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Assessment of clinical and epidemiological data of inflammatory bowel disease in Egyptian children attending Mansoura University Children Hospital 曼苏拉大学儿童医院埃及儿童炎症性肠病的临床和流行病学资料评估
Pub Date : 2023-01-01 DOI: 10.4103/ajop.ajop_11_23
Othman AbouBakr, Khalid Elkasaby, Mohammed Ezz El regal, T. Barakat
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引用次数: 0
Acute intradialytic blood pressure changes in pediatrics; incidence, risk factors and management: single-center experience 儿科急性血溶内血压变化;发病率、危险因素和管理:单中心经验
Pub Date : 2023-01-01 DOI: 10.4103/ajop.ajop_23_23
Reham Wagdy, MohamedA.E.H Thabet, AdelM Baker, ShaymaaR El Sayed
Background Despite Hemodialysis (HD) is a relatively safe procedure for End Stage Kidney Disease (ESKD) patients, Intradialytic (ID) hypotension and hypertension are frequently reported complications in many adults’ studies. However, little is known about acute intradialytic complications in children. Objective This study aimed to assess the incidence of acute ID blood pressure (BP) changes among children attending the HD unit at our institute. Furthermore, it assessed the possible risk factors and the management options. Patients and methods All children with ESKD on chronic HD were enrolled. A checklist was fulfilled every dialysis session over a six-month period, including patient’s demographic data, dialysis session details: frequency/week, duration of session, ultrafiltration volume, BP, vital signs, IVC diameter, dry weight and predialysis weight. All cases were subjected to echocardiography for estimation of cardiac function. Results Thirty-two patients with mean age of 9.16±2.48 years, and who dialyzed a total of 2678 sessions, were included in the current study. ID hypotension was the top (71.8%) of all complications with an incidence rate of 12.6% in all sessions, followed by ID hypertension (25.7%) with an incidence rate of 4.5% in all sessions. ID hypotension was significantly associated with males, with predialytic hypertension (P<0.001), high ultrafiltration rate (P0.033), and longer durations of sessions (mean >3.56 h±0.56 h) (P<0.001). However, less duration (mean < 3.33 h±0.55) and a lower percentage of ID weight loss were independent risk factors for the development of ID hypertension. Conclusion ID blood pressure changes are the most frequent complications in our study; hypotension is on the top of list (12.6% per sessions) followed by hypertension (4.5% per sessions). ID blood pressure is influenced by multiple risk factors; mainly by predialytic hypertension, duration of session and ID weight loss.
尽管血液透析(HD)对于终末期肾病(ESKD)患者是一种相对安全的治疗方法,但在许多成人研究中,透析性低血压和高血压经常被报道为并发症。然而,对儿童急性溶栓并发症知之甚少。目的本研究旨在评估在我院HD病房就诊的儿童急性ID血压(BP)变化的发生率。此外,它还评估了可能的风险因素和管理方案。患者和方法纳入了所有患有慢性HD的ESKD儿童。在6个月的时间里,每次透析都要完成一份检查表,包括患者的人口统计数据、透析细节:频率/周、持续时间、超滤体积、血压、生命体征、下腔静脉直径、干重和透析前体重。所有病例均行超声心动图评估心功能。结果本研究纳入32例患者,平均年龄9.16±2.48岁,透析总次数2678次。低血压是所有并发症中发生率最高的(71.8%),所有疗程的发生率为12.6%,其次是高血压(25.7%),所有疗程的发生率为4.5%。低血压与男性有显著相关性,伴透析前高血压(P3.56 h±0.56 h) (P<0.001)。然而,持续时间较短(平均< 3.33 h±0.55)和ID体重减轻百分比较低是ID高血压发生的独立危险因素。结论ID血压变化是本研究中最常见的并发症;低血压高居榜首(每次治疗12.6%),其次是高血压(每次治疗4.5%)。ID血压受多种危险因素影响;主要与透析前高血压、疗程持续时间和体重减轻有关。
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引用次数: 0
Herlyn-Werner-Wunderlich (HWW) syndrome: a case report Herlyn-Werner-Wunderlich综合征1例
Pub Date : 2023-01-01 DOI: 10.4103/ajop.ajop_17_23
Vijayan Sharmila, Shalini Singh, Vandana Kamatham, ThirunavukkarasuArun Babu
