Exploring novel medical applications for commonly used veterinary drug (tilmicosin antibiotic)
Published on: 31st August, 2017
OCLC Number/Unique Identifier: 7325099093
Tilmicosin (TMC) is a semi synthetic macrolide antibiotic of tylosin derivatives commonly used by veterinaries, has been shown to reveal beneficial pharmacological activities. In the current study, the potential wound healing activity, Anti-oxidant effect (ulcer and hepatoprotective) were investigated. Anti-inflammatory, antipyretic, analgesic (central and peripheral), hypnotic and antispasmodic activity were also screened. This study included adult both sexes of rats (200-250 gm), mice (20-25 gm) and adult rabbits. Experimental wound was induced on the anterior-dorsal side of each rat whereas, ulcer induced by ethanol causing mucosal damage in rats. The oral anti-inflammatory induced through formalin producing edema, antipyretic (Brewer’s yeast induced hyperthermia) and analgesic (writhing test, hot plate method, tail immersion method) while hypnotic effects induced through thiopental sodium. Anti-spasmodic effect on isolated organs (intestinal and uterine muscles) using new method of Modular Single Chamber Organ Bath were carried out on experimental animals. Tilmicosin antibiotic at different two doses of 20 and 40 mg/kg b.wt., has an important role in treatment of ulcer (cytoprotective effect) and improvement the wound healing processes besides anti-inflammatory, analgesics, and anti-pyretic effects. Tilmicosin revealed also hypnotic and intestinal anti-spasmodic effects but showed Pharmacovigilence hepatotoxic effect through the histopathological studies which revealed sever hepatic damage especially at larger dose.
Effects of Fast-Walking on Muscle Activation in Young Adults and Elderly Persons
Published on: 20th January, 2017
OCLC Number/Unique Identifier: 7286424597
Coactivation of agonist and antagonist muscles participates in the regulation of joint stiffness and postural instability. Alterations on muscle activity have been revealed as an important falling risk factor. It is unclear the effects, and age-related differences, of a prolonged demanding task on the muscular coactivation levels. We compared muscle activation amplitude and coactivation of the vastus medialis, biceps femoris, tibialis anterior, and gastrocnemius medialis from surface EMG in 16 young adults (age 21-33) and 8 elderly adults (age 66-72) while fast-walking at 70% of their maximum heart rate. Overall, the elderly demonstrated higher coactivation indexes than the young individuals. Ankle coactivation decreased in the first half of the swing phase, while coactivation at the knee increased in the latter half of the swing phase in our elders. Alterations of muscle activation and coactivation on the knee and ankle were more prominent close to landing and in the swing phase. Our results suggest that these alterations may suggest potential concerns with respect to the risk of falls.
Canine Distemper Virus detection based in Hemaglutinine Gene as target in Reverse Transcriptase-Polymerase Chain Reaction
Published on: 27th December, 2018
OCLC Number/Unique Identifier: 7964755439
Canine Distemper have become a major concern within the veterinary clinical work. Thus, the appearance of many cases of canine distemper in adult animals with their vaccination plan up to date has alarmed veterinarians. Many cases of canine distemper have become a major concern within the clinical veterinary task. The purpose of this work was to detect the gene of hemagglutinin of the virus canine distemper, by using the Polymerase Chain Reaction associated with Reverse transcription (RT-PCR), as confirmation of the clinical diagnosis of disease. For this, peripheral blood samples of animals were used clinically patients and were grouped according to their date of extraction and using vaccines commercial as control.
The results allow to demonstrate a high sensitivity of the technique, besides allowing the use of samples up to seven days of storage at 4°C, despite the fragility of RNA viral.
Detection of canine distemper virus haemagglutinin gene in field samples and its high sensitivity, suggests studying its use as a diagnostic tool complementary to the clinical diagnosis of canine distemper in our country.
