Damage index in childhood-onset systemic lupus erythematosus in Egypt

<p>Abstract</p> <p>Background</p> <p>To investigate the prevalence of cumulative organ damage among Egyptian children with juvenile-onset systemic lupus erythematosus (jSLE) and the relationships between the organ damage and the demographic data, clinical variables, and disease activity.</p> <p>Methods</p> <p>A total of 148 patients with jSLE have been followed in the pediatric rheumatology clinic and section at Cairo University. These patients were evaluated by retrospective chart review. The organ system damage due to SLE was measured using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Risk factors for damage were also studied including demographic criteria as well as clinical and laboratory manifestations.</p> <p>Results</p> <p>Overall, 43.9% of the patients had damage within a mean of 6.57 ± 3.59 years of disease diagnosis. Neuropsychiatric (NPS-21%) and renal (16.9%) system involvement were observed most frequently, followed by cardiovascular (11.5%), skin (9.5%), pulmonary (6.1%), and ocular (4.8%), with a mean SDI score of 0.93 ± 1.37. In our study, the presence of neuropsychiatric manifestations at diagnosis showed the strongest association with the presence of later disease damage.</p> <p>The number of SLE diagnostic criteria at presentation was strongly associated with the total SDI score, and the renal damage was significantly more prevalent in patients with age at disease diagnosis below 10 years of age. A higher mean disease duration was found in patients with musculoskeletal damage.</p> <p>Conclusion</p> <p>We found that cumulative organ damage, as measured by the SDI, was present in 43.9% of Egyptian patients with juvenile-onset SLE. The damage was significantly more likely in patients who had more SLE diagnostic criteria at time of disease presentation and NPS manifestations at the time of diagnosis.</p

Implementation of a bowel management program in the treatment of incontinence in children for primary healthcare providers

Objectives: Our surgical team has devised a bowel management program (BMP) as a basic approach for primary healthcare providers with the least use of resources.Background: Soiling in children is a major problem that has a serious impact on the child’s social and psychological life. Causes vary from idiopathic constipation to postoperative or neuropathic causes as meningomyelocele.Participants and methods: Seventy five children suffering from fecal incontinence were assessed and divided into true incontinence and pseudoincontinence groups. The BMP was applied to both categories in the form of proper diet control, enemas, drugs, and bowel habit alteration. The program was fashioned according to the age, type, severity, and response of each case. A fecal incontinence scoring system was used to assess the results.Results: All cases with pseudoincontinence attained 50% or more improvement in incontinence score whereas the true incontinence cases attained excellent results except in post high anorectal malformation repairs and neurologic groups.Conclusion: Most of the cases suffering from constipation with pseudoincontinence can be treated properly by BMPs, whereas the minority suffering from true incontinence need multidisciplinary work to achieve acceptable results.Keywords: anorectal malformations, bowel management program, chronic idiopathic constipation, fecal incontinence, Hirschsprung’s disea

Liver Enzymes in Children with beta-Thalassemia Major: Correlation with Iron Overload and Viral Hepatitis

BACKGROUND: Beta Thalassemia is the most common chronic hemolytic anemia in Egypt (85.1%) with an estimated carrier rate of 9-10.2%. Injury to the liver, whether acute or chronic, eventually results in an increase in serum concentrations of Alanine transaminase (ALT) and Aspartate transaminase (AST).AIM: Evaluating the potentiating effect of iron overload &amp; viral hepatitis infection on the liver enzymes.PATIENTS AND METHODS: Eighty (80) thalassemia major patients were studied with respect to liver enzymes, ferritin, transferrin saturation, HBsAg, anti-HCV antibody and HCV-PCR for anti-HCV positive patients.RESULTS: Fifty % of the patients were anti-HCV positive and 55% of them were HCV-PCR positive. Patients with elevated ALT and AST levels had significantly higher mean serum ferritin than those with normal levels. Anti-HCV positive patients had higher mean serum ferritin, serum ALT, AST and GGT levels and higher age and duration of blood transfusion than the negative group. HCV-PCR positive patients had higher mean serum ferritin and serum ALT and also higher age and duration of blood transfusion than the negative group.CONCLUSION: Iron overload is a main leading cause of elevated liver enzymes, and presence of HCV infection is significantly related to the increased iron overload

Discharge coefficient and jet deflection studies for combustor liner air-entry holes

In the simple tubular combustor system for turbojets and ramjets, figure 1, at the primary zone it is required to achieve a high heat release and stable flame. At the dilution cone to have a good air flow distribution (Ref. I ), and adequate penetration. In both zones these requirements needs to be with the minimum total pressure loss for high overall efficiency, short liner length, and light simple construction (Ref. 2 ). The air flow distribution between these two zones is still the main problem of the design engineer. But the flow of annular air to these zones is governed by the geometry of the eyetem, hole coonetry and dicehargo coefficient of these holes. For light construction and adequate penetration, the main governing factor is the deflection angle of the liner jots. Cont/d

Multidetector CT evaluation of alternative diagnosis of clinically suspected acute appendicitis, appendicular and nonappendicular lesi

Objective: To assess the accuracy of MDCT in diagnosis and preoperative evaluation of alternatives of acute appendicitis causing RLQP and associated complications. Patients and methods: 350 consecutive patients (250 males and 100 females) with ARLQP underwent MDCT examinations with contrast. Each scan was evaluated independently for the presence of inflammatory process (appendicitis), associated complications and for the detection of other findings rather than acute appendicitis causing RLQP. The radiological findings were compared with histopathological results for operated cases. Results: 146 typical cases out of 350 patients received CT diagnosis of acute appendicitis, 62 with complications such as appendicular abscess (n = 32), appendicolith (n = 7), mucocele (n = 15), retrocecal appendix (n = 5), and retroileal appendix (n = 3); 63 patients received nonappendicular GIT causes, and 79 patients received alternative diagnosis of extra-GIT causes; patients who were operated upon based on either clinical diagnosis or US findings or both, with negative CT findings and pregnant women were excluded from the study. Conclusion: MDCT can be used effectively in the preoperative evaluation of appendicitis, provides high accuracy for detecting complications, detects other findings causing RLQP, and better guides physicians for proper management of these patients

Synthesis and spectral studies of manganese(II), cobalt(ll), nickel(II), copper(II), zinc(II), cadmium(ll) and mercury(II) complexes of 4-oxo-4H-1-benzopyran- 3-carboxaldehyde hydrazone derivatives

308-312A few complexes of Mn(II), Co(II), Ni(II), Cu(II), Zn(II), Cd(II), and Hg(II) with 4-oxo-4H-1 benzopyran- 3-(carboxaldehyde-4-chlorobenzylhydrazone) (BCBH) and 4-oxo-4H-1-benzopyran- 3- (carboxaldehyde-4-methylbenzylhydrazone) (BMBH) have been synthesised and characterized by elemental analysis, molar conductivities, magnetic measurements and IR and visible spectral studies. The IR spectra show that BCBH and BMBH behave as bidentate ligands either in the keto or enol form