scholarly journals Retrospective Evaluation of Chronic Idiopathic Thrombocytopenia in Libyan Children

2021 ◽  
pp. 13-21
Author(s):  
Haloom Abdel Salam Elhashmi ◽  
Ainour Ibrahim Abdulhamid
Keyword(s):  
Platelet Count ◽  
Laboratory Data ◽  
Complete Response ◽  
Response To Therapy ◽  
Treatment Modalities ◽  
Female Ratio ◽  
Idiopathic Thrombocytopenia ◽  
Chronic Itp ◽  
History Of ◽  
The Mean

Immune thrombocytopenic purpura (ITP) is the most common cause of acquired thrombocytopenia in children. Approximately 10-20% of children with Immune thrombocytopenia (ITP) suffer from a chronic clinical disease that requires follow up and medical intervention according to the severity of bleeding manifestation. Aims: To evaluate the demographic, clinical, and laboratory features, treatment modalities, and response to therapy in Libyan children with chronic idiopathic thrombocytopenia. Methods: A retrospective study was conducted at the hematology clinic of the pediatric department, Benghazi medical center, and Benghazi Children Hospital. The duration of the study was from January 1998 to December 2018. comprised of demographics, clinical, laboratory data, therapy and therapy response in Libyan chronic ITP. Results: In our study, the mean age of chronic ITP patients was 4.9 years, slightly higher in male patients 43 (52.4%) With a male/female ratio 1.1:1. The most frequent symptoms were mild   which were limited to bruises and petechiae on the skin. (57.3%). The preceding history of viral infection was uncommon in patients with chronic ITP (22%) while the past history of MMR vaccination is quite rare and constituted only (2%). The mean platelet count before treatment (i.e. at presentation) was (22.7x109/L) while mean platelet count after treatment (213.6 x109/L. Treatment consisted of combined Steroid + IVIG in 27 (77.1% response), steroids in 23 (73.9% response), intravenous immunoglobulin (IVIG) in 11 (90.9% response), and no therapy in 21 (95.2% response).Complete response was achieved in 82.9% % showed a complete response either spontaneous or following the treatment. No patient was presented with intracranial hemorrhage. Conclusions: Chronic ITP in Libyan children had a benign nature, none of our patients developed severe symptoms as life-threatening bleeding like CNS bleeding or died, IVIG give more optimistic response as compare to steroid. And the majority of children with chronic ITP in this study achieved remission.

scholarly journals Prognostic evaluation of immune thrombocytopenia outcomes in Egyptian children: a retrospective single-center experience

2021 ◽  
Vol 20 (3) ◽  
pp. 26-30
Author(s):  
Aliaa Mohammed Diab ◽  
AlRawhaa Ahmed Abouamer ◽  
Ghada Saad Abdel Motaleb ◽  
Khaled Abdelaziem Eid ◽  
Heba Ismaiel Abdelnaiem
Keyword(s):  
Platelet Count ◽  
Immune Thrombocytopenia ◽  
Laboratory Data ◽  
Lactate Dehydrogenase Level ◽  
Female Gender ◽  
University Hospitals ◽  
Female Ratio ◽  
Chronic Itp ◽  
Egyptian Children ◽  
Significant Difference