A great mimicker of Bone Secondaries: Brown Tumors, presenting with a Degenerative Lumber Disc like pain
Published on: 17th July, 2017
OCLC Number/Unique Identifier: 7317646408
This report presents an adult patient suffering from sacroiliitis like low back pain, lumbosacral radiculopathy and elbow swelling. Multimodality imaging revealed multiple lytic bone lesions located in supra acetabular iliac bone, sacrum, and distal end of radius. Painful numerous lesions due to the extension to the articular surfaces are not expected for Brown tumors. Less than ten cases with multiple Brown tumor due to primary hyperparathyroidism has been reported. Although Brown tumors are mostly diagnosed incidentally, this case would awake the physicians about rheumatological symptoms in the presentation of Brown tumors. Since Brown tumors are non-touch bone lesions that are expected to regress after parathyroid adenoma removal, it is important to distinguish Brown tumors from the giant cell tumors.
Evaluation of Horizontal Lip Position in Adults with Different Skeletal Patterns: A Cephalometric Study
Published on: 10th March, 2017
Aim: To evaluate sexual dimorphism in horizontal lip position in adults with different skeletal patterns.
Material and Methods: The sample comprised of 120 patients (Females 18 years and above, Males 21 years and above) with no history of previous orthodontic treatment or functional jaw orthopaedic treatment. They were divided into different groups based on the ANB angle and gender. Group I and II included 30 males and 30 females with skeletal class I malocclusion (ANB 0-4 degree). Group III and IV included 30 males and 30 females with skeletal class II malocclusion respectively (ANB above 4 degree).
Results: When comparison between males and females (Class I+Class II) was done S-line (p<0.001), B-line (p<0.001), E-line (p<0.001), Holdaways angle (p<0.001) and Merrifield angle (p<0.001) were found to be statistically significant. S-line (p<0.001), E-line (p<0.001) and Holdaways angle (p<0.001) were found to be statistically significant when comparison was done between males and females (Class I). When comparison was done between males and females (Class II) only Holdaways angle (p<0.001) showed a significant statistical difference.
Conclusion: Sexual dimorphism was found in various lip parameters. Significant amount of differences were found between Class I and Class II (male and female) subjects.
Normal Value of Skull Base Angle Using the Modified Magnetic Resonance Imaging Technique in Thai Population
Published on: 20th March, 2017
OCLC Number/Unique Identifier: 7286350678
Purpose: To determine the normal value of basal angle measured using the modified MR imaging technique in Thai population compared with the standard value obtained from the Western population.
Material and Methods: We retrospectively evaluated midline sagittal SE T1 weighted MR images in 200 adults and 50 children. The basal angle of the skull base was measured using the modified MR imaging technique described by Koenigsberg et al. The angle was formed by a line extending across the anterior cranial fossa to the tip of the dorsum sellae and another line drawn along the posterior margin of the clivus. The mean values of the basal angles among different age groups and sex were calculated and analyzed.
Results: The mean skull base angle of our adult population was 115° (range 100.5°-130°, SD=5.7) with an inter-observer agreement of 0.85, slightly smaller than the previous study from the USA which was 117°. There was no significant difference between the male and female groups. The mean skull base angle in our children population was 114.7° (range 102- 130.5°, SD=6.3) with an inter-observer agreement of 0.89, quite similar to the previous USA study which was 114°. There was no significant difference between adult and children.
Conclusion: The mean adult skull base angle measured using the modified MR imaging technique in Thai population was slightly smaller than the Western population, while the mean skull base angle of children was quite similar. The basal angle range of 103.6°-126.4° may be used as a guide for the potential range of normal skull base angles in Thai population and possibly also the Southeast Asian population.
Comparison of Lung Function of normal and persons with chronic low back pain and its relation with duration and severity of Chronic Low Back Pain
Published on: 13th October, 2017
OCLC Number/Unique Identifier: 7286424899
Introduction: Chronic low back pain is one of the most prevalent musculoskeletal disorders. Studies have shown certain relations between physical fitness and chronic low back pain (CLBP) by examine some measures of physical fitness. The aim of study was to measure lung function using winspiro PRO in patient with CLBP versus normal healthy individual, and relation of lung function with duration and intensity of CLBP.
Methodology: The study population is comprised of a total of 120 adult persons. 60 subjects with chronic low back pain (41 male and 19 female) with a mean age of 30.69 years (+4.34) and 60 normal individual (39 male and 21 female) with mean age of 29.00 years (+5.34).
