scholarly journals Sydenham’s chorea in Sudan

Author(s):  
Etedal Ahmed A. Ibrahim ◽  
Rogia Hussein Mohamed ◽  
Khabab Abbasher Hussien Mohamed Ahmed ◽  
Mohammed Eltahier Abdalla Omer

Abstract Background: Sydenham’s chorea (SC), is the most common form of acquired chorea in childhood, it is considered as neurological complication of streptococcal pharyngitis. Our aim was to determine the clinical pattern, association of Sydenham’s chorea with other manifestation of ARF and the laboratory findings of Sydenham’s chorea among Sudanese patients.Methods: This study is descriptive , retrospective cross- sectional study. Fifty patients with different age groups, were diagnosed as having Sydenham’s chorea & followed up at The National center for Neurological sciences, in the period (Jan2017 to Nov2019). Data were obtained after patients consent of by personal interview or personal review of patients records through a designed questionnaire including demographic data, symptoms, co morbid illness, risk factors, physical examination and related investigations.Results: The patients’ median age was 13.7 years: 88% of the cases occurred between 7-17 years with female predominance(35) . Generalized chorea was seen in 33 (66%) and hemichorea 17 (34%) patients. weakness and hypotonia were common, behavior change (44%), dysarthria (71%), gait change(17.20%)and deterioration of handwriting (13%) Arthritis occurred in (36%), carditis 30 (60%), arthritis and carditis in 18(36%), and pure chorea 14 (28%). Erythema marginatum and subcutaneous nodules were not observed in our patients. Only13 patients (26%) gave a history of pharyngitis.Conclusion : There were clear evidence of familial predisposition. Sydenham’ chorea commonly presents acutely in majority of patients. Chorea firstly appeared with oro-fascial movement followed by limb involvement. Minority of patients gave a history of pharyngitis. Brain imaging was normal.

2021 ◽  
Author(s):  
Shima Salehi ◽  
Rozita Hosseini Shamsabadi ◽  
Hassan Otukesh ◽  
Reza Shiari ◽  
Monir Sharafi

Abstract Background: Lupus is an inflammatory and autoimmune disease that involves various tissues and organs of the body. Identification of diagnostic elements to rapid identification of seronegative lupus cases is very important in order to prevent morbidity and progression of disease. This study aimed to compare clinical and laboratory findings of seropositive cases with seronegative lupus patients. Methods: This cross-sectional analytic study was performed on 43 children (17 seronegative and 26 seropositive) with lupus who were admitted to Ali Asghar Hospital during 2007-2017. Seropositive patients had anti-nuclear antibody (ANA) titration >1/80, while seronegative patients had ANA titration <1/80 (at the time of disease diagnosis). Clinical and laboratory findings were compared between two groups.Results: Serositis in patients with ANA- was significantly higher than ANA+ (41.17% vs. 23.07%; p = 0.042). ANA- group had higher autoimmune disease history than ANA+ group (42.85% vs. 15.0%; p = 0.041). The family history of the disease in the ANA- group was greater than ANA+ group (50% vs. 23.52%). The percentage of hypertensive patients in ANA- group was higher than ANA+ group (52.94% vs. 26.92%; p = 0.037). Neurologic symptoms in ANA+ and ANA- groups were 38.46% and 17.64%, respectively (p = 0.043). The frequency of patients with thrombocytopenia in ANA+ group was significantly greater than ANA- group (32% vs. 12.5%; p=0.041). There was no significant difference in other clinical and laboratory findings between two groups. Conclusion: Seronegative lupus patients had higher percentage of musculoskeletal symptoms, autoimmune disease history, familial history of disease, and hypertension, while neurological and thrombocytopenia symptoms were higher in seropositive patients compared to seronegative cases. Therefore, evaluation of these factors can be helpful to diagnosis of seronegative patients.


Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Haitham Ahmed ◽  
Di Zhao ◽  
Eliseo Guallar ◽  
Michael J Blaha ◽  
Clinton A Brawner ◽  
...  