Immune thrombocytopenia (ITP) is the most common cause of thrombocytopenia in children. This retrospective study was designed to analyze presenting features of ITP cases in Benha, evaluate outcomes in children and determine prognostic factors. This research was accepted by Research Ethics Committee (REC) of Faculty of Medicine, Benha University (chairman: Prof. Nermeen Adly Mahmoud). Ethics comittee refrence number MS 40-3/2019. Records of 308 children with ITP in Benha University Hospitals and Benha Children Hospital haematology clinics between May 2014 and January 2021 were retrospectively analyzed. Socio-demographic, clinical, and laboratory data of the studied children such as age, gender, the type of residence, the date of diagnosis, complaints at presentation, preceding vaccination or infection, the type of bleeding, initial platelet count, LDH (lactate dehydrogenase) level, initial treatment, and outcomes were recorded. A total of 308 children diagnosed with ITP were included, clinical courses were determined as newly diagnosed and chronic in 71.4% and 28.6%, respectively. The median age of patients at diagnosis was 5 ± 3.4 years. The male/female ratio was 1.14. The median age at diagnosis was significantly higher in chronic ITP patients (p < 0.001); patients ≥ 10 years were more likely to develop chronic ITP than younger ones (p = 0.029). Regarding residency, seasonality, type of bleeding and history of preceding infection or vaccination, the difference was not statistically significant. Initial platelet counts > 20 × 109 were significantly more prevalent in chronic ITP (p < 0.001). LDH level at presentation was significantly higher in chronic cases (p = 0.046). Initial lines of treatment were the following: steroids, IVIG, and IVIG with steroids (in 88%, 5.2%, and 2.9% of the cases, respectively). A total of 3.9% of the children did not receive any treatment. There was no significant difference in the outcomes between the initial lines of treatment (p = 0.105). In our study, age > 10 years, female gender, higher platelet count and high LDH level at presentation were found to increase the probability of chronic ITP.

scholarly journals Sialendoscopy With Intraductal Steroid Irrigation in Patients With Sialadenitis Without Sialoliths

2019 ◽  
Vol 98 (5) ◽  
pp. 291-294 ◽  
Author(s):  
Saudamini J. Lele ◽  
Mickie Hamiter ◽  
Torrey Louise Fourrier ◽  
Cherie-Ann Nathan
Keyword(s):  
Treatment Option ◽  
Case Series ◽  
Complete Response ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Effective Treatment Option ◽  
Patient Reported ◽  
History Of ◽  
The Mean

Sialendoscopy has emerged as a safe, effective and minimally invasive technique for management of obstructive and inflammatory salivary gland disease. The aim of our study was to analyze outcomes of sialendoscopy and steroid irrigation in patients with sialadenitis without sialoliths. We performed a retrospective analysis of patients who underwent interventional sialendoscopy with steroid irrigation from 2013 to 2016, for the treatment of sialadenitis without sialolithiasis. Twenty-two patients underwent interventional sialendoscopy with ductal dilation and steroid irrigation for the treatment of sialadenitis without any evidence of sialolithiasis. Conservative measures had failed in all. Eleven patients had symptoms arising from the parotid gland, 4 patients had symptoms arising from the submandibular gland, while 6 patients had symptoms in both parotid and submandibular glands. One patient complained of only xerostomia without glandular symptoms. The mean age of the study group which included 1 male and 21 females was 44.6 years (range: 3-86 years). Four patients had autoimmune disease, while 7 patients had a history of radioactive iodine therapy. No identifiable cause for sialadenitis was found in the remaining 11 patients. The mean follow-up period was 378.9 days (range: 16-1143 days). All patients underwent sialendoscopy with ductal dilation and steroid irrigation. Twelve patients showed a complete response and 9 patients had a partial response, while 1 patient reported no response. Only 3 patients required repeat sialendoscopy. The combination of sialendoscopy with ductal dilation and steroid irrigation is a safe and effective treatment option for patients with sialadenitis without sialoliths refractory to conservative measures. Prospective studies with a larger case series are needed to establish its role as a definitive treatment option.

Feasibility and safety of percutaneous computed tomography guided radiofrequency ablation of lymph nodes in oligometastatic patients: a single center’s experience

2021 ◽  
Vol 94 (1121) ◽  
pp. 20200445
Author(s):  
Dimitrios Filippiadis ◽  
George Charalampopoulos ◽  
Athanasios Tsochatzis ◽  
Lazaros Reppas ◽  
Argyro Mazioti ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Lymph Nodes ◽  
Clinical Success ◽  
Complete Response ◽  
Tumor Control ◽  
Complication Rates ◽  
Ct Guided ◽  
Female Ratio ◽  
Contrast Enhanced Ct ◽  
The Mean