Results:The result of comparison of the respiratory parameter forced vital capacity (FVC), and maximal voluntary ventilation (MVV) of individual with CLBP show a significant difference as compare to the normal healthy population. In unrelated ‘t’ test the patient with CLBP (N=60) of age 30.51(SD±4.33), height 169cm (SD±1.23), weight 57.86(SD±7.73) and body mass index (BMI) 20.46 (SD±2.54) show a significant difference in respiratory parameter FVC ( t=17.244, P=0.000), and MVV ( t=11.048, P=0.000) as compare to the normal healthy persons (N=60) of age 29.79 (SD±5.28), height 170cm (SD±1.13), weight 59.40(SD±6.97) and BMI 21.59 (SD±3.29).In patient group- FVC range is 34.0% to 75.00% (52.85%±9.30). MVV range is 45.0% to 86.80%. (63.11%±12.06)In control group FVC range is 63.90% to 98.83% (83.63%±7.59). MVV range is 63.00% to 98.00% (78.96%±7.86).
Conclusions:The overall result of the study show that there is a significant difference in the respiratory parameter that is FVC (forced vital capacity), and the MVV (maximum voluntary ventilation) in persons with chronic low back pain as compare to the healthy person of same age, height, weight and body mass index (BMI).
Rehabilitation of proximal humerus fractures: An environmental scan of Canadian physiotherapy practice patterns
Published on: 20th September, 2017
OCLC Number/Unique Identifier: 7286350490
Background: Proximal humerus fractures (PHFs) are common injuries particularly in older adults. Evidence-based protocols for PHF rehabilitation are lacking and physiotherapists use a variety of interventions.
Purpose: To determine practice patterns and perceptions of physiotherapists who treat adults with PHF in Ontario, Canada.
Method: A paper and pencil survey asking about respondent demographics and management of Neer Group 1 (minimally/nondisplaced) and complex (displaced 3- and 4-part) PHF was mailed to 875 randomly selected physiotherapists who were registered with the College of Physiotherapists of Ontario in 2013/2014 and working in practice areas likely to be accessed by adults with PHF.
Results: The response rate was low (10%); 83 physiotherapists completed the survey - 80% had experience managing PHF. Respondents treated 1-5 individuals with PHF annually; more treated Neer Group 1 PHF (89%) than complex PHF (68%). Most individuals with PHF were older than 60 years (64%), female (76%) and accessed physiotherapy through a doctor’s referral (91%) more than 1 month post injury (33%).
Main findings: Physiotherapists manage PHF using multi-component interventions and a minimum of 76% include the following elements: education and progression of passive, active assisted, active range of motion exercises and muscle retraining to build coordination and strength. Use of other elements was variable. The main factors influencing the treatment plan were the ability of the individual with PHF to comply, bone quality, and fracture type. Most respondents were unsure that there is sufficient PHF rehabilitation literature to guide treatment.
Conclusions:This environmental scan is the first North American study to document practice patterns and attitudes of physiotherapists providing PHF rehabilitation. Elements used by physiotherapists in Ontario treating small numbers of individuals with Neer Group 1 or complex PHFs each year align well with the limited PHF rehabilitation literature available.
Potential implications:Multi-disciplinary collaborations to design and conduct large, high quality, multi-centre prognostic studies and RCTs that evaluate the effectiveness of key aspects of non-surgical PHF rehabilitation in various patient groups are needed. Meanwhile, consensus guidelines should be developed in the context of region-specific physiotherapy service models to inform best practice in PHF rehabilitation management.