Herlyn-Werner-Wunderlich (HWW) syndrome OHVIRA syndrome (Obstructed HemiVagina Ipsilateral Renal Agenesis) is rare type of Mullerian duct anomaly, with uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Usually presenting in post-pubertal adolescent girls presenting as pain abdomen or pelvic masses on the side of the obstructed Hemivagina. Here we represent a case report of a 14-year-old girl who presented to our outpatient department complaining lower abdominal pain for 2 months with previous normal menstrual cycles. On General Physical examination well-developed breasts and normal axillary and pubic hair distribution were noted. The Baseline laboratory analysis and hormonal profile were reported normal. Magnetic Resonance Imaging (MRI) provided a fruitful help in correct diagnosis of this rare anomaly. The treatment modality being the surgery to relieve obstruction and its associated complications.
OHVIRA综合征(半阴道梗阻性同侧肾发育不全)是一种罕见的缪勒管异常,伴有子宫凹陷、半阴道梗阻性和同侧肾发育不全。通常出现在青春期后的少女,表现为腹部疼痛或半阴道梗阻一侧的盆腔肿块。在这里,我们报告一个14岁的女孩,她到我们的门诊部抱怨下腹部疼痛2个月,以前的月经周期正常。体格检查发现乳房发育良好,腋毛和阴毛分布正常。基线实验室分析和激素谱报告正常。磁共振成像(MRI)为正确诊断这种罕见的异常提供了卓有成效的帮助。治疗方式为手术解除梗阻及其相关并发症。
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引用次数: 0
Clinico-epidemiological aspects of fever of unknown origin in children: tertiary hospital study 儿童不明原因发热的临床流行病学方面:三级医院研究
Pub Date : 2023-01-01 DOI: 10.4103/ajop.ajop_9_23
Wafaa E.M Attia, MyadaS Elhussiny, SamirM AbuElhassan
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引用次数: 0
Evaluation of serum levels of interferon beta (INF-B) and Nucleotide-binding oligomerization domain 2 (NOD2) gene polymorphism in children with atopic asthma phenotype 儿童特应性哮喘表型血清干扰素β (INF-B)水平和核苷酸结合寡聚化结构域2 (NOD2)基因多态性的评价
Pub Date : 2023-01-01 DOI: 10.4103/ajop.ajop_25_23
RaniaS Aloraby, MagdyM.E Zedan, NashwaK Abousamra, Yahya Wahba, SuzyA El-Mabood Abd El-Hameed
Background People of all ages are primarily affected by the chronic inflammatory disease asthma, which is most common in children. A modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire found 7.7% of Nile Delta schoolchildren had asthma. This research was to show is their association between the underlying gene polymorphisms of NOD2 and serum level of INF beta and atopic asthma phenotype in Egyptian children and evaluate is their relationship between NOD2 gene polymorphism and the serum level of INF beta. Methods The 127 asthmatic children in this case-control study had typical asthma symptoms, and the 39 age- and sex-matched healthy controls. Subjects were divided in to three groups: Atopic asthma phenotype group: included 60 asthmatic children who had allergic rhinitis and atopic dermatitis as a predominant symptom, Wheezy phenotype group: included 67 asthmatic children presented predominantly with wheezes and controls: 39 healthy controls were chosen because they appeared to be in good health, had no history of symptoms similar to those of asthma, and had no relatives who had allergies or asthma. Results Total serum IgE and eosinophil percentage in control groups showed a positive correlation (r=0.640, P=0.006). In asthmatics, serum INF-β and IgE correlated positively (r=0.217, P=0.031). Increased Serum eosinophilic percentage was associated with decreased serum INF-β and increased serum IgE. Conclusions In comparison to the wheezy phenotype group, the percentage of eosinophils is significantly higher in the atopic asthma phenotype. Serum INF-β and IgE levels went up in tandem with the percentage of eosinophils in the blood. rs2066845 NOD2 genotype The GG genotype increased the risk of asthma in general but not the type of asthma.
