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Atlantoaxial subluxation in the pediatric patient: Case series and literature review

Published on: 26th November, 2020

OCLC Number/Unique Identifier: 8799428362

Objective: Atlantoaxial subluxation (AAS) occurs when there is misalignment of the atlantoaxial joint. Several etiologies confer increased risk of AAS in children, including neck trauma, inflammation, infection, or inherent ligamentous laxity of the cervical spine. Methods: A single-center, retrospective case review was performed. Thirty-four patients with an ICD-10 diagnosis of S13.1 were identified. Demographics and clinical data were reviewed for etiology, imaging techniques, treatment, and clinical outcome. Results: Out of thirty-four patients, twenty-two suffered cervical spine trauma, seven presented with Grisel’s Syndrome, four presented with ligamentous laxity, and one had an unrecognizable etiology. Most diagnoses of cervical spine subluxation and/or instability were detected on computerized tomography (CT), while radiography and magnetic resonance imaging (MRI) were largely performed for follow-up monitoring. Six patients underwent cervical spine fusion, five had halo traction, twelve wore a hard and/or soft collar without having surgery or halo traction, and eight were referred to physical therapy without other interventions. Conclusion: Pediatric patients with atlantoaxial subluxation may benefit from limited 3D CT scans of the upper cervical spine for accurate diagnosis. Conservative treatment with hard cervical collar and immobilization after reduction may be attempted, but halo traction and halo vest immobilization may be necessary. If non-operative treatment fails, cervical spine internal reduction and fixation may be necessary to maintain normal C1-C2 alignment.
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Validation of Kinetic Stem Cell (KSC) counting algorithms for rapid quantification of human hematopoietic stem cells

Published on: 28th November, 2022

Specific quantification of therapeutic tissue stem cells (TSCs) is a major challenge. We recently described a computational simulation method for accurate and specific counting of TSCs. The method quantifies TSCs based on their unique asymmetric cell kinetics, which is rate-limiting for TSCs’ production of transiently-amplifying lineage-committed cells and terminally arrested cells during serial cell culture. Because of this basis, the new method is called kinetic stem cell (KSC) counting. Here, we report further validations of the specificity and clinical utility of KSC counting. First, we demonstrate its quantification of the expected increase in the hematopoietic stem cell (HSC) fraction of CD34+-selected preparations of human-mobilized peripheral blood cells, an approved treatment product routinely used for HSC transplantation therapies. Previously, we also used the KSC counting technology to define new mathematical algorithms with the potential for rapid determination of TSC-specific fractions without the need for serial culture. A second important HSC transplantation treatment, CD34+-selected umbilical cord blood (UCB) cells, was used to investigate this prediction. We show that, with an input of only simple population doubling time (PDT) data, the KSC counting-derived “Rabbit algorithms” can be used to rapidly determine the specific HSC fraction of CD34+-selected UCB cell preparations with a high degree of statistical confidence. The algorithms define the stem cell fraction half-life (SCFHL), a new parameter that projects stem cell numbers during expansion culture. These findings further validate KSC counting’s potential to meet the long-standing unmet need for a method to determine stem cell-specific dosage in stem cell medicine.
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Case Report of Gardner-Diamond Syndrome

Published on: 25th July, 2023

Gardner-Diamond syndrome or psychogenic purpura is a rare vasculopathy disorder characterized by spontaneous painful purpuric rash without a history of trauma or antiplatelet or anticoagulant therapy. It occurs in women with mental health disorders. Gardner and Diamond in 1955 described a syndrome of auto erythrocyte sensitization which presented in abnormal crops of painful inflammatory ecchymosis in 4 patients at the site of trauma followed by progressive erythema and edema. We present a 52-year-old age woman who was admitted to the internal medicine department and referred for dermatological consultation for recurrent spontaneous purpuric eruptions. The patient was under treatment for depression for many months. Her investigations and coagulation profile were nearly within normal.
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Lipid-induced cardiovascular diseases

