Seroprevalence of Toxoplasma gondii, Rubella and Cytomegalovirus Among Women of Reproductive Age in Mashhad, Northeast of Iran

Purpose: TORCH syndrome is responsible for 2-3% of all congenital anomalies caused by Toxoplasma gondii (T. gondii), Rubella virus (RV), Cytomegalovirus (CMV), and Herpes simplex virus (HSV). The current study aimed to determine the prevalence of TORCH infection in women in Mashhad. Method: This cross-sectional study was conducted on 417 patients who were referred to three laboratories in Mashhad, Iran. Laboratory data were collected from ​April 2016 to March 2020 to detect the specific IgG and IgM against TORCH syndrome.Result: The specific IgG antibodies were found to be positive in for CMV in 402 cases (96.4%), for RV in 394 cases (94.5%), and for T. gondii in 80 cases (19.2%). Moreover, 7 (1.6%) of them were found to be positive for anti-CMV IgM, 6 (1.4%) for anti-IgM RV, and 8 (1.9%) for anti-IgM T. gondii. In addition, the relationship between age and anti- T. gondii IgG in the age group of 37-47 years was 6.44 times higher than the age group of 17-27 years. Also, The relationship between age and anti-CMV IgG in the age group of 27-37 years was 4.13 times higher than the age group of 37-47 years.Conclusion: All women of reproductive age should be screened for the TORCH complex regularly to prevent congenital TORCH syndrome.

Study to Evaluate Association of Torch Infection with Bad Obstetric History in Pregnant Women at Sms Medical College and Attached Group of Hospitals, Jaipur

Background: Congenital infections are transmissible in utero and it can lead to serious foetal outcomes. These infections can be early detected in pregnant women with bad obstetric history for better foetal outcomes. Aim of the Study was to evaluate the association of TORCH infection with bad obstetric history among pregnant women. Study Design: Observational and comparative study Place and Duration of Study: Central laboratory, Department of Microbiology, SMS Medical College, Jaipur between April 2020 and September 2021. Methodology: 260 blood samples of pregnant women (130 with bad obstetric history and 130 pregnant women without bad obstetric history) were collected. and tested for the presence of IgM and IgG antibodies against Toxoplasma gondii, Rubella virus, Cytomegalovirus by Chemiluminescence and Herpes simplex virus using ELISA kits. Results: Overall TORCH IgM seropositivity in high-risk pregnant women was 17.19%. In pregnant women with bad obstetric history, IgM Seropositivity for Toxoplasma gondii was 3.84% (P value .02), rubella 2.34% (P value .30), Cytomegalovirus 5.47% (P value .08), and 6.25% (P value .56) for Herpes-1 and 2 infections and IgG seropositivity for toxoplasma, rubella, cytomegalovirus and herpes virus was 16.41% (P value .001), 93.75% (P value .11), 98.44% (P value .55), 48.44% (P value .53) respectively. In pregnant women without bad obstetric history, IgM and IgG seropositivity for toxoplasma, rubella, cytomegalovirus and herpes virus was 0/0.77%, 0.76/97.69%, 1.53/99.23% and 4.61/44.62% respectively. The average age of the study population was 27.13 years. Conclusion: As TORCH infections are transmissible in-utero in all the stages of pregnancy and contributes in neonatal and infant deaths, so early diagnosis and appropriate interventions necessary which help in proper management of the pregnant women.

Prenatal Risk Factors on Children’s Cerebral Palsy Case at RSIA Bunda Jakarta

Introduction: Cerebral Palsy is a disease that is less recognized by the public due to the lack of information related to CP in Indonesia. Aims to analyze prenatal risk factors that influence the evidence of CP RSIA Bunda Jakarta.Methods: This study was conducted in April 2021 at RSIA Bunda Jakarta, an analytical study with a case control design. The sample in this study were 124 respondents from mothers of children who underwent outpatient treatment at the RSIA Bunda Jakartaas cases and controls. each taken by simple random sampling technique. Data were analyzed using the test chi-square to analyze the relationship between variables.Results: The results of statistical analysis showed that the risk factors associated with the incidence of CP were maternal age (p= 0.00; OR= 13.25; 95% CI= 2.93-59.93), preeclampsia (p= 0.00; OR= 2,06; 95% CI= 1,71-2,48), TORCH (p= 0.00; OR= 2.40; 95% CI= 1.92-3.01), and antenatal care (p= 0.00; OR= 41.2; 95% CI= 5.45-317.0). Conclusion: Risk factors affecting the occurrence of CP in children include age <20 or ≥35 years, preeclampsia, TORCH infection and antenatal care visits <4 times. It is necessary to increase intervention programs at various levels of health services to diagnose and prevent the occurrence of cerebral palsy in children so that optimal maternal and child health is achieved. and further research is needed to determine other risk factors that can cause CP in children such as perinatal and postnatal risk factors.