所有年龄段的人都主要受到慢性炎症性疾病哮喘的影响,这在儿童中最常见。经修订的儿童哮喘和过敏国际研究(ISAAC)问卷调查发现,尼罗河三角洲学童中有7.7%患有哮喘。本研究旨在揭示埃及儿童NOD2基因多态性与血清中INF β水平和特应性哮喘表型之间的关系,并评估NOD2基因多态性与血清中INF β水平之间的关系。方法选取127例哮喘患儿为典型哮喘症状,39例为年龄、性别匹配的健康对照。受试者被分为三组:特应性哮喘表型组:包括60名以变应性鼻炎和特应性皮炎为主要症状的哮喘儿童;喘息表型组:包括67名以喘息为主的哮喘儿童和对照组:选择健康对照组39名,因为他们看起来身体健康,没有类似哮喘的症状史,没有亲属有过敏或哮喘。结果对照组血清总IgE与嗜酸性粒细胞百分比呈正相关(r=0.640, P=0.006)。哮喘患者血清INF-β与IgE呈正相关(r=0.217, P=0.031)。血清嗜酸性粒细胞百分比升高与血清INF-β降低和血清IgE升高相关。结论与喘息表型组比较,特应性哮喘表型组嗜酸性粒细胞百分比明显高于喘息表型组。血清中INF-β和IgE水平随血液中嗜酸性粒细胞百分比的升高而升高。GG基因型总体上增加哮喘风险,但不增加哮喘类型。
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引用次数: 0
Acardiac twinning with sacrococcygeal teratoma–A rare case report and review of literature 心脏双胞胎合并骶尾畸胎瘤1例罕见报告及文献复习
Pub Date : 2023-01-01 DOI: 10.4103/ajop.ajop_16_23
Vijayan Sharmila, Padmapriya Balakrishnan, ThirunavukkarasuA Babu
Acardiac twin is a rare complication of monozygotic twin pregnancies. It accounts for 1% of monochorionic twin gestations with an incidence of 1 in 35,000 births. We report a rare case of acardiac twin with sacrococcygeal teratoma in a monochorionic twin gestation in view of rare incidence and diagnostic challenge.
双心双生是同卵双生妊娠的罕见并发症。它占单绒毛膜双胎妊娠的1%,发生率为1 / 35000。鉴于罕见的发病率和诊断的挑战,我们报告了一例罕见的单绒毛膜双胞胎妊娠的心脏双胞胎与骶尾骨畸胎瘤。
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引用次数: 0
Pituitary and growth disorders of pediatric survivors of head and neck tumors: a single center study 儿童头颈部肿瘤幸存者的垂体和生长障碍:一项单中心研究
Pub Date : 2023-01-01 DOI: 10.4103/ajop.ajop_21_23
Shaymaa Raafat, OmneyaM Omar, Dotto Aron, RehamA Haleem Abo Elwafa, ShadyH Fadel
Objective The aim was to explore the prevalence and risk factors for pituitary and growth disorders in pediatric brain and neck tumor survivors. Methods 203 children with brain or neck tumors that survived 2 years after tumors treatment were included. Demographic data, anthropometric assessments, characteristics of the tumors, tumor treatment modalities, and hormonal profile evaluation were reported. Results After a mean follow-up of 4.77 years, 62 (30.54%) survivors were diagnosed with at least one pituitary disorder. Growth hormone deficiency (GHD) was detected in 17.28% of survivors, moreover, thyroid-stimulating hormone deficiency (TSHD), luteinizing hormone and follicle-stimulating hormone deficiency (LH/FSHD), adrenocorticotropic hormone deficiency (ACTHD)/cortisol deficiency and central precocious puberty were detected in 10.4, 9.09, 8.06, and 1.69% of survivors, respectively. The prevalence of short stature and obesity was 9.1% and 17.05%, respectively among survivors who attended follow-up clinics during data collection. The risk of developing pituitary disorders was associated with craniopharyngioma histology (OR, 6.207; 95% CI, 1.025–37.581) and a history of hydrocephalus at cancer diagnosis (OR, 3.075; 95% CI, 1.402–6.746). Older age at the time of radiotherapy was associated with a lower risk of developing pituitary disorders (OR, 0.928; 95% CI, 0.864–0.997). Conclusion This study observed a high prevalence of pituitary disorders among survivors of pediatric brain and neck tumors. So proper screening of pituitary disorders in survivors of brain and neck tumors is warranted.
