65 research outputs found

    Diagnostic Dilemma of Cardiac Syncope in Pediatric Patients

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    Aims Syncope is defined as temporary loss of consciousness and postural tone resulting from an abrupt transient decrease in cerebral blood flow. The present work aimed at determining how diagnostic tests are used in the evaluation of pediatric syncope at a tertiary pediatric referral center and to report on the utility and the yield of these tests.Settings and Design Retrospective study conducted at a tertiary referral arrhythmolology serviceMethods and Material The clinical charts of 234 pediatric patients presenting with a primary complaint of syncope with an average age of 7.48 ± 3.82(3.5-16) years were reviewed by the investigators.Statistical analysis used Statistical Package of social science (SPSS) version 9,0 was used for analysis of data.Results The commonest trigger for syncope in the study population was early following exercise (n=65) and the commonest prodrome was palpitation, noted in 25 patients. A murmur was present in 19 of our patients (8.3%) while 10.7% (n=25) had abnormal ECGs. Of the 106 echocardiograms done, 14 (13.2%) were abnormal. Only two of them were missed by ECG. All patients were offered ambulatory 24 hour ECG. One patient with sick sinus syndrome was diagnosed only with Holter.Conclusions Clues to the presence of cardiac syncope may include acute onset of syncope, frequent episodes, low difference between blood pressure readings in supine and erect positions (after standing for 2 minutes) and most importantly an abnormal 12 lead ECG. Transthoracic echo and Holter monitoring have low yield in pediatric syncope

    Trans-scrotal single-incision orchidopexy compared with conventional orchidopexy in palpable undescended testis in a Nigerian Tertiary Hospital

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    Background The standard method of treatment of palpable undescended testes is  through inguinal mobilization and a scrotal sub-dartos pouch. Trans-scrotal single-incision orchidopexy may be a suitable alternative.Aim The aim of this study was to assess as to how trans-scrotal orchidopexy compares with conventional orchidopexy in terms of the suitable placement of the testis in a dependent position in the scrotum and the surgical outcome.Patients and methods Forty children with 42 palpable undescended testes were randomly allotted into the conventional and the trans-scrotal orchidopexy groups over an 18-month period. The age, the testicular position, the side involved, the length of the vas gained after isolation and the division of the processus vaginalis, as well as the placement of the testes in the sub-dartos pouch without tension, were recorded. Postoperative complications and the subjective score of the cosmetic appearance of the scars during follow-up for at least 6 months. Success was defined as suitable placement of the testes in the sub-dartos pouch during operation, no conversion of patients in the single-orchidopexy group to the conventional inguinal approach, no complications and excellent cosmetic appearance of scars.Results The two study groups were well matched for age and testicular positions. About 22 (55%) patients had rightsided undescended testes and 16 (40%) had left-sided undescended testes, and in two (5%) patients, it was bilateral. All testes were satisfactorily placed in the subdartos pouch at surgery. Testicular retraction  was observed in one patient in the conventional group, but in two patients in the trans-scrotal group. All wounds healed satisfactorily without infection. The overall wound complication rate in the trans-scrotal and the conventional groups were 2/21 and 3/21, respectively. In terms of the cosmetic appearance of the scar, patients in the trans-scrotal group had excellent cosmetic appearance as the scars were less visible and hidden in the rugal fold compared with the conventional method.Conclusion Trans-scrotal orchidopexy for palpable undescended testis is simple, safe and has a better cosmetic scar compared with the conventional approachKeywords: conventional, orchidopexy, testis, trans-scrota

    Determination of insecticides malathion and lambda-cyhalothrin residues in zucchini by gas chromatography

