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.

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.

Abstract 3916: Rapidly Improving Stroke Symptoms: Relation to Stroke Volumes and Discharge Disposition

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Clotilde Balucani ◽  
Steven Levine ◽  
Jane Khoury Khoury ◽  
Pooja Khatri ◽  
Jeffrey L Saver ◽  
...  
Keyword(s):  
Nursing Home ◽  
Secondary Outcome ◽  
P Value ◽  
Lesion Volume ◽  
P Values ◽  
Discharge Disposition ◽  
Stroke Study ◽  
Significant Difference ◽  
Discharge Status ◽  
Multiple Logistic Regression Modeling

Background: Rapidly improving stroke symptoms (RISS) is a frequently cited reason for not giving IV rt-PA. However, prior studies have suggested that outcome of acute ischemic stroke patients presenting with RISS is not invariably benign. This raises the possibility that stroke-related disability may be relatively common after RISS. Objective: To explore both discharge disposition and 3-month CT lesion volume in patients with and without RISS based on various pre-specified definitions in The NINDS rt-PA Stroke Study cohort. Methods: The NINDS rt-PA Stroke Study dataset was used to compare baseline to 2-hour NIH Stroke Scale scores (NIHSSS). We calculated baseline NIHSSS - 2hr NIHSSS (positive = improvement [IMP], negative = worsening). Definitions of RISS were raw change in NIHSSS (≥ 4 point IMP) and percent change in NIHSSS (≥ 25% IMP and ≥ 50% IMP). Chi-square and multiple logistic regression modeling were used to assess the association of RISS with outcomes measures. Discharge disposition included: home; relative/friend; rehabilitation; nursing home; death; other. CT lesion volume was based on the 3-month CT scan as previously calculated as a pre-specified secondary outcome of the 2 trials. Results: In the 624 subjects, RISS frequency depended on definition used. Frequencies (all %s) of RISS compared to no-RISS who were discharged Home were 55 vs. 30 for ≥ 4 point IMP, 64 vs. 23 for ≥ 25% IMP, and 78 vs. 30 for ≥ 50% IMP. Frequencies for Discharge to Rehabilitation (RISS vs. no-RISS) were: 1 vs. 36, 14 vs. 41, and 10 vs. 36. Nursing Home discharge frequencies were: 5 vs. 11, 4 vs. 12, and 1 vs. 11. Across all definitions of RISS there was a significant difference in discharge status favoring RISS (all p values < 0.001). Three-month CT lesion volumes (cm3): for RISS ≥ 4 point IMP were: 7.51 [95% Confidence Interval (CI): 1.52, 12.34] vs. no-RISS 19.95 (CI: 2.71, 26.42); for RISS ≥ 25%: 4.64 (CI: 1.07, 7.41) vs. no-RISS 25.96 (CI: 2.99, 33.96); for RISS ≥ 50% IMP: 3.14 (CI: 0.44, 6.36) vs. no-RISS 19.75 (CI: 2.73, 25.50). All p values <0.001.There were no statistically significant rt-PA treatment interactions for CT volume (lowest p-value 0.28) and for discharge status (lowest p-value 0.13). Conclusions: Post hoc exploratory analyses suggest that based on all definitions of RISS used, those patients with RISS were consistently and significantly discharged to a more favorable location than those without RISS. These findings were also consonant with CT lesion volumes at 3 months being significantly smaller for each definition of RISS vs. no RISS. However, while patients with RISS do better in these exploratory outcomes, they still commonly have evidence of cerebral infarction and approximately 2 of 3 with ≥ 4 point IMP and 1 in 5 with at least 50% IMP are not discharged home.

Clinical and Functional Assessment of Dysautonomia and Its Correlation in Alzheimer’s Disease

2012 ◽  
Vol 27 (8) ◽  
pp. 592-599 ◽  
Author(s):  
Beata Zakrzewska-Pniewska ◽  
Malgorzata Gawel ◽  
Elzbieta Szmidt-Salkowska ◽  
Katarzyna Kepczynska ◽  
Monika Nojszewska
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Urinary Incontinence ◽  
Orthostatic Hypotension ◽  
Functional Assessment ◽  
Sympathetic Skin Response ◽  
Test Results ◽  
Significant Difference ◽  
Skin Response ◽  
The Relationship

