The prevalence of atopic dermatitis among children aged between 6 months and 12 years attending primary health care clinics in Qatar 2018-2019

Background: The prevalence of atopic dermatitis among children appears to have increased dramatically over the past decades. Such rapid increase in prevalence cannot be explained fully. Genetic factors, microbiomes (especially staphylococcus aureus infection), food allergy and environmental factors might play a role in such an increment. This study aimed to report the prevalence of atopic dermatitis among children aged 6 months to 12 years attending primary health care centers in Qatar during the year 2018 and 2019.Methods: Cross-sectional retrospective data analysis of all registered cases having at least one visit in any of the 28 health centers dermatology clinics operated by PHCC with a verified diagnosis of atopic dermatitisResults: Out of 4521 patients dermatology clinic visit, 1359 had atopic dermatitis during the period of 2018 and 2019, and the prevalence rate is 30.06 (95% CI 28.72-31.42). In this 1359 atopic dermatitis cases, mean age of patients was 5.09±3.53 years and ranged from 6 months to 12 years. In this 18.9% was <1 years, 41.43% was 1-5 years, 19.35% was 5-8 years and 21.04% was 8-12 years. Prevalence of AD is high in boys 31.42% than girls 28.81% and is high in Qatari population 34.4% than the non-Qatari population 28.7%. The most frequently prescribed medication group was topical emollients (89.8%) followed by antihistamine (81.24%) and antibiotics (56.73%). Steroids were prescribed only for 7.3% of cases.Conclusions: In this study the prevalence of atopic dermatitis was remarkably very high in young children in Qatar. Further prospective research and more efforts are needed to develop a standard treatment regimen for allergic diseases in Qatar

Investigation of an epidemic of Hepatitis E in Nellore in South India

Objective: To determine the incidence of acute hepatitis because of hepatitis E virus (HEV) and the source of the epidemic in Nellore in south India in 2008. Methods: Anti-HEV IgM ELISA and RT-PCR for HEV-RNA were carried out on blood and stool samples from patients with acute hepatitis presenting to different hospitals in the city. The city was divided into 33 clusters, and 20 families from each cluster were systematically interviewed to determine the incidence of hepatitis E in the city. The survey was conducted on 2685 residents of 673 households from 24th November to 4th December 2008. Results: The overall incidence of hepatitis was 5.7% (152/2685), i.e. an estimated 23 915 persons in the city were affected. There were two deaths because of acute hepatitis in the population surveyed translating to an estimated 315 deaths. Men had higher attack rates than women (7.8%vs. 3.5%) and young adults compared to children under 5 years (6.9%vs. 2.9%). Families drinking water from the pumping station at Bujjamarevu had the highest attack rate of 54.5% (39.8-69.2%). HEV IgM antibodies were present in 80/100 plasma samples tested. HEV-RNA was detected in 43/100 individuals tested, and isolates were characterized as genotype 1 by sequencing. Conclusion: Sewage draining into the river close to the pumping stations and broken pipelines crossing sewage drains may have triggered this large outbreak

Genogroup IIb Norovirus Infections and Association with Enteric Symptoms in a Neonatal Nursery in Southern India▿

Noroviruses (NoVs) are increasingly recognized as an important cause of acute gastroenteritis in children worldwide. However, there are limited data on the role of NoVs in neonatal infections and disease. The objectives of the present study were to determine the prevalence of NoVs in neonates with gastrointestinal disease using a case-control study design and to characterize the NoV strains infecting neonates. A total of 309 fecal samples from 161 neonates with gastrointestinal symptoms and 148 asymptomatic controls were screened for genogroup II (GII) NoV using reverse transcription-PCR. A subset of PCR-positive amplicons for the polymerase and capsid regions was sequenced. NoV was detected in 26.2% of samples, with the rate of detection being significantly higher among symptomatic neonates (60/161, 37.2%) than asymptomatic neonates (24/148, 14.1%) (P < 0.001). On the basis of sequencing of 29 strains, a single NoV strain, GIIb, was identified to be the predominant (27/29, 93.1%) cause of neonatal infections. Coinfection with rotavirus was seen in nearly one-third of symptomatic neonates. The study demonstrates a high prevalence of NoV infections in neonates and indicates that coinfection with rotavirus may result in significantly more gastrointestinal disease in this population

Meta-Analyses of Microarray Datasets Identifies ANO1 and FADD as Prognostic Markers of Head and Neck Cancer.

