scholarly journals Pruritus, as a Neglected Symptom, in Opioid Poisoning in Children

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Fariba Farnaghi ◽  
Marjaneh Abbasi Ghadi ◽  
Latif Gachkar ◽  
Hossein Hassanian Moghaddam

Background: Opioid poisoning is common and fatal childhood poisoning in Iran with nonspecific, hidden, vague, and misleading clinical manifestations in some cases. Objectives: The aim of this study was to investigate and emphasize pruritus, as a neglected and helpful symptom in this important poisoning. Methods: In this cross-sectional study, one hundred pediatrics patients (< 14 years) with opioid poisoning who were referred to Loghman Hakim Hospital, Tehran-Iran, from April 2018 to April 2019 were enrolled the study. Demographic data including age, sex, type of poisoning, clinical manifestations including pruritus, its onset, location, duration, and therapy, also laboratory findings including complete blood count (CBC) and Eosinophilia recorded in patient-specific information forms. The collected data were analyzed using SPSS 21 software. Results: The patients’ mean age was 43.4 ± 31.4 months. Fifty-seven (57%) of them were male. Fifty-two (52%) of them reported Pruritus that in 84% observed in face. In 31% of children, itching resulted in skin scratches. The most common clinical manifestations were CNS depression (93%), respiratory suppression (68%), vomiting (52%), pruritus (52%), and meiosis (51%). There was no significant relationship between pruritus and gender, age, laboratory findings, family history of addiction, and allergy. Pruritus had a significant difference with Respiratory suppression (apnea, bradypnea, cyanosis), meiosis, vomiting, and redness of the skin (P-value: 0.05, 0.003, 0.009, and 0.002, respectively). Pruritus was controlled by naloxone in all of our patients. Conclusions: According to the results of the present study, pruritus is a common and helpful clinical manifestation in children with opioid poisoning that helps the physician for correct diagnosis, especially in hidden clinical scenarios.

2021 ◽  
Vol 9 ◽  
pp. 205031212110202
Author(s):  
Rgda Mohamed Osman ◽  
Mounkaila Noma ◽  
Abdallah Elssir Ahmed ◽  
Hanadi Abdelbagi ◽  
Rihab Ali Omer ◽  
...  

Objectives: Rheumatoid arthritis is a chronic inflammatory autoimmune disease. This study aimed to determine the association of interleukin-17A-197G/A polymorphism with rheumatoid arthritis in Sudanese patients. Methods: A case–control study was conducted between March and December 2018. Clinical and demographic data of the study participants were collected and analyzed. Polymerase chain reaction restriction fragment length polymorphism molecular technique was done to investigate interleukin-17A-197G/A polymorphisms. All statistical tests were considered statistically significant when p < 0.05. Results: The study population included 266 participants aged between 1 and 85 years, with an average of 40 years, classified into 85 (31.2%) cases (mean age 48.5 ± 11.3 years), and 181 (68.8%) controls (mean age 35.3 ± 15.9 years). The interleukin-17A homozygote AA genotype was more frequent among the control group compared to the case group; 95 (52.5%) and 7 (8.2%), respectively. The homozygote GG and the heterozygote AG genotypes were proportionally not different among the cases and control groups; 13 (54.2%) and 11 (45.8%), and 65 (46.4%) and 75 (53.6%), respectively. According to the distribution of interleukin-17A genotypes, a statistically significant difference was observed among cases with the interleukin-17A AA and AG genotypes, p values 0.001 and 0.004, respectively. For the association interleukin-17A genotypes and family history a negatively significant association was reported (95% confidence interval, –0.219, p value = 0.001). There was also a negatively significant association of interleukin-17A genotypes and anti-cyclic citrullinated peptide (95% confidence interval, −0.141, p value = 0.002). Conclusion: This study is the first study in Sudan established the association between interleukin-17A-197G/A (rs2275913) polymorphisms and susceptibly to rheumatoid arthritis. These findings appeal for further research in Sudan to investigate the exact role of IL-17A in immunopathology and disease severity among Sudanese rheumatoid arthritis


2021 ◽  
Vol 7 (1) ◽  
pp. ID20
Author(s):  
Shahid Alam ◽  
Sardar Bakht Khan ◽  
Qamar Wahid Khattak ◽  
Syed Zain Ul Abidin ◽  
Salman Farooqi ◽  
...  