Background: The declines in peak heart rate (HR) and fitness level with age are related; however, whether this association differs based on gender is not well appreciated. In a large cross-sectional cohort of women and men referred for a clinically indicated exercise treadmill test (ETT), we set out to determine whether the decrease in peak HR by age varied by gender (and fitness) in the Henry Ford Exercise Testing (FIT) project. Methods: We analyzed data on 38,196 apparently-healthy patients aged 18-96 [mean age 51 ± 12 yrs, 25% black, 48% women] who completed an ETT. Those with history of coronary heart disease, congestive heart failure, diabetes on medications, atrial fibrillation or flutter, or taking AV nodal blocking medications were excluded. Being “fit” was defined as achieving ≥ the median MET level for each sex/age-decile group. Peak HR vs age was plotted, and regression lines were used to determine the intercept and slope for each group. Results: Men had higher peak HR than women but with a greater decline over time; the respective intercepts and slopes for peak HR estimates were 202.9 and 0.90 for men and 197.3 and 0.80 for women, (p-interaction = 0.023). Fit people also started out with higher peak HR but approached unfit people at higher age groups; respective intercept and slope by fitness status were 203.0 and 0.87 for fit and 194.7 and 0.83 for unfit (p-interaction <0.001). Separate regression lines were generated for categories of fit men/unfit men, fit women/unfit women ( Figure ). Fit and unfit men had similar declines in peak HR with increasing age (slope=0.92); whereas fit women (slope=0.81) had a slightly greater decline in peak HR with increasing age than unfit women (slope=0.73). However, peak absolute HR for fit people still remains higher than for unfit people even into elderly ages. Conclusion: In this cross-sectional cohort of patients referred for a clinical ETT, we found that the age-related decline in peak HR is influenced by both gender and fitness status.


2021 ◽  
Vol 6 (1) ◽  
pp. 99-104
Author(s):  
S. M. Gamde ◽  
◽  
P. J. Tongvwam ◽  
K. Hauwa ◽  
A. M. Ganau ◽  
...  

Urinary schistosomiasis is a severe threat to global health with uncountable morbidities in Africa including Nigeria where control interventions focused on children in public and private schools neglecting Almajiri children. This undermined control interventions as those infected contaminate the environments with infective stages of the parasite. The objective of the study was to identify the prevalence of urinary schistosomiasis amongst Almajiri children in Silame, Sokoto State, North-western Nigeria. This was a cross-sectional descriptive study, socio-demographic data was collected in April 2020 on 206 consented Almajiri children in Silame and their urine samples were examined using the sedimentation method. The study showed a prevalence of 35.4% among the Almajiri children in Silame, Sokoto State, North-western Nigeria. The highest prevalence was found among children within the age range 16-20 years (63.6%) while the lowest prevalence was among those in the age range 6-10 years (24.4%). There was a statistically significant difference in the occurrence of urinary schistosomiasis between the age groups (χ 2 = 11.637a , df =3, p=0.002). Urinary schistosomiasis was prevalent among Almajiri children in the study area and parasite infection was associated with the participant's socio-demographic factors such as age, level of education, and water contact activities. Hence, the National Schistosomiasis Control Programs should incorporate the Almajiri children in the control interventions Keywords: Schistosoma hematobium infection; Makarantarallo;Almajiri;Silame


Author(s):  
Halil ONDER ◽  
Ersin Kasim ULUSOY ◽  
Caner BAYDAR ◽  
Mustafa KIRAZ ◽  
Muhammet Okay ORUN ◽  
...  

ABSTRACT Background: Psychiatric problems and sleep disturbances are comorbidities that are frequently encountered among people with epilepsy. However, their presence among the spouses of peoples with epilepsy remains to be elucidated. Objective: The objective of this study was to evaluate the spouses of people with epilepsy (PWE), with and without a history of seizures during sleep, in terms of depression, anxiety and sleep quality. Methods: This prospective, cross-sectional study was conducted in three groups of 18 to 65-year-olds. Group 1 consisted of healthy spouses of 127 healthy volunteers without any known neurological disease; group 2 comprised spouses of 63 PWE who had no history of seizure during sleep; and group 3 consisted of spouses of 63 PWE who had a history of at least one seizure during sleep in the course of the previous year. Questionnaires seeking demographic data and the Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory and Beck Anxiety Inventory were applied to all participants. Results: The depression scores of the group of spouses of PWE were higher than those of the control group and were higher in group 3 than in group 2 (p = 0.017). The anxiety scores of the group of spouses of PWE were significantly higher than those of the control group, but no difference in anxiety scores was found between group 2 and group 3 (p = 0.170). The mean PSQI score of group 3 was higher than that of group 2 (p = 0.029). However, regression analyses did not show any difference between these groups. Conclusion: We found that the PSQI scores, which reflected sleep quality, were higher among the spouses of PWE who had seizures during sleep and who had more severe epilepsy.