Objectives: To retrospectively evaluate feasibility and safety of CT-guided percutaneous radiofrequency ablation (RFA) of metastatic lymph nodes (LN) in terms of achieving local tumor control. Methods: Institutional database research identified 16 patients with 24 metastatic LNs who underwent percutaneous CT-guided radiofrequency ablation. Mean patient age was 66.6 ± 15.70 years (range 40–87) and male/female ratio was 8/8. Contrast-enhanced CT or MRI was used for post-ablation follow-up. Patient and tumor characteristics and RFA technique were evaluated. Technical and clinical success on per tumor and per patient basis as well as complication rates were recorded. Results: Mean size of the treated nodes was 1.78 ± 0.83 cm. The mean number of tumors per patient was 1.5 ± 0.63. The mean procedure time was 56.29 ± 24.27 min including local anesthesia, electrode(s) placement, ablation and post-procedural CT evaluation. Median length of hospital stay was 1.13 ± 0.34 days. On a per lesion basis, the overall complete response post-ablation according to the mRECIST criteria applied was 75% (18/24) of evaluable tumors. Repeat treatment of an index tumor was performed on two patients (three lesions) with complete response achieved in 87.5% (21/24) of evaluable tumors following a second RFA. On a per patient basis, disease progression was noted in 10/16 patients at a mean of 13.9 ± 6.03 months post the ablation procedure. Conclusion: CT-guided percutaneous RFA for oligometastatic LNs is a safe and feasible therapy. Advances in knowledge: With this percutaneous therapeutic option, metastatic LNs can be eradicated with a very low complication rate.

scholarly journals Acute renal failure in children: outcome and prognostic factors

2016 ◽  
Vol 43 (6) ◽  
pp. 205
Author(s):  
Partini P Trihono ◽  
Ommy A Soesilo ◽  
Rulina Suradi
Keyword(s):  
Renal Failure ◽  
Logistic Regression ◽  
Acute Renal Failure ◽  
Prognostic Factors ◽  
Poor Prognosis ◽  
Laboratory Data ◽  
Bivariate Analysis ◽  
Female Ratio ◽  
Significant Relationships ◽  
The Mean

Background Acute renal failure (ARF) is an emergency conditionwith a high mortality rate despite the long-known dialysis and ad-vanced supportive care. Only few studies on prognostic factors ofARF in children are available in the literature, which are difficult tocompare to each other due to the different definitions of the ARFoutcome used.Objective To find out the clinical and laboratory characteristics ofchildren with acute renal failure and the prognostic factors affect-ing the outcome.Methods This observational prospective study was conducted onchildren with acute renal failure hospitalized in the Department ofChild Health, Cipto Mangunkusumo Hospital, between July andDecember 2001. Patients with acute on chronic renal failure wereexcluded. Clinical and laboratory data were taken at the time ofdiagnosis and the outcomes were noted after 2 weeks of observa-tion. We classified the outcome as cured, uncured, and dead. Ana-lytical study was done to find out the relationships among variousprognostic factors.Results Fifty-six children with ARF were recruited in this study.Male to female ratio was 1.3:1; the mean age was 4.4 year-old.The most frequent presenting symptom was dyspnea (34%), fol-lowed by oliguria (29%). The most frequent primary disease wasmalignancy (20%). Most of the patients had renal-type of ARF(73%). The outcomes were cure (71%), no cure (16%), and death(13%). Bivariate analysis and logistic regression revealed thatyounger age (OR=13.6; 95%CI 1.01;183.60) and the need for di-alysis (OR=10; 95%CI 1.53;65.97) had significant relationships withmortality or no cure.Conclusion We should be aware when finding ARF patientsless than 5 year-old and have the indications for dialysis, due tothe poor prognosis they might have

Effect Of Prednisone On Platelet Function In Patients With Bleeding Disorders

1981 ◽  
Author(s):  
R McKenna ◽  
F Bachmann ◽  
O Pichairut ◽  
B Whittaker
Keyword(s):  
Platelet Count ◽  
Platelet Function ◽  
Bleeding Time ◽  
Platelet Factor ◽  
Von Willebrand's Disease ◽  
Von Willebrand’S Disease ◽  
Before And After ◽  
History Of ◽  
The Mean ◽  
One Year