The aims were to assess dysautonomia in Alzheimer’s Disease (AD), clinically and electrophysiologically, using sympathetic skin response (SSR) test and R-R interval variation (RRIV) test and to analyze the relationship between symptoms of dysautonomia and SSR/RRIV results. A tota of 54 patients with AD and 37 controls were evaluated using Autonomic Symptoms Questionnaire and SSR/RRIV test. Clinical dysautonomia was observed in 66% of patients (eg, orthostatic hypotension in 34.5%, constipation in 17.2%, urinary incontinence in 13.8%). The SSR test was abnormal in 26%, but the RRIV test was abnormal in 97.7% of cases; there was significant difference in RRIV test results between AD and controls (R mean 8.05% and 14.6%, respectively). In AD, clinical dysautonomia occurs at a various degree, and the abnormal SSR and RRIV test results were not always related to the presence of clinical dysautonomia; this observation points that the tests could be used as a useful tool in the assessment of subclinical dysautonomia.

scholarly journals Investigation of autonomic dysfunction in primary Raynaud’s phenomenon with sympathetic skin response (SSR), R-R interval variation (RRIV) and composite autonomic symptom score (COMPASS)-31

2021 ◽  
Vol 26 (4) ◽  
pp. 693-698
Author(s):  
Hüseyin Sicim ◽  
Özgür Boyraz ◽  
Ertan Demirdas ◽  
Hakan Kartal ◽  
Gökhan Erol ◽  
...  
Keyword(s):  
Autonomic Dysfunction ◽  
Valsalva Maneuver ◽  
Raynaud’S Phenomenon ◽  
Sympathetic Skin Response ◽  
Raynaud's Phenomenon ◽  
Deep Breathing ◽  
Control Groups ◽  
Significant Difference ◽  
Skin Response ◽  
And Control

Background: In this study, we aimed to investigate the autonomic dysfunction in patients with primary Raynaud’s phenomenon with using sympathetic skin response (SSR) as a neurophysiologic test, R-R interval variation analysis and composite autonomic symptom score (COMPASS)-31 questionnaire. Methods: Palmar SSR to median nerve electrical stimulation was recorded in 38 patients with 36 healthy age and sex-matched control subjects. The SSR was recorded from the palmar surface of both left and right hands for patients and control groups. The amplitudes and latencies formed as a result of electrical stimulation were calculated and compared between the two groups. Additionally, R-R interval variability was examined during normal breathing, deep breathing, standing up and Valsalva maneuver in both groups. Furthermore, we asked to complete the COMPASS-31 questionnaire, a validated tool to assess symptoms of autonomic dysfunction. And by calculating total COMPASS-31 scores, the relationship between the two groups was investigated. Results: The Raynaud’s phenomenon and control groups were similar in age (37.4 ± 11.6 vs. 34.9 ± 13.0 years), had identical gender ratios and similar body mass index (24.5 ± 6.1 vs. 25.7 ± 4.6%). Palmar SSR to median nerve stimulation of RP patients shows significantly delayed latency (1890 ± 146) (p=0.03). And no difference between amplitudes in comparison to the control group. In the patient and control groups, R-R interval measurements were evaluated during rest and deep breathing, standing up and Valsalva maneuver. When the R-R interval measurements of the patient and control groups at rest and deep breathing were compared, there was no statistically significant difference between the groups. In addition, COMPASS-31 questionnaire scoring system was applied to both groups. The mean COMPASS-31 score was higher in patient group (22.8 ± 13.8), than from healthy controls (8.9 ± 7.8) (p=0.02) Conclusions: Autonomic dysfunction plays a role in the etiology of Raynaud’s phenomenon, due to latency prolongation in the sympathetic skin response and significant difference between COMPASS-31 tests, and these tests can be used in the diagnosis stage of this disease.

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 Predictors of Death in Severe COVID-19 Patients at Millennium COVID-19 Care Center in Ethiopia: A Case-Control Study

2020 ◽  
Author(s):  
Endalkachew H. Maru ◽  
Tigist W. Leulseged ◽  
Ishmael S. Hassen ◽  
Wuletaw C. Zewde ◽  
Nigat W. Chamesew ◽  
...  
Keyword(s):  
Case Control Study ◽  
Care Center ◽  
Binary Logistic Regression ◽  
Case Control ◽  
P Value ◽  
Chi Square ◽  
P Values ◽  
Significant Difference ◽  
Chi Square Test ◽  
Control Study

ABSTRACTBackgroundAs the number of new cases and death due to COVID-19 is increasing, understanding the characteristics of severe COVID-19 patients and identifying characteristics that lead to death is a key to make an informed decision. In Ethiopia, as of September 27, 2020, a total of 72,700 cases and 1165 deaths were reported.ObjectiveThe study aimed to assess the determinants of death in Severe COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia.MethodsA case-control study of 147 Severe COVID-19 patients (49 deaths and 98 discharged alive cases) was conducted from August to September 2020. A comparison of underlying characteristics between cases (death) and controls (alive) was assessed using a chi-square test and an independent t-test with a p-value of <0.05 considered as having a statistically significant difference. Multivariable binary logistic regression was used to assess a statistically significant association between the predictor variables and outcome of Severe COVID-19 (Alive Vs Death) where Adjusted Odds ratio (AOR), 95% CIs for AOR, and P-values were used for testing significance and interpretation of results.ResultsHaving diabetes mellitus (AOR= 3.257, 95% CI= 1.348, 7.867, p-value=0.00), fever (AOR=0.328, 95% CI: 0.123, 0.878, p-value= 0.027) and Shortness of breath (AOR= 4.034, 95% CI= 1.481, 10.988, p-value=0.006) were found to be significant predictors of death in Severe COVID-19 patients.ConclusionsThe outcome of death in Severe COVID-19 patients is found to be associated with exposures to being diabetic and having SOB at admission. On the other hand, having a fever at admission was associated with a favorable outcome of being discharged alive.

