose of 2 mg·kg−1 (0.8 ml·kg−1) before the beginning of the procedure. Group B: Patients in this group received Levobupivacaine 0.25% at a dose of 2 mg·kg−1 (0.8 ml·kg−1) in addition to Dexmedetomidine 1 μg·kg−1 in 1 ml normal saline before the beginning of the procedure. Results The results of the study revealed that there was significant reduction in FLACC score in group B at 4, 8, and 12 hours postoperatively compared to group A, at the twenty-fourth hour there was no significant difference. Regarding the duration of analgesia postoperatively we found statistically significant increase in group B compared to that in group A (p-value &lt;0.001). Regarding the number of doses of analgesia required post operatively (Paracetamol 15ml/kg/dose) there was a statistically significant decrease in patients requirement in group B compared to that in group A (p-value &lt;0.001). Conclusion Dexmedetomidine as adjuvant to Levobupivacaine provided significantly prolonged postoperative analgesia, reduced the postoperative analgesic requirements and better parents’ satisfaction as compared with caudal analgesia using Levobupivacaine alone in children undergoing hernia repair.

scholarly journals Awareness of Systemic Lupus Erythematosus among Primary Health Care Patients in Riyadh, Saudi Arabia

2018 ◽  
Vol 6 (12) ◽  
pp. 2386-2392 ◽  
Author(s):  
Kholoud A. Bin Haikel ◽  
Bader Al Tulaihi
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Health Care ◽  
Primary Health Care ◽  
Lupus Erythematosus ◽  
Categorical Variables ◽  
P Value ◽  
Systemic Lupus ◽  
Male And Female ◽  
Primary Health ◽  
Significant Difference

AIM: To measure the level of Systemic Lupus Erythematosus awareness among visitors in PHC at KAMC and to explores the factors which influence the Systemic Lupus Erythematosus awareness. METHODS: The study was a cross-sectional study conducted between February and September 2018 in four primary health care centers belong to King Abdulaziz Medical City. The study participants were male and female adult visitors to the centers` age from 18 to 60 years of age. The sample size was 400 participants. The participants were enrolled via a random convenience sampling method. Study data was collected using a self-administered questionnaire. Analytic statistics were done using the Chi-square (c2) test for associations and/or the difference between two categorical variables. A P-value ≤ 0.05 was considered statistically significant. RESULTS: The awareness about Systemic Lupus Erythematosus among male and female was not statistically significant as (P = 0.304), but there was a statistically significant difference according to education level. Visitors with high school education are aware of Systemic Lupus Erythematosus than those with a lower level of education (Primary & Middle school) who are not aware of the Systemic Lupus Erythematosus by (P = 0.023). CONCLUSION: The study shows that this survey is valuable and beneficial to the community as it helps people to assess their knowledge about Systemic Lupus Erythematosus and become aware of this disease, as well as awareness of Systemic Lupus Erythematosus should be promoted among the community.

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