Evaluation of Single Bilateral Intratesticular Injection of Cetrimide for Nonsurgical Sterilization of Adult Male Albino Mice
Published on: 27th July, 2020
OCLC Number/Unique Identifier: 8650662346
Nonsurgical fertility control is increasingly advocated as more cost-effective than surgical sterilization to manage stray animal populations in a different part of the world. An experimental study was conducted from December 2018 to April 2019 at Mekelle University to evaluate the effect of single bilateral intratesticular injection of cetrimide 2% in adult albino mice. A total of 20 clinically healthy albino mice selected based on their age and sex and were divided randomly into five groups and evaluation was conducted for 30 days after intratesticular injection of cetrimide solution 2% at the dose rate of 5, 10, 15 and 20 mg per testis and for control 0.1 mL normal saline per testis per 100 g body weight were given. All albino mice were evaluated for 30 days at a fixed interval. Change in body weight, scrotal width, sexual behavior, and fertility performance was also assessed. On day 30, all albino mice were sacrificed for histopathological study. Means ± Standard deviation of the mean, one-way, and a mixed model ANOVA (for repeated measures) was used to summarize the data, determine the effects of group and time on bodyweight and scrotal width. The significant increase in body weight (p - 0.001) and significant reduction of scrotal width (p - 0.001) were noted in all cetrimide treated in comparison to control groups. In addition, there was a significant (p < 0.05) reduction of scrotal width in albino mice after intratesticular injection of cetrimide on day 1, 10, 15, 20, 25, and 30 with respect to their experimental groups. Testicular histology revealed that there were multinucleated giant cells in seminiferous tubules, derangement of tubular architecture along with infiltration of leucocytes and appearance of fibrous tissue were seen on testicular sections at a dose rate of 15 and 20 mg. Similarly, a significant change in the sexual behavior of the treated males and no pregnancy was detected on female albino mice after 21 days post-coital at 10, 15, or 20 mg cetrimide-treated males. In conclusion, a single bilateral intratesticular injection of cetrimide 2% at a dose of 15 and 20 mg might provide an effective way of sterilization and may be considered as an alternative to surgical castration in male animals. Besides, further assessment should be done in the future to identify the mechanism of infertility.
Detection of IDH mutations in cerebrospinal fluid: A discussion of liquid biopsy in neuropathology
Published on: 17th September, 2020
OCLC Number/Unique Identifier: 8873201615
Isocitrate dehydrogenase (IDH) mutations are a common event in secondary glioblastoma multiforme and lower-grade adult infiltrative astrocytomas and independently confer a better prognosis [1,2]. These are highly conserved mutations during glioma progression and thus also a useful diagnostic marker amenable to modern molecular sequencing methods. These mutations can even be detected in sites distant from the primary tumour. We use an illustrative case of a patient with radiologically suspected recurrent astrocytoma and negative histology, but positive IDH-mutated tumour DNA detected within CSF. Our results demonstrated the usefulness of liquid biopsy for recurrent glioma within the context of equivocal or negative histopathological results, whilst also showing the ability to detect a de-novo IDH-2 mutation not present in the previous resection. Building on this ‘proof-of-concept’ result, we also take the opportunity to briefly review the current literature describing the various liquid biopsy substrates available to diagnose infiltrative gliomas, namely the study of circulating tumour DNA, circulating tumour cells, and extracellular vesicles. We outline the current challenges and prospects of liquid biopsies in these tumours and suggest that more studies are required to overcome these challenges and harness the potential benefits of liquid biopsies in guiding our management of gliomas
Clinical characteristics, management, maternal and neonatal outcome among seven severe and critically ill pregnant women with COVID-19 pneumonia
Published on: 30th November, 2020
OCLC Number/Unique Identifier: 8812298810
Pneumonia caused by the Novel coronavirus disease 2019 (COVID-19) is a highly infectious disease and the ongoing outbreak has been declared as a Pandemic by the World health organization. Pneumonia is a serious disease in pregnancy and requires prompt attention. Viral pneumonia has higher morbidity and mortality compared to bacterial pneumonia in pregnancy. All efforts are well exerted to understand the newly emerged disease features but still some areas are gray.
The treatment is primarily supportive with antivirals, steroids, anticoagulation and antibiotics for secondary bacterial infection. Severe cases require intensive care monitoring with oxygen support, mechanical ventilation. Investigational therapies include convalescent plasma, cytokine release inhibitors and other immunomodulatory agents like interferons. The mortality appears driven by the presence of severe Adult Respiratory Syndrome (ARDS) and organs failure.
COVID pandemic is a challenging and stressful socio-economic situation with widespread fear of infection, disease and death. In the specialty of obstetrics and gynecology, studies are being conducted to ascertain the manifestation of disease in pregnant women and the fetal outcome.
The aim of our case series is to describe the demographics, clinical characteristics, laboratory and radiological findings, feto- maternal outcome of severe and critical COVID pneumonia in pregnant women in Latifa Hospital.