The head and neck squamous cell carcinoma (HNSCC) transcriptome has been profiled extensively, nevertheless, identifying biomarkers that are clinically relevant and thereby with translational benefit, has been a major challenge. The objective of this study was to use a meta-analysis based approach to catalog candidate biomarkers with high potential for clinical application in HNSCC. Data from publically available microarray series (N = 20) profiled using Agilent (4X44K G4112F) and Affymetrix (HGU133A, U133A_2, U133Plus 2) platforms was downloaded and analyzed in a platform/chip-specific manner (GeneSpring software v12.5, Agilent, USA). Principal Component Analysis (PCA) and clustering analysis was carried out iteratively for segregating outliers; 140 normal and 277 tumor samples from 15 series were included in the final analysis. The analyses identified 181 differentially expressed, concordant and statistically significant genes; STRING analysis revealed interactions between 122 of them, with two major gene clusters connected by multiple nodes (MYC, FOS and HSPA4). Validation in the HNSCC-specific database (N = 528) in The Cancer Genome Atlas (TCGA) identified a panel (ECT2, ANO1, TP63, FADD, EXT1, NCBP2) that was altered in 30% of the samples. Validation in treatment naïve (Group I; N = 12) and post treatment (Group II; N = 12) patients identified 8 genes significantly associated with the disease (Area under curve>0.6). Correlation with recurrence/re-recurrence showed ANO1 had highest efficacy (sensitivity: 0.8, specificity: 0.6) to predict failure in Group I. UBE2V2, PLAC8, FADD and TTK showed high sensitivity (1.00) in Group I while UBE2V2 and CRYM were highly sensitive (>0.8) in predicting re-recurrence in Group II. Further, TCGA analysis showed that ANO1 and FADD, located at 11q13, were co-expressed at transcript level and significantly associated with overall and disease-free survival (p<0.05). The meta-analysis approach adopted in this study has identified candidate markers correlated with disease outcome in HNSCC; further validation in a larger cohort of patients will establish their clinical relevance

Validation with the TCGA database.

<p>The selected markers were analyzed in the TCGA database for the co-expression, overall survival and disease free survival for their significance in the HNSCC TCGA provisional study. <i>ANO1</i> and <i>FADD</i> showed highest correlation in the co-expression analysis (A) with Pearson’s and Spearman’s correlation (0.68). <i>ANO1</i> and <i>FADD</i> were further analyzed for their overall survival (OS) (B and D) and Disease free survival (DFS) (<i>ANO1</i>; C). Patients with <i>ANO1</i> over-expression showed low median survival (18.96 vs 56.44 months; p = 0.0003) and low DFS (20.04 vs 53.09 months; <i>p</i> = 0.02) when compared with the cohort without alterations (B and C). <i>FADD</i> showed association with OS wherein low median survival (21.48 vs 57.42; <i>p</i> = 0.002) was observed in patients with an upregulation of the gene (D). Both <i>ANO1</i> and <i>FADD</i> when assessed in combination, were associated with low median survival (21.48 vs 57.88; <i>p</i> = 0.0007) (E) and disease free survival (25.72 vs 53.09; <i>p</i> = 0.04) (F) in altered cases when compared to cases without alterations.</p

Validation of the markers in patients.

<p>Quantitative gene expression profiling of the selected markers was carried out in Group I (primary; A) and the Group II (recurrent; B) cohort. <i>PLAC8</i> and <i>UBE2V2</i> were validated in all the samples (100%) of Group I with regard to regulation trends whereas other genes showed similar trend in >60% of the samples. In Group II, >60% of the patients showed concordant regulation trends for four genes. Based on the patient follow-up, the Group I was sub-categorized into non-recurrent (C) and recurrent (D) and the expression was further evaluated. ROC curve analysis in the Group I patients showed that <i>PLAC8</i> (E), <i>FOS</i> (F), <i>ANO1</i> (G) and <i>UBE2V2</i> (H) had highest association with the disease (AUC >0.8). Bar represents the median fold change of Normals.</p

Identification of Protein-Protein Interaction.

<p>Analysis for protein-protein interaction by STRING network identified two major interconnecting clusters with high degree interactions between the genes (N = 122). These 2 major clusters were interconnected by the nodes MYC, FN1, FOS and HSPA4. The number of lines represent the levels of evidence as indicated in the color legend. The different sizes of the node are based on the extent of protein structural information available for each gene while the colors of the node are a visual aid used for better representation. The markers from this analysis selected for patient validation are encircled.</p