Background: Physical activity is one of the leading health indicators, considered an essential factor in the population's health and quality of life promotion. Physical inactivity is the fourth leading risk factor for global mortality. Physical inactivity has been linked with chronic disease and obesity in most populations. This study aims to compare the prevalence of physical activity and overweight/obesity among students of the university. Methods: A cross-sectional survey was conducted from March to September 2019 on undergraduate students from different departments of Peshawar University. A sample of 377 (male n = 243, female n = 134) was taken through convenience sampling. Those individuals who were physically disabled and not willing to participate were excluded from the study. Those meeting the inclusion criteria were given the International Physical Activity Questionnaire (IPAQ short form). Demographic data included age, weight, and height was self-stated by the participants. The levels of physical activity in each of three domains (leisure, transport, and domestic) were calculated and presented as metabolic equivalent (M.E.T.) hour per week in the form of means, percentage, and frequency in different physical activity domains. Results: The overall sample showed that 13.70% of participants were inactive, 27.76% showed a low level of physical activity, 41.29% showed moderate physical activity level, and 17.24% showed a high level of physical activity. A total of 90.98% of participants were involved in leisure physical activities, 93.10% presented transport-related physical activity, and 74.80% were involved in domestic-related physical activity. Average time spent during sitting was found to be 53.32 hrs/week and 7.61 hrs/ day, with females being more involved in sitting activities as compared to males. A significant difference was found between B.M.I. and sitting domain (p-value 0.002) with a Pearson value of -0.12 showing a negative correlation. Conclusion: The B.M.I. and Physical Activity are found negatively associated with each other. Male students were more physically active than females as females spend their majority of time sitting. It is concluded that students are moderately active, while a minimal percent of students are highly active. There were a few numbers of respondents too who were physically inactive, which shows that there is still unawareness of physical activity on the university level.


2018 ◽  
Vol 26 (8) ◽  
pp. 144-150
Author(s):  
Ali Alkazzaz ◽  
Murtadha Najah Jawad ◽  
Zeyad Tareq Kareem

Background: Rheumatoid arthritis (RA) patients receiving receive anti-TNF agents are at increased risk of reactivation of latent tuberculosis infection (LTBI). The tuberculin skin test (TST) is widely used to screen LTBI and providing preventive treatment, in an effort to meet the WHO target of a 90% reduction in TB by 2035. Objectives: To determine the proportion of TST conversion among RA patients after 1 year of anti-TNF treatment and association of positive TST result with patients’ socio-demographic characteristics and medical history. Methods: This community-based cross-sectional study was conducted at the Department of Rheumatology of Marjan Teaching Hospital in Iraq, for a period of 1 year. Patients with RA/and spondyloarthropathy, and who received anti-TNF therapy for >1 year, underwent TST. Their demographic data and medical history were also obtained. All statistical analysis was performed using SPSS (Version 20) and, p < 0.05 was considered as a sign. Data from the baseline and 1 year follow-up was subjected to the Kolmogorov-Smirnov test to determine whether they were normally distributed. Chi-Square test used to test significance of TST among etanrecept and infliximab at the end of the study. Results: A total of 96 patients were enrolled, including 55 (57.3%) males and 41 (42.3%) females with an average age of 41.1, and mostly 68 (70.8%) from Babylon Governorate of Iraq. A total of 40 (41.7%) patients had rheumatoid arthritis alone, and the remaining 56 (58.3%) had a comorbidity of spondyloarthropathy. Majority of the patients 65 (67.7%) received the biological agent infliximab, while 31 (32.3%) patients received Etanercept for RA for a period of 1 year. There was a statistically significant decreasing in the median ESR and disease activity  from the baseline to the end of the study (p-value <0.01). There was no significant difference in TST results based on gender or age. Both infliximab and etanercept were significantly associated with a decreasing  in ESR and disease activity Conclusion: This study has shown that there was very low TST conversion among RA patients after 1 year of anti-TNF treatment and, age and gender were not associated with TST.


