CELIAC DISEASE AMONG GASTROINTESTINAL PATIENTS IN YEMEN: ITS PREVALENCE, SYMPTOMS AND ACCOMPANYING SIGNS, AND ITS ASSOCIATION WITH AGE AND GENDER

2021 ◽  
Author(s):  
Omar Ahmed Ismael Al-dossary ◽  
Redhwan A. Ahmed ◽  
Khaled Abdulkareem A Al-Moyed ◽  
Azhar Azher Mohammed Al-Ankoshy ◽  
Mohammed Mohammed Ali Al-Najhi ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Peer Review ◽  
Chronic Diarrhea ◽  
Clinical Signs ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Abdominal Distension ◽  
High Rate ◽  
Serological Markers ◽  
Cross Sectional

Background and objectives: Celiac disease is a long-standing autoimmune illness that principally affects the small intestine. Typical symptoms comprise digestive problems such as chronic diarrhea, flatulence, malabsorption, loss of appetite, and failure of children to grow normally. The prevalence of celiac disease has not been established in Yemen, either in the general population or in symptomatic patients. Therefore, the current study aimed to assess the prevalence of disease in symptomatic patients and to investigate associated symptoms and signs; and whether prevalence of CD varies greatly between different ages and genders in a hospital in Sana'a.  Methods: A cross sectional study based on the results of serological markers; IgA anti-tissue glutaminase and small bowel biopsies of 600 patients with gastrointestinal symptoms who were all patients who attended in the research period. Data were collected from hospital records during the period from March 2014 to December 2018. 600 suspected patients (245 males and 355 females) were subjects and the mean age of ±SD patients was 30.6±14.5 years (range 2-92 years). Results: The prevalence of CD among patients with gastrointestinal symptoms was 9.2%. There was a significant association between CD with females (rate being 11.3% , OR=1.9, p=0.03), and  2-19 years age group (21.4% , OR=4.3, p<0.001), Considering the clinical signs and symptoms there was a significant association between celiac disease and chronic diarrhea (OR=18.4), steatorrhea ( OR=9.6), foul odor (OR=8.3), weight loss (OR=5.7), anemia (OR=10.2), abdominal distension (OR=3.1), mouth ulcers (OR=7.2), abdominal bleeding (OR=13.5), diabetes mellitus I  (OR=18), and hypothyroidism (OR=79.3). Conclusion: A high rate of CD was identified among gastrointestinal symptoms patients arriving at the general hospital in Sana’a, Yemen, and this demonstrates the importance of general practitioners in identifying patients with CD, especially in the absence of a medical facility for CD, and this was facilitated through the serological markers test.                     Peer Review History: Received: 11 September 2021; Revised: 12 October; Accepted: 29 October, Available online: 15 November 2021 Academic Editor:  Ahmad Najib, Universitas Muslim Indonesia,  Indones UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Dr. Gulam Mohammed Husain, National Research Institute of Unani Medicine for Skin Disorders, Hyderabad, India, [email protected] Dr. Vanina Doris Edo’o, University of Yaounde I, Yaounde, Cameroun, [email protected] Similar Articles: THE ASSOCIATION OF ADULT MALE AND FEMALE INFERTILITY WITH CELIAC DISEASE PATIENTS IN YEMEN

scholarly journals The Optimum Cut-off Value of the Nelwan Score to Diagnose Typhoid Fever in Adults

2021 ◽  
Author(s):  
Erni Juwita Nelwan ◽  
Luh Putu Listya Paramita ◽  
Robert Sinto ◽  
Fransiscus Nikodemus Hosea ◽  
Pringgodigdo Nugroho ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Sensitivity Specificity