There is considerable controversy regarding the effect of Prednisone on the hemostatic mechanism of normal people versus patients with bleeding diatheses. We administered Prednisone 15 mg TID to patients with a positive history of a bleeding disorder, and evaluated the bleeding time and other in-vitrc tests of platelet function prior to and between the 5th and 7th day after Prednisone.Eleven patients were admitted into this study over a one year period. All patients had a history of excessive bruising, epistaxis, bleeding after dental extractions, and gastrointestinal or other bleeding in various combinations. Two out of the eleven had template bleeding times of greater than 15 minutes both before and after the Prednisone. These two patients were subsequently proven to have von Willebrand’s disease by the washed platelet ristocetin assay. In the remaining 9 patients, the pre-Prednisone bleeding time was 9.3 ±3.7 minutes (x ± 1 S.D.) whereas the post-Prednisone bleeding time was 5.8 ±3.6 minutes (x ±1 S.D.). These results were significant(td=3.83;df:7;p=0.007).Platelet aggregation in response to exogenous ADP (1 μM, 3 μM) Sigma bovine tendon collagen (1.8 mg/ml F) and epinephrine (5.5 × 104M), platelet retention in a glass bead column or platelet factor 3 availability did not improve or worsen after Prednisone therapy. The mean platelet count of 328,000±94,000 (x ±1 S.D.) was significantly (p=0.05) higher than the mean pre-Prednisone platelet count of 268,000±77,000 (x ±1 S.D.).In conclusion, we have shown that large doses of Prednisone appear to shorten the bleeding time in patients with significant defects in the primary hemostatic mechanism. However the bleeding time improvement is not evident in patients with von Willebrand’s disease.

Stroke in a Subsaharan Nigerian Hospital—A Retrospective Study

1989 ◽  
Vol 19 (1) ◽  
pp. 11-14 ◽  
Author(s):  
S A Bwala
Keyword(s):  
Duration Of Symptoms ◽  
Female Ratio ◽  
Transient Ischaemic Attacks ◽  
History Of ◽  
Hospital Deaths ◽  
Insulin Dependent ◽  
The Mean ◽  
The University ◽  
First Time ◽  
Male To Female

The case records of 53 consecutive Nigerian inpatients with stroke in the University of Maiduguri Teaching Hospital, Maiduguri were retrospectively reviewed. The mean age at presentation was 55 years and the male to female ratio was 2.5: 1. The mean duration of symptoms before presentation was 11.1 weeks and the average duration of stay in hospital was 3 weeks. Thirty-three (63%) of the lesions were infarctive and 19 (37%) were haemorrhagic. Only 3 (6%) patients gave a history of prior transient ischaemic attacks (TIAs). Forty-two (79%) patients were hypertensive at presentation out of which 27 (64%) had the hypertension diagnosed for the first time. Four (8%) patients were non-insulin dependent diabetics. There were 11 hospital deaths (21%). Thus hypertension, more than half undiagnosed at admission, was the most common risk factor for stroke in the hospital population studied.

scholarly journals Outcome of combined surgical and intralesional steroids injection therapy for management of ear keloid

2020 ◽  
Vol 9 (1) ◽  
pp. 43-48
Author(s):  
Amir Bajracharya
Keyword(s):  
Triamcinolone Acetonide ◽  
Corticosteroid Injection ◽  
Surgical Excision ◽  
Good Alternative ◽  
Injection Therapy ◽  
Treatment Modalities ◽  
Aesthetic Outcome ◽  
Intralesional Corticosteroid ◽  
History Of ◽  
The Mean