Study of Congenital Malformation in a Tertiary Care Teaching Hospital

Objective: Congenital anomaly is one of the most important causes & being the 5th most common cause of neonatal mortality & morbidity. It may present as a structural or functional abnormality. These defects occur due to defective embryogenesis. Associated factors may be maternal age, maternal TORCH infection, drugs, genetic factors. Antenatal USG reduces the incidence.Materials and Methods: A cross-sectional study was done in the Pediatric department over 1 year. Diagnosis of all congenital anomalies was done by the concerned pediatrician& pediatric surgeon. Data was collected in the specified format.Results: A total of 10205 cases of age group 1 month to 5 years presented to the paediatric OPD, out of which 193 children were diagnosed as congenital anomalies in 1 year. Males were found to be affected the most. The most common system involved was found to be the genitourinary system (36.78%). The second most common system involved was the gastrointestinal system (33.67%). The least common system involved was the musculoskeletal system.Conclusion: Congenital anomalies are a major cause of neonatal & infantile mortality & morbidity. Routine screening with a level II targeted scan for all the pregnant mothers should be mandatory. Adequate nutrition, parental education & Rubella vaccination of the mother can decrease the prevalence of congenital anomalies to some extend.

The Role of Certain Congenital Infections in Aplastic Anemia and Prognostic Value of Fetal Hemoglobin as a Follow-Up Marker

Background: TORCH infection has a role in aplastic anemia (AA). Fetal hemoglobin may be high in certain acquired hematological conditions such as aplastic anemia. We conducted this study to evaluate the correlation between certain congenital infections and severity of aplastic anemia and to study fetal Hb as a follow up marker during treatment of aplastic anemia. The aim of study was to correlation between certain congenital infection and severity of aplastic anemia and to study of hemoglobin F (HbF) as a follow up marker during treatment of aplastic anemia. Methods: Our prospective study was conducted on 20 children aged up to 18 years diagnosed with aplastic anemia following either bone marrow aspiration or biopsy that proves bone marrow hypocellularity with absence infiltrative BM disease or inherited BM disease recruited from Pediatric Hematology-Oncology Unit of Tanta University Hospital. Patients were classified according to level of HbF in to high HbF group and normal HbF group. Results: TORCH infections were detected in certain numbers of patients . HbF decreased in high HbF group after treatment. There was significant increase in CBC parameters in high HbF group than normal HbF group after treatment. There was insignificant decrease in mortality in high HbF group than normal HbF group. Mild to moderate cases were significantly higher with TORCH IgM +ve cases Conclusions: Acquired AA is associated with TORCH infection. In treated cases of AA, improvement of hematological parameters is associated with high HbF and from these results, it can be used as a prognostic marker to monitor the successful response of these cases to the used line of treatment.

TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING PREVENTION OF TORCH INFECTIONS DURING PREGNANCY AMONG ANTENATAL MOTHERS ATTENDING ANTENATAL OPDS OF SELECTED HOSPITALS

Aim:To assess the effectiveness of structured teaching programme on knowledge regarding prevention of TORCH infections during pregnancy among antenatal mothers attending antenatal OPDS of selected hospitals. Participants and setting: The research design used in this study was one group pre test and post test, no control group. The study was conducted in Miraj city, India.The investigator selected 100antenatal mothers who fulfilled the inclusion criteria were selected by using non probability convenience sampling technique. Intervention: The investigator assessed the knowledge on TORCH infection using the structured interview schedule. It took about 10 – 15 minutes for each individual. Soon after the pretest educational package was given through health talk, A.V. aids . The post test was conducted after 7 days and scoring was analyzed. Measurement and findings: To assess the effectiveness of education programme which was done by calculating the t value (0.527) which is confirmed that there was statistically significant difference between pre and post test knowledge at p<0.05 level. Conclusion:There was association between the pre-test knowledge scores with selected demographical variables. Thus the null hypothesis was rejected and H1 hypothesis and H2 hypothesis was accepted.

Pediatric Neurologic Radiology

Chapter 15 examines radiologic images for common pediatric neurologic disorders. These include head and neck disorders such as choanal atresia and congenital piriform aperture stenosis, branchial cleft cysts, thyroglossal duct cyst, fibromatosis colli, and retinoblastoma. The chapter goes on to look at spine diseases such as tethered cord, spinal dysraphism, caudal regression, pars interarticularis defect, and ventriculus terminalis. Brain abnormalities examined include germinal matrix hemorrhage, periventricular leukomalacia, craniosynostosis, and TORCH infection. Intracranial tumors looked at include posterior fossa neoplasms and supratentorial, intraventricular, and suprasellar tumors. Other brain abnormalities include those from trauma, vascular malformations, Dandy-Walker malformation, and migration and proliferation anomalies.