AbstractIntroductionTyphoid fever can be challenging to diagnose since clinicians often depend merely on clinical presentation. Clinical scores are useful to provide more accurate diagnosis. Variables in Nelwan Score are derived from clinical signs and symptoms of suspected cases for typhoid. Diagnostic value of Nelwan Score based on a cut-off value has never been evaluated.MethodsA cross sectional study was conducted between July 2017 and January 2018 in five hospitals and two Primary Health Centers in Jakarta and Tangerang. The inclusion criteria were patients with 3-14 days of fever and gastrointestinal symptoms between July 2017 and January 2018. Diagnosis are confirmed by blood culture, rectal swab culture, or PCR. Cut-off analysis was performed by using Receiver Operating Characteristic (ROC) curve and diagnostic value was analyzed to generate sensitivity, specificity, predictive value and likelihood ratio.ResultFrom 233 subjects involved, 4.72% of them were confirmed to have typhoid fever. The optimal cut-off value of Nelwan Score is 10 with AUC 71.3%. This cut-off value has sensitivity 81.8%, specificity 60.8%, PPV 9.3%, NPV 98.5%, LR + 2.086, and LR – 0.299.ConclusionNelwan Score with cut-off value of 10 provides a good diagnostic performance as a screening tool for patients with suspected typhoid fever clinical presentation.

Sonographic Presentation of the Celiac disease

2020 ◽  
pp. 50-55
Author(s):  
OJS Admin
Keyword(s):  
Small Intestine ◽  
Celiac Disease ◽  
Short Stature ◽  
Clinical Condition ◽  
Chronic Diarrhea ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Behavioral Characteristics ◽  
Oral Manifestation ◽  
Clinical Signs And Symptoms

Celiac disease is an autoimmune clinical condition of the small intestine, effecting mostly genetically susceptible individuals. Celiac disease has a myriad of clinical signs and symptoms affecting multiple body systems. It is characterized by chronic diarrhea, weakness, anemia, short stature, osteoporosis, oral manifestation with hypo-genesis of teeth enamel, dermatitis and skin patches behavioral characteristics.

scholarly journals Evaluation of Clinical Symptoms of Patients with Celiac Disease Referred to Khatamolanbia Clinic in Yazd City in 2014

2020 ◽  
Author(s):  
Mahmoud B Baghbanian ◽  
Mohsen Akhondi-Meybodi
Keyword(s):  
Weight Loss ◽  
Celiac Disease ◽  
Bone Pain ◽  
Clinical Symptoms ◽  
Systemic Disease ◽  
Clinical Signs ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Chi Square ◽  
Yazd City

Introduction: The clinical features of celiac disease vary. Common classic signs and symptoms include diarrhea, weight loss, and abdominal distention. Celiac as a systemic disease may suffer people of all ages and with many races and ethnic groups.  Celiac disease also has other symptoms that got less attention. These signs are constipation, bloating, oral plague, bone pain, anemia, Vitiligo, hypocalcemia, hypothyroidism and seizures.  In this study, it was decided to evaluate the prevalence of gastrointestinal and non-gastrointestinal clinical signs of celiac disease. Methods: This descriptive study was conducted on 150 patients with celiac disease referred to Khatamolanbiya Clinic in 2014.The gastrointestinal and non-gastrointestinal clinical signs of the patients were studied. Patients with celiac disease were included who had both positive tissue anti-transglutaminase antibodies and some degree of mucosal atrophy on duodenal mucosal endoscopy. After collecting the data, the coded information was entered into SPSS version 22 software and the results were analyzed using Chi-Square, T and Wilcoxon tests. Results: The results showed that celiac disease in the study was 1.3 times more frequently in women than men. As well as the symptoms of anemia in the population studied (40.67%) had the highest and seizures (0.67%) had the lowest rates. After anemia, hypothyroidism with 26% prevalence was the most prevalent in the community. Diarrhea with 24.7% is the mostcommon in gastrointestinal symptoms   and is the third most common after anemia and hypothyroidism. Conclusion: The results of this study showed that non-gastrointestinal symptoms (bone pain, anemia, vitiligo, hypocalcaemia, hypothyroidism, and seizures) are more common than gastrointestinal symptoms such as diarrhea, steatorrhea, weight loss, nausea, vomiting, abdominal pain, bloating, and oral thrush in patients with celiac disease.

scholarly journals SPECTRUM OF HISTOPATHOLOGICAL PATTERNS OF DUODENAL BIOPSIES IN PATIENTS WITH UNEXPLAINED ANAEMIA AND CHRONIC DIARRHEA AND THEIR CORRELATION WITH ENDOSCOPIC FINDINGS AND SEROLOGICAL MARKERS