Background: Ear keloid is one of the challenging problems that affect people of different races with substantial aesthetic outcomes. Various types of treatment modalities, including intralesional corticosteroid injection are advocated to lower recurrence following excision. Objectives: To investigate the efficacy of a combined excision and postoperative intralesional triamcinolone acetonide (TA) injection for treating ear keloid patients. Methodology: This was a descriptive study done to observe the outcome of combined approach of surgical and intra-lesional steroids injection therapy for ear keloids. Age, sex, site, size, duration, recurrence, and aesthetic outcome were evaluated. Results: A total of 18 patients representing 19 ear keloids, with one case having bilateral and 3 pediatric cases were included from February 2018 to January 2019.The mean age was 22 years with female to male ratio of 5:1, site were left sided 9 (50%), right 8 (44%) and 1(6%) bilateral. About 10 (53%) cases were at helix, and 9(47%) at ear lobule. Mean length of ear keloid was 1.53 cm with range of 0.5-3cm and mean breath 1.39cm with the range of 0.5-2.5 cm. The mean duration of ear keloid was 9.47 months. 2 (11%) cases showed a history of recurrence. Injection triamcinolone acetonide hypersensitivity was noted by 1 (5.3%) patient. Evaluation for all patients with aesthetic outcome was mean ± standard deviation (4.38±1.025). Conclusion: Management of ear keloid using the combination of surgical excision and intra-lesional steroids injection therapy can be a good alternative option with low recurrence rate.

scholarly journals Immediate Pre-Splenectomy Platelet Count Predicts Splenectomy Response in Adult Immune Thrombocytopenia Patients

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 11-11
Author(s):  
O. A. Soboleva ◽  
K. I. Ntanisian ◽  
E. K. Egorova ◽  
A. L. Melikyan ◽  
E. G. Gemdzhian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Immune Thrombocytopenia ◽  
Conflicts Of Interest ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Complete Response ◽  
Preoperative Treatment ◽  
Female Ratio ◽  
Factors Associated

Background: Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by isolated thrombocytopenia. Splenectomy remains an effective and safe treatment for ITP. Objective: Identify and estimate risk factors associated with no response (platelet count &lt; 30 x 109/L) to splenectomy for adult ITP patients. Patients and Methods: The study conducted at National Research Center for Hematology (Moscow) from 03/2015 to 11/2019 included all patients (in total, 111) with ITP, who underwent laparoscopic splenectomy. Median (Med) platelet count at admission was 12 x 109/L (range from 1 to 239 x 109/L). The time from diagnosis of ITP to splenectomy varied from 3 months to 51 years. All patients had received from 1 to 3 lines of treatment prior to splenectomy. Pre-splenectomy treatment was carried out at platelet count &lt; 20 x 109/L and/or in the presence of bleeding. Results: Of the 111 patients 31 were male (Med age 43 years [IQR 27-55]) and 80 were female (Med age 37 [IQR 29-49]). The male/female ratio was 1:2.6. Complete response to splenectomy (platelet count &gt; 100 x 109/L) was achieved in 79/111 (71.2%) cases, 11/111 (9.9%) patients had partial response (platelet count: 30-100 x 109/L) and 21/111 (18.9%) failed to respond (platelet count &lt; 30 x 109/L). Patients who achieved complete response to splenectomy had a significantly higher immediate pre-splenectomy platelet count than non-responders: Med platelet count (95% CI): 47 (35-58) vs 16 (9-20) (x 109/L), Mann-Whitney U test, P &lt; 0.001 (CI, confidence interval) (Figure 1). Multivariate logistic regression analysis was carried out to identify factors associated with splenectomy outcome (response/no response). Multivariate analysis included patient's gender and age, duration of ITP, grade of bleeding at admission, platelet count at admission, preoperative platelet count and number of prior lines of therapy. Continuous variables were dichotomized using ROC analysis, in particular, cut-off point for preoperative platelet count was 23 x 109/L. As a result, following statistically significant (Wald test) factors were selected: • an unfavorable predictor: immediate pre-splenectomy platelet count &lt; 23 x 109/L, RR (95% CI): 2.5 (1.1-8.6), P = 0.001 (RR, relative risk) (Figure 1) and • combined unfavorable risk factor: male gender in the age over 60 (compared to men in the age ≤60 and women in general), RR (95% CI): 2.0 (0.9-7.1), P = 0.05 (Figure 2). Response rate was negatively correlated (in univariate analysis) with the number of treatment lines prior to splenectomy (negative Spearman's rank correlation coefficient, −0.30; P = 0.01). When preoperative platelet count ≥ 23 x 109/L was achieved, probability of complete response to splenectomy was 80% (Figure 3). The rate of postoperative complications was 12.6%. According to our follow-up data (up to 5 years) 66/79 (83.5%) patients maintained complete response. Conclusions: High-risk groups were identified: patients with immediate pre-splenectomy platelet count &lt; 23 x 109/L (i.e. with no effect of preoperative treatment) and men over the age of 60. Identified risk factors could be taken into account in decision-making process. Disclosures No relevant conflicts of interest to declare.