Changes in Serum Markers of Atherogenesis and Hematological Profile after the consumption of Quail eggs
Published on: 10th May, 2017
OCLC Number/Unique Identifier: 7286423137
Previous studies suggest that diets with more eggs than is recommended may be used as part of a healthy diet in some countries. However, whether quail egg diets could form part of such diet has not been explored. The aim of the present study is to evaluate the effect of quail egg consumption on serum markers of atherogenesis and hematological parameters in healthy volunteers. Thirty adult subjects participated in this study after ascertaining their baseline health status. They were fed 3 eggs per day and 8hourlyfor 30 days. They were evaluated for serum levels of cholesterol sub-fractions, AIP and hematological parameters at days 0, 10 and 30 after the consumption of quail eggs. At day10, serum levels of cholesterol sub-fractions (TG, HDL-C and LDL-C) were not significantly (p>0.05) different from the corresponding values at baseline. Serum levels of VLDL-C and calculated AIP significantly (p<0.05) decreased compared to the levels at baseline. At day 30, serum levels of HDL-C, TG and VLDL-C significantly (p<0.05) increased, while LDL-C and AIP significantly decreased. Also, total RBC, HB, PCV, MCV, MCH and MCHC were not significantly different from the levels at baseline. At day 30, RBC, PCV and HB significantly (p<0.05) increased compared to the levels at baseline, while MCV, MCH and MCHC were not significantly (p>0.05) different from the baseline values.
Indeed, long-term consumption of quail egg may be associated with improvement in serum markers of atherogenesis and hematological parameters due to its varied nutrient constituents and their activities.
Cytomegalovirus pneumonia and Cryptogenic organizing pneumonia following pediatric stem cell transplantation for leukemia
Published on: 12th September, 2017
OCLC Number/Unique Identifier: 7355939062
Background: Knowledge of pulmonary complications (PCs) in children after hematopoetic stem cell transplantation (allo-HSCT) is limited; most data are from adult studies.
Case: We describe a 8 year old girl with high risk acute myeloid leukemia who developed graft versus host disease (GVHD) on Day 20, Cytomegalovirus (CMV) pneumonia on Day 50 and Cryptogenic organizing pneumonia (COP) on Day 170 after allo-HSCT.
Discussion: Cryptogenic organizing pneumonia is a rare noninfectious PCs that can be idiopathic or have several risk factors as a secondary causes, such as viral respiratory infections, drugs, GVHD and allo-HSCT. Viral respiratory infections and alloimmune lung syndromes have been reported in a few patients who have undergone transplantation.
Conclusion: Transplant physicians should be kept in mind for the development of alloimmune lung syndrome in the form of COP following CMV pneumonia in patients after allo- HSCT
Prevalence of reported drug allergy and its impact on Beta lactam use with financial and health implications
Published on: 22nd August, 2017
OCLC Number/Unique Identifier: 7317598807
Background:While recognition and documentation of true drug allergy is critically important, most physicians acknowledge that its prevalence is likely overestimated, often on the basis of historical, sometimes anecdotal evidence. Correct or not, once applied, drug allergy labels may result in altered, potentially inferior therapy, increased costs and prolonged hospitalisation.
Objective:Estimate the point prevalence, accuracy and symptomatology of self-reported drug allergy in a typical, large NHS Acute Trust adult inpatient population. In the subset with penicillin allergy (PA), estimate additional management costs from the use of alternative antibiotics and readmission rates in the previous 5 years.
Methods:Data on self-reported drug allergies were extracted from 440 adult inpatient prescription charts over a 4 month period. Where penicillin allergy (PA) was reported, alternative antibiotic regimens were recorded and their additional costs calculated. Hospital electronic records were used to assess readmission rates of PA patients.
Results:194/440 inpatients (44.5%) reported at least one drug allergy. Antibiotic allergy was most commonly reported (51%), followed by analgesic (23%) and antiemetic (12%) allergy. PA accounted for 76% of reported antibiotic allergy. The commonest reported symptoms were cutaneous (42%) and gastrointestinal (18%). Where antibiotic therapy was required for patients with PA to manage acute infections, Ciprofloxacin, Clarithromycin, Teicoplanin, Clindamycin and Cefuroxime were the most commonly employed alternatives. Extrapolation of these figures to include the entire Trust inpatient population suggested that the use of alternative antibiotics in PA patients incurred additional annual expenditure of £268,000. Further, 87% of PA patients had been admitted more than once in the preceding 5 years, with 74% requiring further courses of antibiotics during these admissions.