2021 ◽  
Vol 71 (5) ◽  
pp. 1893-96
Author(s):  
Muhammad Awais Yasin ◽  
Muhammad Asif Farooq ◽  
Nasir Uddin ◽  
Bushra Parveen ◽  
Asma Asghar ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Chronic Diarrhea ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Upper Gastrointestinal Endoscopy ◽  
Serological Markers ◽  
Cross Sectional ◽  
History Of ◽  
Duodenal Biopsies ◽  
Malignant Diagnosis

Objective: To evaluate different histopathological patterns and correlate them with indications, findings of Esophagogastroduodenoscopy Esophago-gastro-duodenal (EGD) and serological markers in patients presenting of unexplained anemia and chronic diarrhea. Study Design: Cross sectional study. Place and Duration of Study: Departments of Pathology and Gastroenterology, Combined Military Hospital Lahore Pakistan, from Jul to Dec 2020. Methodology: Histopathological patterns of endoscopic duodenal biopsies, submitted for evaluation of unexplained anemia and chronic diarrhea were studied. Hemoglobin and anti-tTG levels were recorded. Adults with history of unexplained diarrhea and anaemia were included. Biopsies with malignant diagnosis or unfit for evaluation were excluded. Histopathological patterns were correlated with indications and findings of Esophagogastroduodenoscopy and serological markers of celiac disease. Results: The most common indication for Esophagogastroduodenoscopy in 145 patients was chronic diarrhea. Upper gastrointestinal endoscopy in 2/3rd of patients revealed no pathology. Histopathological patterns of duodenal biopsies revealed only 15% cases suggestive of celiac disease. Only 12 patients were suggestive of celiac disease both on Esophagogastroduodenoscopy and histopathology combined. Half of patients with anti tTG level >100 u/ml, showed histopathological features of celiac disease on. There was no correlation between histopathological patterns, indications of Esophagogastroduodenoscopy, morphology of Esophagogastroduodenoscopy and serological markers of celiac disease. Conclusion: Indications for Esophagogastroduodenoscopy, Esophagogastroduodenoscopic findings and histopathological patterns cannot diagnose celiac disease alone.

Celiac Disease in Kosovar Albanian Children: Evaluation of Clinical Features and Diagnosis

2020 ◽  
Vol 16 (3) ◽  
pp. 241-247
Author(s):  
Atifete Ramosaj-Morina ◽  
Alije Keka-Sylaj ◽  
Arbana Baloku Zejnullahu ◽  
Lidvana Spahiu ◽  
Virgjina Hasbahta ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Dominant Mode ◽  
Primary School Children ◽  
Cross Sectional ◽  
Classical Form ◽  
Wide Range ◽  
The Mean

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostly showed atypical symptoms (p<0.001). The classical form of celiac disease occurred in 78% of the cases. Sixty (95%) patients carried HLA-DQ2.5, DQ2.2 and/or HLA-DQ8 heterodimers, and only three of them tested negative. Conclusions: Kosovo, as the majority of developing countries, is still facing the classical form of celiac disease as the dominant mode of presentation; as a result, most children with other forms of the celiac disease remain undiagnosed. : Physicians should be aware of the wide range of clinical presentations and utilize low testing thresholds in order to prevent potential long-term problems associated with untreated celiac disease.

scholarly journals Abdominal Distension Associated with Luminal Fungi in the Intestines of Axolotl Larvae

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Chiara Zullian ◽  
Aurore Dodelet-Devillers ◽  
Stéphane Roy ◽  
Pierre Hélie ◽  
Pascal Vachon
Keyword(s):  
Clinical Signs ◽  
Abdominal Distension ◽  
Total Body Length ◽  
Body Parts ◽  
Research Model ◽  
Cross Sectional ◽  
Light Darkness ◽  
Clear Plastic ◽  
Total Body ◽  
Plastic Containers