2020 ◽  
Vol 8 (1) ◽  
pp. 65-68
Author(s):  
Sumit Jeena ◽  
Jaswinder Kaur ◽  
Nishant Wadhwa

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.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hisham Mohamed Fathey Elshawaf ◽  
Mohamed Ismail Shabayek ◽  
Mohamed Ahmed Saleh Ahmed

Abstract Background Percutaneous Nephrolithotomy (PCNL) is the preferred technique for treating large renal stones (over 2cm in diameter). It involves keyhole surgery performed through a small skin incision overlying the kidney. Objectives Our study aimed at evaluating the safety and efficacy of local hemostatic sealant (surgiflo®) use in tubeless PCNL to enhance postoperative outcomes of PCNL. Patients and Methods We randomized our patients into two groups, Group A nephrostomy tube was used as standard PCNL, and at group B tubeless PCNL was done followed by injection of the local hemostatic flowable gelatin matrix (surgiflo®) under fluoroscopic guidance in the prone position Results There was no statistically significant difference between two groups regarding demographic data age, sex and BMI (P- value 0.280, 0.736 and 0.440 respectively), stone site and size (P- value 0.525 and 0.533 respectively), operative time (P- value 0.855), intraoperative complications as blood loss and pelvicalyceal perforation, (P- value 0.92 and P- value 0.83 respectively), postoperative complication as fever, haematuria and UTI (P- value 1.000, 0,113 and 1.000 respectivly), and Hb drop (P- value 0.735). Conclusion Tubeless PCNL with hemostatic sealant use is associated with less pain, no leakage from nephrostomy tract, less narcotic agent use, and a shorter hospital stay.


2021 ◽  
Vol 8 (9) ◽  
pp. 36-42
Author(s):  
Gagang Guntaran Kalbuningwang ◽  
Dwi Hari Susilo ◽  
Marjono Dwi Wibowo

Background: Recently, there is some consistent evidence that the inflammatory process is related to the development and progression of cancer. Platelet-lymphocyte ratio (PLR) may acts as simple biomarker for predicting the occurrence of cancer. Since fine needle aspiration could not distinguish between follicular thyroid carcinoma and benign lesion, the researchers were interested in conducting research correlation of PLR towards incidence of follicular thyroid carcinoma in Dr Soetomo Hospital Surabaya. Methods: This study used secondary data from medical record of surgical pathology report diagnosed with follicular thyroid carcinoma who had undergone thyroid surgery at RSUD Dr. Soetomo Surabaya. Preoperative complete blood count was investigated then platelet-lymphocyte ratio was counted. Results: The total research subjects were 40 people, consisting of 31 women (77.5%), 9 men (22.5%). Among three analyses between gender, age, and PLR towards follicular thyroid carcinoma, there is only one analysis which statistically had significant difference, that is correlation between PLR value towards incidence of follicular thyroid carcinoma (p value = 0.003). Two remaining analyses showed there were no statistically significant difference between gender (p value = 0.451) and age (p value = 0.336) towards follicular thyroid carcinoma. It was also found that patients with the higher PLR value had eight point five times higher suffering follicular thyroid carcinoma than those who had low PLR value. Conclusion: According to this study, there was a statistically significant difference between PLR towards incidence of follicular thyroid carcinoma. The higher platelet-lymphocyte ratio (PLR) value, it is more likely to develop follicular thyroid carcinoma. Keywords: Platelet lymphocyte ratio, platelet-lymphocyte ratio, follicular thyroid carcinoma


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  


2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S35-S36
Author(s):  
Michael P Peterson ◽  
Matthew A Firpo ◽  
Irma D Fleming ◽  
Clement Vachet ◽  
Zachary T Huston ◽  
...  

Abstract Introduction Although trained specialists easily identify most full and superficial partial thickness burn injuries, deep partial-thickness injuries present a true challenge to the clinician. Various imaging modalities to assess perfusion and determine healing potential include skin biopsy with histology, laser doppler imaging, active dynamic and static infrared thermography, vital dyes, indocyanine green video angiography and others. Prior studies indicate, with small clinical and animal studies, forward looking infrared is a valid tool to assess healing potential and 21-day healing within the first 48 hrs after presentation. The aim of our study is to determine if an absolute increase or decrease in temperature (°C) measurements across a burn wound in a large clinical cohort correlates with 21-day healing after 48 hrs from time of injury. Methods After informed photo consent was obtained, thermographic images were captured at presentation, 24hrs, and 48hrs from patients admitted to our center between October 2018 and August 2019. Thermographic images were reviewed and temp measurements obtained using a linear vector through the wound. Next we determined if patients healed within 21 days. Data collected includes demographic data, burn characteristics, injury site (based on Lund Browder segmentation) and wound temp (average, minimum, maximum). Data was analyzed using Wilcoxon rank sum test with continuity correction. Results We reviewed images for 159 burn sites from 29 patients, the largest image set to be reviewed to date. The cases were 84% male, the mean and range was 33.1 years (1.7 – 70) for age and 25% (2 – 54.5) for TBSA. We found an average temp difference between 24 hrs – 48 hrs (p-value= 0.007) was significant, and no significant difference in average temp change when evaluating admit – 24 hrs (p-value=0.053) and admit – 48 hrs (p-value=0.316), consistent with predictions of prior studies. Average temp from admit – 24 hrs decreased by 0.86°C in healed (n=48) vs non-healed (n=91); increased on average by 1.25°C in healed (n=39) vs non-healed (n=74) from 24 hrs – 48 hrs; and showed a modest decrease by 0.3°C in healed (n=50) vs non-healed (n=82) when comparing admit 48 hr temp. Conclusions These data demonstrate that burn wound temperature difference between 24 and 48 hours after admittance as measured by infrared thermography correlates with clinical outcomes and 21 day healing. Applicability of Research to Practice Infrared thermography is a validated tool to assess burn depth after 48 hrs. In the future, this modality may impact triage in the military, rural, accidental and non-accidental disasters.


