Impact of Breast Milk Secretory Immunoglobulin A on Infants Acute Gastroenteritis

BACKGROUND: Acute gastroenteritis is one of the most common infections in childhood and it can be especially dangerous in the first 6 months of life with a higher risk of moderate and severe dehydration, especially in infants who are not exclusively breastfed. Secretory immunoglobulin A (sIgA) is the first line of defense on the intestinal epithelium from pathogenic microorganisms and intestinal toxins. AIM: The aim of this study was to determine whether breast milk sIgA has some protective effect on the intestinal epithelium as well as on the severity and duration of the clinical signs in infants with acute gastroenteritis depending on the type of nutrition. MATERIALS AND METHODS: A total of 23 infants with acute gastroenteritis divided into two groups based on the feeding patterns (type of milk) were included in the study. Investigated indicators were severity of symptoms, dehydration degree, and the need for parenteral rehydration. RESULTS: We identified a statistically significant association between group affiliation and the sIgA levels in stool between the first and the second groups (p = 0.001346). The most common cause of acute gastroenteritis in infants was Rotavirus. Our study has shown that exclusive breastfeeding reduces the risk of Rotavirus infection, especially in the first 6 months of life, OR = 0.0758, 95% confidence interval (CI) (0.0071–0.8074). CONCLUSION: The presence of breast milk sIgA in infants has an effect on the severity of the clinical picture of acute gastroenteritis by reducing the frequency of vomiting, the number and severity of diarrheal episodes, the risk of moderate and severe dehydration, and fever frequency

Alpha Glutathione S-transferase – A Potential Biomarker for Intestinal Epithelial Damage in Infants with Acute Gastroenteritis

BACKGROUND: Acute gastroenteritis is a leading cause of morbidity and mortality in children under 3 years of age worldwide and mostly can be dangerous in the first 12 months of life especially in infants who are not exclusively breastfed. Intestinal pathogens cause enterocyte infection which leads to cell death, lumen extrusion, and intestinal villous atrophy. AIM: The aim of this study was to assess whether alpha glutathione S-transferase (α-GST) can be a biomarker for early intestinal epithelial damage in infants with acute gastroenteritis and the degree of correlation of its serum values with the degree of intestinal epithelial damage associated with infant nutrition. MATERIALS AND METHODS: A total of 23 infants with acute gastroenteritis divided into two groups based on the feeding patterns (type of milk) were included in the study. The values of α-GST in serum between exclusively breastfed and non-exclusively breastfed infants were examined. RESULTS: It was found a statistically significant association between group affiliation and the α-GST levels in serum between the first and the second group (p = 0.002260). It was revealed that Rotavirus can cause erosion of the intestinal epithelium through the positive values of α-GST in Rotavirus positive cases. CONCLUSION: In this study, it was found that α-GST is a biomarker for early intestinal epithelial damage in infants primarily with Rotavirus acute gastroenteritis. α-GST serum values were significantly lower in infants who were exclusively breastfed compared with infants who were not exclusively breastfed

Анемии во детската возраст

Анемија е состојба каде што циркулирачката маса на крв не ги задоволува потребите на ткивата од кислород, т.е концентрацијата на хемоглобинот во крвта е пониска од нормалната, а при тоа бројот на Ер може да биде нормален, помал па и поголем. Долната граница на хемоглобинот е индивидуална и зависи од полот и возраста (возрасен Hgb<130g/l, новородено < 150 g/l, до 6 месеци Hgb < 95 g/l, од 6 месеци до 6 години Hgb< 110 g/l, од 7-14 години Hgb < 120 g/l).Анемиите се почести во детската возраст поради зголемените потреби поврзани со обновата на ткивата и системите и процесот на растење и развиток ( кај деца под 5 години и во пубертет)

Pleuropneumonia in a 7 Year Old Boy

Background: Pleuropneumonia takes a prominent place in childhood morbidity. Very often in children it can be manifested with atypical clinical presentation. Objective: To present atypical case of Pleuropneumonia in a seven year old boy. Methods: Seven year old boy with acute onset headache, abdominal pain, vomiting and febrile. On physical examination conscious, febrile (39 C), pale, dehydrated, pharynx hyperemic, abdominal distension and pain on abdominal palpation. Blood test with leucocytosis (Le= 31), elevated infalamotory markers (CRP=221mg/l), abdominal ultrasound with normal findings. Abdominal x ray - Mesohypogastric righ with distended intestinal viscera and with hydroaeric levels in formation. Due to suspicion of an acute abdomen, the child was transferred to the surgical department. After 12 hours of obsrevation still febrile, dehydrated, but with acute appearance of tachidispnea and chest pain on the left hemitorax. On examination febrile 40 C, tachidispnoic. Lung auscultation - vesicular breathing weakened to the left in the middle and basal parts. Chest x ray - Paracardiac basal left with larger zone of non-homogeneous shading in addition to inflammatory consolidation, right with peribronchitic infiltrates and sings of pleural effussion - Left dome of the diaphragm isn’t followed and left frenicocostal sinus is shaded. Pleural ultrasound showed pleural effusion in left frenicocostal sinus. Results: After appropriate antibiotic treatment, oxygen therapy, corticotherapy and inhalation therapy with a complete regression of the auscultatory finding. Control chest x ray and pleural ultrasound with complete regression of inflammatory consolidation and pleural effusion. Conclusion: Very often pleuropneumonia in children can be manifested with atypical clinical picture and it’s a diagnostic and therapeutic problem because it’s often not recognized and not thought of