Author(s):  
P. Kalpana ◽  
A. Kavitha

Background: The objective was to study the determinants of anemia among pregnant women. There is a negative effect on the health of the mother and as well as that of the child due to anemia in women with pregnancy. Death rate is more in women who are pregnant and having anemia. The objective of this study was to study the determinants of anemia among pregnant women.Methods: A hospital based cross sectional study was carried out among 40 pregnant women over a period of six months. Demographic data like age, residence, occupation etc was recorded. Obstetric data like gravida, parity, previous LSCS was also recorded. The data was presented as means and student’s t test was applied.Results: The mean age was 23.43±3.4 years. Majority were young between the ages of 19-22 years. Majority belonged to urban residents i.e. 57.5%. 20% of the subjects were found to be illiterate. Majority of the mothers were housewives i.e. 82.5%. Majority were multi-gravida i.e. 60%. Majority had no history of abortions in the past i.e. 75%. Out of total 19 repeat pregnancies, majority i.e. 84.2% had lower segment cesarean section. Majority reported that they had normal menstrual history. The mean hemoglobin level was found out to be 7.94 gm/dl. It was found that the mean hemoglobin level did not differ significantly across age, residence, education, occupation, gravidity, history of abortions, type of delivery but differed significantly by abnormal menstrual cycle.Conclusions: Mean hemoglobin level was more in women with normal menstrual history compared to those women with abnormal menstrual history and this difference was found out to be statistically significant. Hence abnormal menses should be promptly treated, hemoglobin assessed.


2020 ◽  
Vol 7 (11) ◽  
pp. 1626
Author(s):  
Ivany Lestari Goutama ◽  
Hendsun . ◽  
Yohanes Firmansyah ◽  
Ernawati Su

Background: Cardiovascular relative risk (CVRISK) is the latest cardiovascular relative risk score to evaluate the magnitude of cardiovascular risk in healthy people regardless of age and cardiovascular risk severity. The aim of the study is to determine the correlation between each independent variables of CVRISK score in individuals with and without history of cardiovascular diseases (CVD).Methods: The study design is cross-sectional study. We conducted it online through social media using Google forms from June to August 2020. Participants include all productive age groups from 16 to 60 years. The data were processed using excel and statistically tested. Descriptive data analysis uses tabulated data which is displayed in numbers or proportions (categorical) and single data distribution (numeric). Statistical association analysis uses the categorical-correlation test with 2 statistical tests that use eta on nominal-ordinal variables and contingency coefficients on nominal-nominal variables.Results: There is a strong autocorrelation between hypertension and high tryglyceride levels (p value 0.001; correlation 0.549; risks 30.14%), nutritional status and low-density lipoprotein cholesterol (LDL-C) levels in CVD group (p value 0.002; correlation 0.774; risks 59.90%) and non-CVD group (p value 0.000; correlation 0.757; risks 57.3%). Hypertension and risky LDL-C levels firmly proves a very strong correlations and significant relationship in CVD groups (p value 0.014; correlation 0.947; risks 89.68%).Conclusions: There is a correlation that varies from weak to very strong among the independent variables in the CVRISK scoring of the participants. Further research is needed to determine the potentiality of CVRISK as an early prevention in determining the cardiovascular risk of individuals with and without history of CVD.


2021 ◽  
Author(s):  
Ting Huang ◽  
Shasha Xie ◽  
Liqing Ding ◽  
Hui Luo

Abstract Objectives: To identify and reclassify the patients in the LN cohort, and to further analyze the prominent clinical features and clinical significance of each cluster of patients.Methods: This is a cross-sectional study of a cohort of 635 LN patients from the Rheumatology Department of Xiangya Hospital of Central South University. Demographic data, laboratory findings and clinical evaluation system include physician’s global assessment and the SLICC/ACR Damage Index were collected. Using two-step cluster analysis, patients with similar clinical property were identified and compared.Results: Among the 635 LN patients, 599 patients (94.3%) were female. The mean age of the patients were 33.8 ± 10.4 years. Three subgroups were identified by two-step cluster analysis. Cluster 1 included 130 (20.5%) patients, Cluster 2 included 132(20.8%) patients and Cluster 3 included 373 (58.7%) patients. Cluster 3 was the largest group of mild disease activity, patients in this cluster had lower white blood cells, neutrophils, lymphocytes and mean SDI scores compared to those in the other two clusters. Cluster 1 was the smallest group of severe damage, patients in this cluster had multiple positive auto-antibodies, higher SDI scores and lower complement level. Patients of cluster 2 had the highest levels of granulocytes, but the results of other laboratory tests were roughly between the cluster 1 and cluster 3.Conclusions: This study reclassified three groups of LN patients in a large cohort. Our research shows that the multiple positive ANA antibody may be related to the high SDI score of LN patients. Clinicians can identify patients at different stages through cluster analysis to better implement prognosis.