2021 ◽  
Vol 74 (1-2) ◽  
pp. 33-37
Author(s):  
Sanja Jakovljevic ◽  
Ljuba Vujanovic ◽  
Dejan Ogorelica ◽  
Aleksandra Fejsa-Levakov ◽  
Jasmina Sekulic

Introduction. Grover?s disease is characterized by pruriginous polymorphic rash with a variable course and duration. Although the etiology is still unknown, the disease is often associated with other dermatoses, malignant diseases, use of certain medications, as well as immunosuppression. Case Report. We report a case of a 70-year-old male patient who was referred for examination to the Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, due to a rash that lasted for nine months. The first lesions on the skin appeared around the nipples as exudative eczematous plaques. A few months later, identical lesions appeared on the lower legs. During treatment with systemic antihistamines and topical corticosteroids, there were episodes of transient improvements and re-exacerbations. In the meantime, erythematous brownish, round and oval papules appeared on the abdomen and the back, accompanied by intense itch. Laboratory findings revealed eosinophilia and elevated serum immunoglobulin E levels. A skin biopsy of the back lesion was performed and the histopathological examination confirmed the diagnosis of Grover?s disease. After the systemic treatment using corticosteroids and antihistamines, with gradual dose reduction and application of topical corticosteroids and emollients, complete regression of the skin lesions was achieved. Conclusion. Since the clinical manifestations of the disease may be nonspecific and discrete, dermatopathological analysis is of crucial importance in making the correct diagnosis. In patients with atopy, the treatment with systemic corticosteroids, antihistamines and topical agents may lead to regression of skin lesions with a significant improvement in the quality of life.


2019 ◽  
Vol 26 (11) ◽  
pp. 1820-1824
Author(s):  
Benash Altaf ◽  
Shireen Jawed ◽  
Fakiha Behram ◽  
Zeeshan Ali Khan ◽  
Shakeela Naz

Objectives: Pakistan has highest mortality rate due to hypertension and its complications. Hypertension is a squealed of Pre- hypertension which is believed to start at adolescent and continue to adulthood. Association of blood group with hypertension is evident but still hypothesized. This study aims to find the frequency of prehypertension and its association with blood group. Study Design: Cross sectional study. Setting:  Aziz Fatimah Medical and Dental College, Faisalabad. Period: 15 March’18 to 15 Sep’18. Material and Methods:  It was comprised of in comprised of 100 MBBS students. Demographic data including age, weight, height, waist and hip circumference, and BMI was determined. Blood group was determined with help of conventional slide method. Blood pressure was measured by auscultatory method. Data was analyzed by using SPSS 21. Continuous variables are given in mean and standard deviation. Categorical data was given in frequency and percentages. P value≤ 0.05 is taken as significant. Results: Out of 100 participants most common blood group was group ‘O’ (43%) followed by B (35 %) and AB (13%) and A (9%).36% of total population was pre-hypertensive and 64% were normotensive. Prehypertension is most commonly found in blood group ‘A’ (77%) followed by blood group ‘O’ (46.5%). Significant difference was found in means of SBP (p value= 0.001*) and DBP (p value= 0.000*) among the various blood groups. Conclusion: Most common blood group in studied population was ‘O’ although hypertension was most commonly observed in blood group A followed by ‘O’.


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