目的探讨小儿脑颈部肿瘤幸存者垂体及生长障碍的患病率及危险因素。方法对203例经肿瘤治疗后存活2年的脑、颈部肿瘤患儿进行分析。报告了人口统计数据、人体测量评估、肿瘤特征、肿瘤治疗方式和激素谱评估。结果平均随访4.77年,62例(30.54%)幸存者被诊断患有至少一种垂体疾病。17.28%的幸存者存在生长激素缺乏症(GHD),而促甲状腺激素缺乏症(TSHD)、促黄体生成素和促卵泡激素缺乏症(LH/FSHD)、促肾上腺皮质激素缺乏症(ACTHD)/皮质醇缺乏症和中性性早熟分别占幸存者的10.4%、9.09、8.06和1.69%。在数据收集期间参加随访诊所的幸存者中,身材矮小和肥胖的患病率分别为9.1%和17.05%。发生垂体疾病的风险与颅咽管瘤组织学相关(OR, 6.207;95% CI, 1.025-37.581)和癌症诊断时有脑积水史(OR, 3.075;95% ci, 1.402-6.746)。放疗时年龄越大,发生垂体疾病的风险越低(OR, 0.928;95% ci, 0.864-0.997)。结论:本研究观察到儿童脑颈部肿瘤幸存者中垂体疾病的高发率。因此,对脑瘤和颈部肿瘤幸存者进行适当的垂体疾病筛查是有必要的。
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引用次数: 0
Maternal sickle cell disease leading to placental insufficiency and fetal growth restriction: a case report and review of literature 母亲镰状细胞病导致胎盘功能不全和胎儿生长受限:1例报告和文献复习
Pub Date : 2023-01-01 DOI: 10.4103/ajop.ajop_13_23
Thirunavukkarasu Arun Babu, Padmapriya Balakrishnan, Vijayan Sharmila
Anemia in pregnancy is a common condition having a significant effect on the outcome of pregnancy. A thorough understanding of epidemiology along with proper clinical history, clinical examination and focussed investigations will help to diagnose the cause of anemia early during pregnancy. We report a case of 22-year-old primigravida who presented at third trimester with anemia complicating pregnancy with fetal growth restriction due to sickle cell disease. The sickle cell disease was suspected with histopathological examination of placenta.