Conclusion:Self-reported drug allergy, and in particular PA, is common in hospital inpatient populations and, in addition to the potentially unnecessary hazards to individual patients resulting from the use of alternative antibiotics, results in a considerable additional financial burden to the healthcare system. This problem could be eliminated by the provision of a nationwide and equitable tertiary Allergy service.
Stem cell therapy in children with acute liver failure: The dream could come true
Published on: 11th January, 2021
OCLC Number/Unique Identifier: 8899340842
Acute liver failure (ALF) in children is a severe disease with a high mortality rate. The current treatment strategies are still defective, with many cases die when liver transplantation is unavailable. The current protocol of steroids therapy improved the survival rate of hepatitis A virus (HAV)-related ALF. However, there is still a high mortality for non-HAV cases. Stem cell therapy (SCT) has been tried in experimental animals with ALF and in few adult studies with acute-on-chronic liver failure. No previous trials of SCT have been tested in children with ALF. The absence of SCT application in ALF in children could be due to some issues. These could be related to safety, sources, administration route, optimum dosage, efficacy, and survival. It is proposed that could be the future therapy if these obstacles have been well studied and solved.
Systematic review and meta-analysis of drug induced liver injury secondary to biologic medications in inflammatory bowel disease
Published on: 1st February, 2021
OCLC Number/Unique Identifier: 8979496760
Drug-induced Hepatotoxicity and biologic drugs have historically been challenging in IBD. We aim to study the prevalence of hepatotoxicity in adult patients using biologic medications.
AsdamarinTM relieves functional dyspepsia in healthy adults in only 7 days: A randomized, double-blind, placebo-controlled pilot study
Published on: 9th July, 2021
OCLC Number/Unique Identifier: 9206105427
Functional dyspepsia (FD) is a prevalent global health concern increasing with years. Inspired by the Traditional Chinese Medicine (TCM) liver-stomach disharmony syndrome in order to find a quick natural alternative treatment, a Ferula asafoetida-Silybum marianum (Asdamarin™) combined extract has been developed and proved its rapid efficiency and its safety with a 7-day randomized, double-blind, placebo-controlled pilot study (CTRI/2018/05/013993 dated 21/05/2018) conducted on 70 healthy human volunteers (aged 18–60 years) supplemented with 250 mg / twice a day of either a placebo or Asdamarin™. Subjects were evaluated from baseline to the end of the study (EOS) through changes in Gastrointestinal Symptom Rating Scale (GSRS), changes in Glasgow Dyspepsia Severity Score (GDSS) and changes in the short form of Nepean Dyspepsia Index (NDI-SF) for Quality of Life. Compared to the baseline a significant reduction (p < 0.001) of GDSS questionnaire score was noted in the Asdamarin™ group (from 5.66 ± 3.1 at baseline to 5.09 ± 2.8 at the End Of Study (EOS)) compared to placebo group (from 2.77 ± 1.3 baseline to 2.69 ± 1.3 EOS), a significant decrease (p < 0.001) of GSRS score noted in the Asdamarin™ group (from 32.11 ± 8.6 baseline to 19.11 ± 5.4 EOS) compared to the placebo group (from 25.23 ± 3.6 baseline to 23.2 ± 4.9 EOS), and a significant reduction (p < 0.001) of NDI-SF scoring was noted in the Asdamarin™ group (from 15.74 ± 4.1 baseline to 11.54 ± 2.1 EOS) compared to placebo group (from 12.54 ± 3.2 baseline to 11.63 ± 2.6 EOS). Asdamarin™ has been found safe and very well tolerated during the study.
The impact of skin disorders on patients’ quality of life in Malaysia
Published on: 24th January, 2019
OCLC Number/Unique Identifier: 7997941944
Background: Skin diseases is a common worldwide problem. It affected every aspect of patients’ quality of life (QOL) mainly physically, socially and psychologically.
Objectives: to assess the impact of skin disorders on patients’ quality of life and to identify factors associated with it.