Published on: 23rd November, 2017

OCLC Number/Unique Identifier: 7666351562

Cardiovascular diseases are the leading cause of death worldwide. There are many evidences that the dysfunctioning lipotoxicity is the one of major factors of cardiovascular diseases such as, atherosclerosis, hypertension, and coronary heart disease. Obesity and diabetes increase circulating lipids that are likely with more generation of toxic intermediates, which leading to the complications associated with cardiovascular diseases. Indeed, lipotoxicity is a metabolic syndrome caused by abnormal lipid accumulation, which leads to cellular dysfunction and necrosis. Here we review the factors that induced pathogenesis of cardiovascular diseases by lipid accumulation and the mechanisms underlying the lipotoxicity.
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An update on the approaches of avoidance of propagation of chronic kidney disease resulting in reversal or possible need or avoidance of kidney transplantation - a systematic review

Published on: 10th May, 2022

Chronic Kidney Disease (CKD) by definition is a disease characterized by irreversible elimination of renal function, which keeps propagating as corroborated by an estimated glomerular filtration rate (eGFR) of < 60 ml/min/1.73m2, the constant existence of presentation which pointed to Kidney injury (proteinuria, active sediments of urine, histological injury, structural aberrations or prior history with regards to Kidney transplantation) or both that are persistent for greaterthan 3 mths [1].
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Removal of Chromium from Aqueous Solution by Thermally Treated Mgal Layered Double Hydroxide

Published on: 11th January, 2017

OCLC Number/Unique Identifier: 7286428770

MgAl based layered double hydroxide (MgAl-LDH) was used as adsorbent for the removal of chromium oxyanion from an aqueous solution. MgAl-LDH was synthesized successfully using co-precipitation method, and was characterized by X-Ray Diffractometer (XRD), Scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX). MgAl-LDH was thermally treated for improving the chromium adsorption. Samples were treated at 220°C and 450°C. A negligible difference of total chromium adsorption capacities was observed between MgAl-LDH000 and MgAl-LDH220 as 12.56 mg/g and 11.01 mg/g. The maximum chromium adsorption capacity of MgAl-LDH was 88.07 mg/g at 500g/l chromium concentration for MgAl-LDH which has been thermally treated at 450°C (MgAl-LDH450). The results indicated that memory effects of thermally treated MgAl-LDH at certain temperatures were retained and enhanced chromium removal efficiency.
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Laparoscopic surgical treatment of median arcuate ligament syndrome with the retrograde division technique: a case report

Published on: 18th May, 2022

Median arcuate ligament syndrome is a rare entity. This clinical condition develops by compression of the root of a celiac artery with the median arcuate ligament. The typical triad of this syndrome is the following; abdominal discomfort and pain, especially after a meal, and weight loss. In diagnosis, other causes should be ruled out and compression must be demonstrated by any type of imaging method. The main principle of treatment is cutting down the median arcuate ligament. A 54-year-old woman presented with untreatable recurrent abdominal pain and was diagnosed with median arcuate ligament syndrome by imaging with angiographic computed tomography. This patient was operated on. We performed laparoscopic division of median arcuate ligament with the retrograde surgical dissection technique. The patient was discharged from the hospital without any complaint on the third day after surgery. She was still symptom-free after 12 months.The laparoscopic retrograde dissection approach is a safe and feasible treatment modality for median arcuate ligament syndrome.
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Glomerular hyperfiltration in Yemeni children with sickle cell disease