Axolotls show a remarkable regeneration capacity compared with higher vertebrates, regenerating missing appendages such as limbs and tail as well as other body parts (i.e., apex of the heart, forebrain, and jaw) after amputations which makes this animal a very interesting research model for tissue regeneration mechanisms. Larvae are individually housed in a 20% Holtfreter’s solution within clear plastic containers. The photoperiod light : darkness cycle is 12 : 12 h. Larvae with a total body length of less than 5 cm are fed once a day with large brine shrimp and blood worm. Albino larvae appeared to have a tendency to exhibit abdominal distention. No clinical signs of illness seemed to be associated with the condition; however, these animals exhibit a relatively slower growth rate. To better characterize this condition, we performed histological sectioning for cross sectional slide preparation on wild type and albino axolotl larvae following euthanasia. The only lesion seen in the albino larvae was a thickened gut wall and the presence of fungi within the intestines. We hypothesize that this may be due to a lower efficacy of the albino larvae’s immune system.

STUDY OF ABSOLUTE, IMMATURE NEUTROPHIL COUNT AND CRP AS DIAGNOSTIC MARKERS FOR EARLY ONSET NEONATAL SEPSIS.

2021 ◽  
pp. 25-26
Author(s):  
Pooja Poswal ◽  
Manisha Rohilla ◽  
Sunil Arora ◽  
Irbinder Kour Bali
Keyword(s):  
Blood Culture ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
Hematological Parameters ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms

Introduction: Neonatal Sepsis is difcult to differentiate from other conditions due to non- specic clinical signs and symptoms. Inammation in neonates shows variations in hematological parameters. Our study is to evaluate the hematological parameters and C-reactive protein estimation in neonatal sepsis for early diagnosis. Material And Methods: It was a cross-sectional study including 80 neonates admitted in the neonatal care unit, 40 (proven sepsis) and 40 probable cases); blood culture being the gold standard. Hematological parameters, immature to total neutrophil ratio (I/T ratio), Absolute neutrophil count (ANC), CRP and Blood culture were done as per standard protocols. Results: ANC had highest sensitivity of 90% followed by I/T ratio (87.5%) and CRP (77.5%). The sensitivity and specicity for the combination of ANC and I/T ratio was 78.3% and 83.6% respectively. Conclusion: ANC, I/T Ratio and CRP are quick, simple and cost-effective routine laboratory tests which help in neonatal sepsis prediction and to start proper and timely antibiotic therapy.

scholarly journals Clinical and Paraclinical Screening for Celiac Disease in Children with Intractable Epilepsy

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Golnaz Ghazizadeh Esslami ◽  
Bahar Allahverdi ◽  
Reza Shervin Badv ◽  
Morteza Heidari ◽  
Nahid Khosroshahi ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Serological Test ◽  
Venous Blood ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Intractable Epilepsy ◽  
Underlying Disease ◽  
Growth Disorders ◽  
Serological Tests ◽  
Cross Sectional

Background. Celiac disease is the inflammatory entropy caused by hypersensitivity to gluten, which occurs in susceptible individuals. Some studies have suggested a link between celiac disease and epilepsy in children. Our aim was to screen for clinical and paraclinical features of celiac disease in children with intractable epilepsy. Methods. This was a cross-sectional study. Children aged 2 to 18 years with refractory epilepsy that referred to the pediatric neurology clinic within one year (2018–2019) were enrolled. Demographic and clinical characteristics of patients, especially clinical manifestations of celiac disease, were recorded in a questionnaire. A venous blood sample was sent to determine the total IgA, anti-tTG (IgA), and anti-endomysial antibody (IgA). Endoscopy was performed in cases where the celiac serological test was positive. Results. Seventy children with idiopathic drug-resistant epilepsy (44 boys) were evaluated. The height-for-age index was 49.2% and the weight-for-age index was 38.2% less than normal. Constipation (48.6%), anorexia (25.7%), and abdominal pain (21.4%) were the most common gastrointestinal symptoms. Celiac serological tests were negative in all children. Therefore, endoscopy and bowel biopsy were not performed in any case. Conclusion. Celiac disease was not found in any patient with intractable epilepsy. Gastrointestinal symptoms and growth disorders in this group may be related to the underlying disease or medications and not to celiac disease.

scholarly journals Leprosy in a prison population: A new active search strategy and a prospective clinical analysis