Hemorrhagic shock as a primary and unusual manifestation of gastric cancer

Gastric cancer represents a major health burden worldwide.The cause of gastric cancer is multifactorial, although infection with Helicobacter pylori is considered to be the primary cause. The early stages of gastric cancer are usually asymptomatic or associated with nonspecific symptoms, such as dyspepsia. Advanced stages and ulcerated tumors may be associated with signs of upper digestive bleeding and hemorrhagic shock. Upper gastrointestinal endoscopy is the first preferred diagnostic procedure. The only chance for cure of gastric cancer is surgical removal of the tumor and the adjacent lymph nodes. Case report: 67 year old male presented with melena and haematemesis. On examination pale, covered with cold sweat, adynamic, hypotensive TA = 60/30 mmHg in hemorrhagic shock. After initial stabilization esophagogastroduodenoscopy was performed and showed irregular and longitudinal ulceration with elevated and subminated edges, necrotic bottom of the lesion with a fixed coagulum. Gastric cancer was suspected and the patient was transferred to Digestive Surgery where a total gastrectomy was performed. The pathohistological finding is in addition to gastric adenocarcinoma.Conclusion: Epidemiologic studies suggest that eating more fresh fruit and vegetables, eating less salted food and eradicating Helicobacter pylori can decrease the risk of gastric adenocarcinoma. The best way for prevention is to carry out an effective screening program in high-risk groups and in high-incidence areas, so that early discovery, early diagnosis and early treatment can be achieved

Навики во исхраната и нутритативниот статус на децата

Раното детство е најважно за целокупниот развој на личноста. Во овој период кај детето се јавува сознание дека тоа е самостојна единка која и припаѓа на својата средина, а се изразува преку определени барања, желби, акции, постапки и однeсување

Child with cholestatsis and massive hepatomegaly

Во овој труд се зборува случај на женско дете на 2,5 годишна возраст со појава на нагло пожолтување и масивна хепатомегалија и изразито заостанување во растот и развојот како во висина така и во тежина. По целокупното испитување во матчниот центар и сомневање за карцином на црн дроб детето е префрлено на понатамошно испитување на Клиниката за детски болести во Скопје каде е дијаганостицирано заболувањето Цистична фиброза. По започнување на соодветна терапија со суплементација со панкреасни ензими, соодветна терапија со додаток на мултивитамински и енергетски препарати постигнато е забележително напредување во висина и тежина како и повлекување на жолтицата и хепатомегалијата

Cisticna fibroza- klinicka prezentacija, dijagnoza i tretman

Cystic fibrosis (CF) or mucoviscidosis is the most common inherited disease of white race. Is a heterogeneous multisystem disease that affects many epithelial organs, especially exocrine glands. Clinically important phenomena in the lining of the bronchus and lung, pancreas, bile ducts, intestine, salivary, sweat glands and seminal ducts. But most of the patients have chronic lung disease, pancreatic insufficiency, and increased concentration of chloride in the sweat that forms the famous triad of cystic fibrosis. Prognosis of most patients with cystic fibrosis determines chronic pulmonary disease and it is still a major cause of death in these patients

Карцином на простата – дијагноза,третман,препораки

Prostate cancer is an individual and unpredictable disease whose malignant potential can not always be predicted. The prostate cancer grows slowly and takes 10 to 15 years to manifest symptoms. Prostate cancer in Macedonia is on the rise, while awareness of timely medical examinations is very small. Annually from the disease, which is second reason of mortality in men, affects about 70 new patients annualy, and 90% are detected at a late stage when complete cure is not possible. Prostate cancer if detected promptly with timely therapy leads to cure in 98% of cases

Пристап кон пациент со НСТЕМИ миокарден инфаркт

За НСТЕМИ зборуваме кај : 1.пациенти со акутно настаната болка во градниот кош и без СТ елевации во ЕКГ 2. Пациенти кои имаат постојани или повремени СТ денивелации или инверзен (негативен ) Т бран, аплатиран Т бран , псевдонормализација на Т бранот или пак се без промени во ЕКГ-то. 3. Зголемен Т тропонин- (маркер кој е зголемен при уништување на миокардните клетки