Published on: 12th January, 2021

OCLC Number/Unique Identifier: 8899350598

Background: Glomerular hyperfiltration (GH) is a common feature of sickle cell nephropathy (SCN) starting at infancy and represents an early marker of incipient glomerular injury and renal dysfunction. Methods: This study aimed to determine the prevalence and correlates of GH among children (≤ 16 years) with sickle cell disease (SCD) at their steady state, recruited over 6 months at the Pediatric Outpatient Clinic in Al-Sadaqa General Teaching Hospital, Aden, Yemen. Glomerular filtration rate (eGFR) was estimated using the Schwartz formula. Data on clinical history, anthropometry, blood pressure (BP) and laboratory investigations were collected. Results: Of 101 children (mean age 7.2 ± 3.9 years), 65 (64.4%) were males. The prevalence of GH was observed in 36 (35.6%) children, who were significantly older (10.7 ± 3.2 vs. 5.2 ± 2.7 years, p < 0.001) and had a lower fetal Hb level (5 ± 3.3 vs. 9 ± 7.1, p = 0.02). All children were normotensive, but hyperfiltrating children showed significantly higher systolic (97.2 ± 7.3 vs. 89.7 ± 5.2 mmHg) and diastolic pressure (55.1 ± 5.0 vs. 49 ± 4.3 mmHg) (all p < 0.001). Among evaluated children, 25.7% had hyperfiltration alone, whereas 9.9% had an associated microalbuminuria (MA), and no significant difference in eGFR between those with and without MA (158.4 ± 33.7 vs. 160.7 ± 29.8 ml/min/173m2, p = 0.84). Conclusion: This study demonstrated a relatively high prevalence of GH in Yemeni children with SCD that increased with age. Recognition of hyperfiltration and other early markers of nephropathy in this population could help to develop renal protective strategies to prevent progressive loss of kidney function.
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Contrast Echocardiography for the Detection of a Giant Right Coronary Artery Aneurysm: A Useful Diagnostic Tool

Published on: 22nd August, 2024

Coronary artery aneurysm is an uncommon condition defined as abnormal dilatation of the coronary artery.We report the case of a man admitted to the Emergency Department for suspected intestinal obstruction. At abdominal/thoracic Computed Tomography (CT) it was reported a suspected pericardial cyst. Contrast echocardiography showed a clear pattern of blood flow inside the mass with a probable origin at a very limited region where it was also possible to sample an ECG-synchronized system-diastolic Pulse-Wave (PW)-Doppler pattern, typical for a coronary artery flow. Our suspicion of a giant coronary artery aneurysm was then confirmed by coronary CT and coronary angiography. The patient was transferred to a Cardiac Surgery center where he underwent surgical treatment for the aneurysm.Most coronary aneurysms are clinically silent and are often incidentally detected. Coronary angiography is the ‘‘gold standard’’ for diagnosis and evaluation of coronary artery aneurysms. Among non-invasive diagnostic techniques, Computed Tomography Coronary Angiography is the best method for coronary artery anatomy and coronary abnormalities. However, echocardiography with the use of a contrast agent, a cost-effective non-radiation nature, and a widespread use method, maybe a reliable method to detect and characterize the masses, allowing a differential diagnosis.Learning objective1.    Recognition and evaluation of cardiac masses require first-line imaging methods such as echocardiography.2.    The use of additional non-invasive (cardiac CT or MRI) and/or invasive imaging methods are often required. 3.    Contrast echocardiography may be helpful, as second-line imaging methods, to better characterize the mass and approach the correct diagnosis.
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Edible Mushrooms and Their Holistic Approach on Health

Published on: 14th August, 2023

During this period of time, mushroom experience changes in functional aspects and consumption areas. Due to its magnificent role in promoting health, it was considered one of the most healthy sources of food. Agaricus spp., Marcrolepoita spp., Auricularia spp, Armillaria spp, Pholoita, Hericium, Grifola spp, Flammulina, and Hypsizygus spp. are some most commonly consumed mushrooms in the world. They provide inexpensive means of nutritious and tasty food worldwide. However, ancient people are also very much aware of their holistic function towards health and that was why they used mushrooms for medicinal purposes in the past onwards. Mushroom plays an important role in the treatment of some lethal diseases like cancer, inflammation, autoimmune disorders, allergy, hypertension, arthritis, hyperglycemia, atherosclerosis, and many more. Meanwhile, researchers still focus on other functions of mushrooms in health science and also explore their anticancerous activity. However, many findings are left to be found in the future. This review paper throws light on the various important mushrooms and their functions related to human health, and also ongoing research towards treating some critical diseases.
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