Immunohistochemical study of trophoblast cells using abortion material in the gestation period 9-12 weeks of pregnancy in women against the background of inflammatory diseases of the female genital organs

This article is devoted to the results of studies of trophoblast during the gestation of 9-12 weeks. This study is a fragment of a series of immunohistochemical studies of trophoblast with TORCH infection, which are scheduled to be carried out at different gestational dates. Purpose of the study – in various types of trophoblast using the immunohistochemical method to establish the features of the expression of metalloproteinase-2 using abortion material in gestation period 9-12 weeks of pregnancy with TORCH infection compared with observations without an infectious process. Material and methods. The main group of the study consisted of 24 observations of TORCH infection, and the control group - 22 observations of an aborted pregnancy without signs of an infectious process (abortion for social reasons). The study examined abortion material 9-12 weeks of gestation. The method of microdensitometry in a specialized computer program ImageJ evaluated the optical density of the color, and an immunohistochemical procedure was performed on metalloproteinase-2 with primary antibodies and a polymer antigen imaging system using DAKO diaminobenzidine. Results. According to the results of immunohistochemical studies using computer microdensitometry at a gestational age of 9-12 weeks, the very expression of metalloproteinase-2 is observed in the invasive trophoblast, the smallest - in the syncytotrophoblast of the choric villi, both with TORCH infection and without an infectious process, and intermediate values are noted in chorionic villus cytotrophoblast and cell column cytotrophoblast. Infection, the expression of metalloproteinase-2 is reduced in all four types of trophoblast (cytotrophoblast of chorionic villi; cytotrophoblast of cell columns; invasive cytotrophoblast in endometrial fragments), with TORCH except for syncytotrophoblast of chorionic villi. Conclusions. According to the results of immunohistochemical studies using computer microdensitometry at a gestational age of 9-12 weeks, both with TORCH infection and without an infectious process, the largest expression of metalloproteinase-2 is observed in invasive trophoblast, the smallest - in the syncytiotrophoblast of chorionic villi, and intermediate indices are noted in the cytotrophoblast of chorionic villi and the cytotrophoblast of cell columns. The expression of metalloproteinase-2 decreases in all types of trophoblast with TORCH infection, excluding the syncytiotrophoblast of chorionic villi.

Asymmetric cortical development and prognosis in fetuses with isolated mild fetal ventriculomegaly: an observational prospective study

Background Assessments of cortical development and identifying factors that may result in a poor prognosis for fetuses with isolated mild ventriculomegaly (IMVM) is a hot research topic. We aimed to perform a constant, detailed assessment of cortical development in IMVM fetuses using ultrasound and determine whether asymmetric cortical development occurred. Moreover, we aimed to estimate the prognosis of IMVM fetuses and compare the difference in the prognosis of IMVM fetuses presenting symmetric and asymmetric cortical maturation. Methods IMVM was diagnosed by regular ultrasound, neurosonography and fetal MRI. Genetic and TORCH examinations were conducted to exclude common genetic abnormalities and TORCH infection of fetuses. Ultrasound examinations were conducted at an interval of 2–3 weeks to record sulcus development in IMVM fetuses using a scoring system. The neonatal behavioral neurological assessment (NBNA), the Ages and Stages Questionnaire, Third Edition (ASQ-3) and the Bayley Scales of Infant Development, First Edition (BSID-I) were performed after birth. Results Forty fetuses with IMVM were included: twenty showed asymmetric cortical maturation and twenty showed symmetric cortical maturation. For IMVM fetuses presenting asymmetric cortical maturation, the mean gestational age (GA) at the first diagnosis of relatively delayed development was 24.23 weeks for the parieto-occipital sulcus, 24.71 weeks for the calcarine sulcus, and 26.43 weeks for the cingulate sulcus. All the sulci with delayed development underwent ‘catch-up growth’ and developed to the same grade as the sulci of the other hemisphere. The mean GA at which the two sides developed to the same grade was 29.40 weeks for the parieto-occipital sulcus, 29.30 weeks for the calcarine sulcus and 31.27 weeks for the cingulate sulcus. The NBNA, ASQ-3 and BSID-I scores of all patients were in the normal range. Conclusions IMVM fetuses may show mild asymmetric cortical maturation in the second trimester, but the relatively delayed sulci undergo ‘catch-up growth’. The neurodevelopment of IMVM fetuses presenting asymmetric cortical maturation and ‘catch-up growth’ is not statistically significantly different from IMVM fetuses presenting symmetric cortical maturation.