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    AbstractA sensitive gas chromatographic method has been developed for the determination of malathion and lambda-cyhalothrin (λ-cyhalothrin) insecticide residues in zucchini. The developed method consists of extraction with acetone, purification and partitioning with methylene chloride, column chromatographic clean-up, and finally capillary gas chromatographic determination of the insecticides. The recoveries of method were greater than 90% and limit of determination was 0.001ppm for both insecticides. The method was applied to determine residues and the rate of disappearance of malathion and λ-cyhalothrin from fruits of zucchini (open field treatment, 50cc of Malason/Cormandel 57% EC (emulsifiable concentrate) for 100L of water, 20cc of LAMBDA SUPER FOG 5% liquid for 100L of water). The insecticide incorporated into the plants decreased rapidly with a half-life time around 0.77day (18.5h) for malathion and 4days for λ-cyhalothrin. It is not recommended to use zucchini before 12h of malathion application. For λ-cyhalothrin, the preharvest interval is 5days. Four market samples were chosen from different regions from A.R.E. and all of them showed no residues of malathion or λ-cyhalothrin

    Microplastic and natural sediment in bed load saltation: material does not dictate the fate

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    Microplastic (MP) pollution is a well document threat to our aquatic and terrestrial ecosystems, however, the mechanisms by which MPs are transported in river flows are still unknown. The transport of MPs and natural sediment in aquatic flows could be somewhat comparable, as particles are similar in size. However, it is unknown how the lower density of MPs and their different material properties impact their transport dynamics. To answer this, novel laboratory experiments on bed load saltation dynamics in an open-channel flow, using high-speed camera imaging and the detection of 11,035 individual saltation events were used to identify the similarities and differences between spherical MPs and spherical natural sediments transport. The tested MPs varied in terms of size and material properties (density and elasticity). Our analysis shows that the Rouse number accurately describes saltation length, height, transport velocity and collision angles equally well for both MPs and natural sediments. Through statistical inference, the distribution functions of saltation trajectory characteristics for MPs were analogous to natural sediment with only one sediment experiment (1.4 % of cases) differing from all other plastic experiments. Similarly, only nine experiments (9.3 % of cases) showed that collision angles for MPs differed from those of natural sediment experiments. Differences observed in terms of restitution become negligible in overall transport dynamics as turbulence overcomes the kinetic energy lost at particle-bed impact, which keeps particle motion independent from impact. Overall, spherical MP particles behave similarly to spherical natural sediments in aquatic environments under the examined experimental conditions. This is significant because there is an established body of knowledge for sediment transport that can serve as a foundation for the study of MP transport

    Serum Amyloid A Level in Egyptian Children with Familial Mediterranean Fever

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    Background and Objectives. SAA is an acute-phase reactant detected during an FMF attack or other inflammatory conditions. High SAA levels may increase the risk of amyloidosis. The aim of the study is to measure the serum amyloid A (SAA) level in a group of Egyptian children with familial Mediterranean fever (FMF) and study its various correlates, if any. Methods. The study enrolled seventy-one children with FMF. Results. SAA level was high in 78.9% of the studied patients with a mean of 81.62±31.6 mg/L, and CRP was positive in 31% of patients. There was no significant releation between SAA level and any demographic or clinical manifestation. High SAA was more frequent in V726A allele (16.9%) followed by M694V allele (12.3%). Elevated SAA levels were more frequent in patients on low colchicine doses. Forty-five percent (45%) of patients have low adherence to colchicine therapy. Interpretation and Conclusion. High SAA levels were detected two weeks after last FMF attack in a large percentage of Egyptian FMF children. This indicates that subclinical inflammation continues during attack-free periods, and SAA could be used as a marker of it

    PPIP5K2 and PCSK1 are Candidate Genetic Contributors to Familial Keratoconus

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    Keratoconus (KC) is the most common corneal ectatic disorder affecting >300,000 people in the US. KC normally has its onset in adolescence, progressively worsening through the third to fourth decades of life. KC patients report significant impaired vision-related quality of life. Genetic factors play an important role in KC pathogenesis. To identify novel genes in familial KC patients, we performed whole exome and genome sequencing in a four-generation family. We identified potential variants in the PPIP5K2 and PCSK1 genes. Using in vitro cellular model and in vivo gene-trap mouse model, we found critical evidence to support the role of PPIP5K2 in normal corneal function and KC pathogenesis. The gene-trap mouse showed irregular corneal surfaces and pathological corneal thinning resembling KC. For the first time, we have integrated corneal tomography and pachymetry mapping into characterization of mouse corneal phenotypes which could be widely implemented in basic and translational research for KC diagnosis and therapy in the future
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