Author(s):  
Saleh Habibi ◽  
Arefeh Babazadeh ◽  
Soheil Ebrahimpour ◽  
Parisa Sabbagh ◽  
Mehran Shokri

Abstract Morbidity and mortality are higher in older adults with community-acquired pneumonia (CAP) than in other age groups. Also, CAP in older adults has various clinical manifestations with other. A higher mortality rate in the elderly with CAP may contribute to a delay in management. Consequently, the purpose of this study was to investigate the clinical and laboratory manifestations of CAP in the elderly. This cross-sectional study was conducted on 221 elderly patients with CAP who were admitted to Ayatollah Rouhani Hospital, in Babol, northern of Iran, in 2017-2019. Patient outcomes included 170 cases that recovered from CAP, and 51 cases that died of complications. Patients were evaluated in terms of their clinical and laboratory manifestations. The most common symptoms of pneumonia were cough (79.6%), sputum (73.8%), weakness (72.9%), fever (56%), dyspnea (46.2%). The most frequent underlying disease was ischemic heart disease (43.9%). In our study, clinical and laboratory characteristics in older patients with CAP were evaluated and compared with other studies confirming past findings, but there were differences in some cases, such as vital signs, gastrointestinal symptoms, and disturbance of the level of consciousness. Therefore, it recommends carefully taking the patients’ initial histories and accurately recording their clinical and laboratory symptoms.


PEDIATRICS ◽  
1958 ◽  
Vol 21 (4) ◽  
pp. 582-595
Author(s):  
A. H. Chapman ◽  
Loraine Pilkey ◽  
Mary Jane Gibbons

A psychosomatic study was made of eight children with Sydenham's chorea. The children ranged in age from 7 to 16 years. Three patients had a history of rheumatic fever and three had no evidence of rheumatic disease; in two patients the evidence for rheumatic fever was equivocal, one probably having had it and the other probably not. The eight children were found to be emotionally quite disturbed. Their personality structure was characterized by a triad of (a) marked passivity, (b) schizoid withdrawal from people, with two of the children being frankly schizophrenic, and (c) much underlying anxiety. Obsessive, phobic and depressive features were separately present in some of the children. In five cases the onset of Sydenham's chorea closely followed an episode of marked emotional stress, and in two others the correlation of chorea with emotional stress was equivocal. The literature was reviewed, and it was pointed out that in over half of all reported cases of Sydenham's chorea evidence of rheumatic fever could not be found. It is felt that Sydenham's chorea can be understood only as a psychosomatic illness potentially caused by a number of agents acting individually or jointly, and varying in their respective importance from case to case. Severe personality disorder and rheumatic fever are two such etiologic agents which may be operative in Sydenham's chorea. The importance of further psychosomatic study and experimental psychotherapy in the comprehensive medical study and management of children with this disorder is emphasized.


2014 ◽  
Vol 6 (3) ◽  
pp. 49-57 ◽  
Author(s):  
Fiekumo Igbida Buseri ◽  
Charity Ngozi Okonkwo

Background: This study aims at investigating the seroprevalence of HIV infection among status naive pregnant women and probable vertical transmission in Sokoto, Nigeria.Materials and Methods: This cross-sectional study examined 13,026 apparently healthy pregnant women aged between 14 and 45 years and 312 mother-baby pairs in 4 different hospital settings in Sokoto State, North West, Nigeria between March, 2011 and February, 2013. The babies were aged between 8 and 16 months. HIV screening was performed using qualitative rapid tests and ELISA and HIV-DNA polymerase chain reaction (PCR) techniques. Measurement of CD4+ T-lymphocytes was carried out by the BD FACScount System. All seropositive pregnant women were immediately placed on triple antiretroviral therapy (ART) throughout the duration of the pregnancy and beyond.Results: An overall 2.4% prevalence of HIV-1 infection among the pregnant women and 20.5% incident of mother-to-child transmission were found. Of the seropositive pregnant women, 75.0% were full-time house wives, 13.8% and 11.2% were traders and civil servants respectively; of which, 70.2% were within the ages of 14 and 27 years (youthful predominance). Pearson’s χ2analysis did not show any statistically significant difference in the Mean values in the 4 health facilities (χ2 =2.084, df=3, P-value=0.555). Similarly, no significant difference in HIV seropositivity in the demographic data of the pregnant women were observed (P>0.05). Infection was recorded in all age groups but there was no statistical significance between age groups and infection (P = 0.833). Of the 64 seropositive babies, 62 (92.5%) contracted HIV from antiretroviral therapy non-adherence mothers (χ2 =271.457, df=1, P<0.01), OR=1506.6 (95%CI=285.5-7950.4). Conclusion: This study found high prevalence of vertical transmission due to ART non-adherence. Intervention initiatives should, therefore, focus seriously on ART non-adherence. DOI: http://dx.doi.org/10.3126/ajms.v6i3.11530Asian Journal of Medical Sciences Vol.6(3) 2015 49-57  


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