scholarly journals Clinical Characteristics, Dynamic Profile of Radiology and Laboratory Findings in Coronavirus Disease 2019

2020 ◽  
Author(s):  
ailing liu ◽  
Jing Zhang ◽  
Wei Qiao ◽  
Wei Zang ◽  
Yingying Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Laboratory Data ◽  
Oxygenation Index ◽  
Laboratory Findings ◽  
Single Centre Study ◽  
History Of ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Dynamic Profile

Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, more and more data from different area and different stages of disease have been needed.Methods In this retrospective, single-centre study, we included all 38 confirmed cases of Covid-19 in Weihai from Jan 24 to Feb 24, 2020. Patients were divided into group A by normal Oxygenation Index (OI), group B by abnormal OI (less than 400 mmHg).The dynamic changes in clinical laboratory parameters were tracked from day 1 to day 32 after the onset of the disease at 4-day intervals. Cases were analyzed for clinical, radiological features and laboratory data. Outcomes were followed up until Feb 24, 2020.Results 38 patients with Covid-19 were included in this study, 68.42% patients were family clustered, and 97.37% patients had a history of exposure. The mean days between exposure and onset were about 5 days. Most patients were men, mean age was 43 years, 52.6% patients had chronic diseases. Most patients had fever or cough, about a third of patients had expectoration or fatigue, and 5 (13.16%) patients had shortness of breath.

scholarly journals Clinical Spectrum and Neuroimaging Changes in Neurodegenerative Disorder-Experiences in Tertiary Care Hospital of Bangladesh

2021 ◽  
Vol 2 (6) ◽  
pp. 10-14
Author(s):  
Gopen Kumar Kundu ◽  
Rumana Islam ◽  
Noor E-Sabah ◽  
ABM Mukib
Keyword(s):  
Neurodegenerative Diseases ◽  
Tertiary Care Hospital ◽  
Neurodegenerative Disorder ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Care Hospital ◽  
Female Ratio ◽  
History Of ◽  
The Mean ◽  
Male To Female

Neurodegenerative diseases (NDD) are a heterogeneous group of disorders characterized by progressive loss of previously acquired skills that are of varied etiology, clinical manifestations, and natural course. There is a paucity of data on clinical profile of neurodegenerative diseases in our population. We conducted a retrospective study with 68 diagnosed cases of NDD at a tertiary care hospital in Bangladesh. Among them, more than one-third of children were in 1-5 years age group. The mean age was 10.2±3.1 year and male to female ratio was 2:1. Fifty percent of cases had a history of consanguineous parents. Leukodystrophy was most common (30.88%) among NDDs, followed by Wilson disease (26.47), SSPE (22.1%), and Degenerative Ataxia (20.59%). Motor skill regression was the most common presentation (97%), followed by speech regression in 91% and Gait disorder in 83% of children. Seizure was presenting features in 24% of children. Neuroimaging abnormalities were found in 80.88% NDD cases. Among them white matter hyper intensity in 29.41%, cerabeller atrophy in 13.25 %, and cerebral atropy in 11.76% of children. Eye changes were found in about two-thirds (69.12%) of cases of NDD. Among them, optic atrophy was found in 29.41%, and KF rings in 25.00% of cases.

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