Comparison of Three Topical Fluorides Using Computer Imaging

2006 ◽  
Vol 30 (2) ◽  
pp. 139-144 ◽  
Author(s):  
Muhammad Faisal Khattak ◽  
John Patrick Conry ◽  
Ching-Chang Ko
Keyword(s):  
In Vitro Study ◽  
Analysis Of Covariance ◽  
Fluoride Varnish ◽  
Permanent Teeth ◽  
P Value ◽  
P Values ◽  
Significant Difference ◽  
Topical Fluorides

The purpose of this in vitro study was to evaluate the short and long-term effectiveness of fluoride varnish and compare it with the two most commonly used topical fluorides, i.e., fluoride gel and foam.A second purpose of the study was to compare the effectiveness of these preparations on primary and permanent teeth. Enamel slabs with a thickness of 500 microns were obtained from caries free primary molars and premolars. They were divided into four groups: control, foam (F), gel (G) and varnish (V). Fluorides were applied to the enamel slabs according to the manufacturer's instructions and were placed in a 5.1 pH acidic gel for one week. The amount of demineralization from the enamel was measured by calculating the amount of light reflected from these surfaces. This was done by using a Charged Couple Device attached to a high resolution microscope with image processing software, Optima 5.22. The enamel slabs were placed in a freshly prepared acidic gel for a second week without application of fluorides. This was done to mimic a situation where fluoride is eventually brushed away from teeth. Reflective images were recorded under the previously described conditions. A two-way analysis of covariance was used to compare the treatments. The results showed no statistically significant difference (with Bonferroni correction) in the effectiveness of different fluoride preparations over the short-term (Week I comparison; p-values: F vs. G 0.079, F vs.V 0.030, G vs.V 0.44). However, the long-term protection provided by fluoride varnish was far more than fluoride gel and foam (Week II comparison; p-values: F vs. G 9X10-5 , F vs.V 7X10-8, G vs.V 1X10-4). Fluorides were equally effective for both primary and permanent enamels (p-value 0.24). The results of this study suggest that fluoride varnish is beneficial for use with white spot lesions, newly erupted permanent teeth and early decalcification in primary dentition.

scholarly journals Challenges and Issues of Female Primary Education: A Case Study of Rajanpur, Pakistan

2021 ◽  
Vol 2 (2) ◽  
pp. 172-186
Author(s):  
Zahid Zulfiqar ◽  
Kamran Ishfaq ◽  
Sajid Pervez
Keyword(s):  
Primary Education ◽  
Local Level ◽  
Simple Random Sampling ◽  
School Facilities ◽  
P Value ◽  
Monthly Income ◽  
P Values ◽  
Significant Difference ◽  
Primary School Age ◽  
Academic Qualifications

The study attempted to examine the socio-cultural factors which create problems in female primary education; to determine the role of families/parents in female primary education and to examine the lack of school facilities that creates hindrance in the school enrolment of the children. The study population of the study was all parents whose children were primary school age by using the interview schedule. The researcher used the stratified simple random sampling and selected the 300 respondents for the study. The researcher used the SPSS software and did the descriptive and inferential statistical analysis. The findings of the study show that majority 155 (51.7) percent of the respondents were uneducated; majority 85(23.3) percent of the respondents whose monthly income was <6000; majority 95 (31.7) percent of the respondents were laborers; culture is significantly and positively correlated with parental and school facilities with p-values .011 and .000 respectively; furthermore, the parental attitude was significantly and positively correlated with school facilities with p-value .000. The results of ANOVA showed that the levels of cultural, parental, and school facilities among different academic qualifications of the household. The findings show that there is a significant difference in the levels of cultural, parental, and school facilities among different academic qualifications of the household with p-values .000, .000, and .000 respectively. The findings showed that there was a significant difference in the levels of cultural, parental, and school facilities among different monthly income levels of the household with p-values .000; .000, and .000 respectively. The study recommended that government may have to pay attention in the studied area; construct new schools, give scholarships to needy students and start awareness seminars at the local level.

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 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.

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