妊娠期贫血是一种常见的疾病,对妊娠结局有重大影响。对流行病学的全面了解以及适当的临床病史、临床检查和重点调查将有助于诊断妊娠早期贫血的原因。我们报告一例22岁的初产妇谁提出了在妊娠晚期贫血合并胎儿生长受限,由于镰状细胞病。胎盘组织病理学检查怀疑镰状细胞病。
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引用次数: 0
Role of reticulocyte haemoglobin content in diagnosis of iron deficiency anaemia 网织红细胞血红蛋白含量在缺铁性贫血诊断中的作用
Pub Date : 2023-01-01 DOI: 10.4103/ajop.ajop_24_23
AsmaaA.A Abozid, MohamedA Badr, ShaimaaS.A Elashkar, WeaamA Ismail, Dianna Hanna
Background Multiple studies have demonstrated the value of detecting reticulocyte Hb (CHr) in peripheral blood samples for the diagnosis of iron insufficiency. It has been shown to be a reliable iron marker for gauging the efficacy of iron therapy and giving a precise assessment of iron status. Aim of work To improve the management of children with iron deficiency anaemia via evaluation of the significance of CHr in the diagnosis of IDA and comparing CHr with other iron parameters especially transferrin saturation and serum ferritin. Methods The study was a prospective, case-control study. It was conducted at the out-patient hematology clinic, pediatrics department, Zagazig University Hospital during six months from September 2022 to February 2023 after obtaining approval from Institutional Review Board (IRB #:9660-26-7-2022). Consecutive, non-selected 40 patients referred for anemia diagnosis were included in the study in addition to healthy 40 children of matched age and sex attending pediatric clinics for other causes than anemia who served as control group. All patients were subjected to full history taking, routine clinical examination, laboratory investigations including CBC and (CHr), iron parameters including serum iron, serum ferritin, TIBC, Transferrin saturation. Results The best cutoff of reticulocytes hemoglobin in diagnosis of anemia is ≥28.8%, area under curve 0.943, sensitivity 92.5%, specificity 82.5%, positive predictive value 84.1%, negative predictive value 91.7%, overall accuracy 87.5%. There is statistically highly significant difference between the studied groups regarding reticulocyte hemoglobin. Conclusion Our study demonstrates that CHr is a useful parameter that can be confidently used in the diagnosis of IDA. CHr can be a good predictor of IDA as evidenced by the correlations between the CHr and conventional haemtological and biochemical parameters of iron deficiency anemia.
背景:多项研究表明,检测网织红细胞Hb (CHr)在外周血样本诊断铁不足的价值。它已被证明是一种可靠的铁标记物,用于衡量铁治疗的疗效,并给出铁状态的精确评估。目的通过评价CHr对IDA诊断的意义,并将CHr与其他铁参数特别是转铁蛋白饱和度和血清铁蛋白进行比较,提高对缺铁性贫血儿童的治疗水平。方法采用前瞻性病例对照研究。在获得机构审查委员会(irb#:9660-26-7-2022)批准后,该研究于2022年9月至2023年2月在Zagazig大学医院儿科门诊血液科进行,为期六个月。连续的、未选择的40例被诊断为贫血的患者被纳入研究,另外40名年龄和性别匹配的健康儿童因贫血以外的其他原因在儿科诊所就诊,作为对照组。所有患者均接受完整病史、常规临床检查、实验室检查(包括CBC和(CHr))、铁参数(包括血清铁、血清铁蛋白、TIBC、转铁蛋白饱和度)。结果网织红细胞血红蛋白诊断贫血的最佳临界值≥28.8%,曲线下面积0.943,敏感性92.5%,特异性82.5%,阳性预测值84.1%,阴性预测值91.7%,总体准确率87.5%。两组间网织红细胞血红蛋白的差异有统计学高度显著性。结论CHr是诊断IDA的有效参数,可用于临床诊断。CHr与缺铁性贫血的常规血液学和生化参数之间的相关性证明了CHr可以很好地预测IDA。
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引用次数: 0
Mature teratoma presenting as presacrococcygeal cystic mass in a neonate: a rare case report 成熟畸胎瘤表现为新生儿肩尾骨前囊性肿块:罕见病例报告
Pub Date : 2023-01-01 DOI: 10.4103/ajop.ajop_5_23
T. Babu, P. Balakrishnan
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引用次数: 0
期刊
Alexandria Journal of Pediatrics
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