2020 ◽  
Vol 14 (12) ◽  
pp. e0008917
Author(s):  
Fred Bernardes Filho ◽  
Jaci Maria Santana ◽  
Regina Coeli Palma de Almeida ◽  
Glauber Voltan ◽  
Natália Aparecida de Paula ◽  
...  
Keyword(s):  
Search Strategy ◽  
Clinical Symptoms ◽  
Prison Population ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Skin Lesions ◽  
Clinical Analysis ◽  
Skin Area ◽  
Cross Sectional ◽  
Active Search

Background This study evaluates an active search strategy for leprosy diagnosis based on responses to a Leprosy Suspicion Questionnaire (LSQ), and analyzing the clinical, immunoepidemiological and follow-up aspects for individuals living in a prison population. Methods A cross-sectional study based on a questionnaire posing 14 questions about leprosy symptoms and signs that was distributed to 1,400 prisoners. This was followed by dermatoneurological examination, anti-PGL-I serology and RLEP-PCR. Those without leprosy were placed in the Non-leprosy Group (NLG, n = 1,216) and those diagnosed with clinical symptoms of leprosy were placed in the Leprosy Group (LG, n = 34). Findings In total, 896 LSQ were returned (64%), and 187 (20.9%) of the responses were deemed as positive for signs/symptoms, answering 2.7 questions on average. Clinically, 1,250 (89.3%) of the prisoners were evaluated resulting in the diagnosis of 34 new cases (LG), based on well-accepted clinical signs and symptoms, a new case detection rate of 2.7% within this population, while the NLG were comprised of 1,216 individuals. The confinement time medians were 39 months in the LG while it was 36 months in the NLG (p>0.05). The 31 leprosy cases who responded to the questionnaire (LSQ+) had an average of 1.5 responses. The symptoms “anesthetized skin area” and “pain in nerves” were most commonly mentioned in the LG while “tingling, numbness in the hands/feet”, “sensation of pricks and needles”, “pain in nerves” and “spots on the skin” responses were found in more than 30% of questionnaires in the NLG. Clinically, 88.2% had dysesthetic macular skin lesions and 97.1% presented some peripheral nerve impairment, 71.9% with some degree of disability. All cases were multibacillary, confirming a late diagnosis. Anti-PGL-I results in the LG were higher than in the NLG (p<0.0001), while the RLEP-PCR was positive in 11.8% of the patients. Interpretation Our findings within the penitentiary demonstrated a hidden prevalence of leprosy, although the individuals diagnosed were likely infected while living in their former communities and not as a result of exposure in the prison. The LSQ proved to be an important screening tool to help identify leprosy cases in prisons.

scholarly journals Clinical symptoms, paraclinical tests and histopathological results in children with acute appendicitis in Zabol southeast of Iran: a cross-sectional study

2017 ◽  
Vol 5 (7) ◽  
pp. 2836
Author(s):  
Mehran Hesaraki
Keyword(s):  
Acute Appendicitis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Intestinal Loop ◽  
Negative Appendectomy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Histopathological Results

Background: This article aimed to assessment clinical signs and symptoms, paraclinical tests and histopathological results in children with acute appendicitis.Methods: A cross-sectional study conducted on 100 children with acute appendicitis in an urban hospital in southeast of Iran from January to December 2016. Participants were selected by simple random sampling method. Clinical signs and symptoms, paraclinical tests and histopathological results recorded in checklists. The data were analyzed using SPSS 22.Results: Mean age of the patients was 10.26±3.25, fourthly-eight of patients (58.5%) were males and 34 patients (41.5%) were females. The most frequent clinical signs and symptoms were acute suppurative appendicitis with peri appendicitis (45.83%) and acute suppurative appendicitis (39.58%). The most frequent results in ultrasound reports were Intestinal loop thickness greater than 6 mm without peristalsis (positive report) (46.34%) and Invisible appendix (nega Hesaraki tive report) (13.41%).Conclusions: The results of this study showed that abdominal pain and RLQ tenderness were the most common signs and symptoms and WBC left-shift was the most common laboratory finding. Since the rate of negative appendectomy in this study was consistent with surgical results and other articles, it is concluded that diagnostic accuracy of preoperative appendectomy was acceptable and most children with acute appendicitis underwent appendectomy.

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