Methodology: This cross-sectional study was conducted in outpatient dermatology clinic of a tertiary hospital in Malaysia. A random sample of 145 patients with acne, psoriasis and atopic dermatitis (AD) were interviewed using DLQI questionnaire during their scheduled follow-up appointments at dermatology clinic.
Main outcome measure: Self-reported patients’ QOL due to their skin diseases.
Results and discussion: Out of three skin diseases psoriasis patients had the highest prevalence (39.3%) followed by AD (34.5%) and acne (26.2%). Patients’ QOL was highly influenced by their skin conditions especially on working/schooling domain. Furthermore, several factors were identified, namely age, working environment, concurrent skin diseases, usage of supplement for skin diseases and type of food as aggravating factors—that may influence patients’ QOL. QOL among females and younger adults was found to be more significantly influenced as compared to males and elderly. With respect to working environment, those who had both indoor and outdoor working environment showed the highest impact of their skin conditions on their QOL. Single patients were more influenced by their skin conditions when compared to those who are married, however it was not significant.
Conclusion: Our findings revealed skin disease had negatively impacted individual QOL with different level of aspects. Among the three diseases, AD patients had the worst impact on QOL. Significant predictors of QOL did not relate solely to skin diseases but also other factors such as type of food and working environment.
Higher venom-specific IgE levels differentiate children with previous local large reactions from children with previous systemic reactions of different severity
Published on: 19th March, 2021
OCLC Number/Unique Identifier: 8972361005
Introduction: Risk factors for systemic reactions (SRs) from hymenoptera venom (HV) allergy are well known in the adult population but they have been little studied in the pediatric one.
Method: The aim of our study was to identify risk factors for SRs in a population of children allergic to HV, comparing a series of clinical (age, gender, atopy, asthma) and laboratory (total IgE, tryptase, venom-specific IgE levels) variables between patients with at least two large local reactions (LLRs) and patients with SRs of different severity for the identified insect. We selected a population of HV allergic children aged < 15 years with LLRs or SRs stratified according to Mueller grades after stinging.
Results: The population included 80 children, 35 with at least 2 LLRs and 45 with SRs. The level of specific IgE for vespid (Polistes dominula, Vespula species) venoms was significantly higher (p = 0.0321) in children with SRs (Mueller grade II+III+IV) than in those with LLRs and the same significance was also found for specific IgE for Apis mellifera, considering SRs group (Mueller grade I+II+III+IV) in respect with LLRs group (p = 0.0001).
Conclusion: The main difference in our pediatric population was the highest level of specific IgE in children with a history of SRs compared to those with a history of LLRs for both vespids and honey bees. These results, once confirmed on a larger population, could suggest the opportunity to follow the behavior of venom specific IgE in children with LLRs to reveal a risk to develop future more serious reactions.
Predictors of Candidemia infections and its associated risk of mortality among adult and pediatric cancer patients: A retrospective study in Lahore, Punjab, Pakistan
Published on: 18th May, 2018
OCLC Number/Unique Identifier: 7666319312
Objectives: As the cancer patients are at higher risk of premature deaths due to candidemia. So, the present study aims to evaluate the predictors of candidemia along with its outcomes among hospitalized adults and pediatric cancer patients.
Methods: A retrospective study was conducted at a tertiary care cancer hospital in Lahore, Pakistan. The data was collected from the medical records of all the patients who were found positive for Candida species between 1st January 2017 and 31st June 2017. Data were analyzed by using Statistical Packages for Social Sciences (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) and Microsoft Excel (MS Office 2010).
Results: Overall, 135 patients were detected with candidemia. Based on blood culture test results, it was found that out of 100 cultures positive for any microorganism there were 2 cases of candidemia. Multivariate analysis revealed that hematological malignancies (AOR: 2.1), and shock (AOR: 9.1) were significantly associated with high risk of mortalities during the index hospitalization, while risk of mortality among cancer patients suffering from Candida albican infection (AOR: 0.47) and those who were administered with antifungal agent after sensitivity report of the fungal culture (AOR: 0.2) was significantly less. Also, there was no significant association of empiric therapy of antifungal agent with the risk of mortality before a positive culture found (p>0.05).
Conclusion: Although, no risk factor was found to be associated significantly with candidemia among cancer patients. But hematological malignancies, non-albican candidemia and shock were predictors of higher risk mortality during index hospitalization.
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