6 research outputs found
ANTI-TTG AMONG CHILDREN WITH CHRONIC FUNCTIONAL CONSTIPATION UNRESPONSIVE TO 6 WEEKS OF TREATMENT OF CONSTIPATION
ABSTRACT BACKGROUND Celiac disease is a glutten induced enteropathy. Some authors recommended screening celiac in children with constipation. There are studies to evaluate celiac disease in children with constipation. But most of them included children regardless to treatment failure. OBJECTIVE The aim of this study was to evaluate frequency of elevated anti TTG in children with constipation after failure to improve during 6 week of appropriate treatment of constipation. METHODS In this cross sectional study, 550 children with prolonged constipation were included. Place of study was Pediatric Gastroenterology clinic of Abuzar children’s hospital. Prolonged constipation was defined as a constipation which failed to resolved after 6 weeks of appropriate treatment. Constipation was defined according to ROME III criteria. After parental agreement, 5 mL of blood was obtained. Serum anti TTG level was measure using ELISA method by Orientec kit. Anti TTG>10 was considered positive if IgA was normal. SPSS version 16.0 (Chicago, IL, USA) was used for data analysis. Chi square, t-test, and Mann Whitney test used for data analysis. RESULTS In this study 550 children (m=277, f=273) were included. Mean age of the cases was 6.8±2.9 year. Anti TTG antibody level was 5.8±2.8 unit/mL. Of these case, 42 (7.6%) had positive anti-TTG antibody. Celiac disease was confirmed in 40 cases after histopathology examination. CONCLUSION Anti-TTG was positive in 7.6% children with chronic constipation who failed to respond after 6 week of treatment. Another multicenter study with longer follow up period is recommended
RELIABILITY OF BARR, LEECH, AND BLETHYN SCORE IN USING OF PLAIN RADIOGRAPHY IN DETERMINING FECAL IMPACTION IN CHILDREN WITH AND WITHOUT CONSTIPATION
ABSTRACT Background - Several scoring was developed for evaluation of children with fecal retention using plain radiograph. There are controversies about specificity and sensitivity of these scoring system. Objectives - The aim of this study was to evaluate Barr, Blethyn, and Leech score in evaluation of fecal load in plain radiograph. Methods - This case control study was conducted on children aged 2-14 years old with abdominal pain who visited Abuzar children's Hospital of Ahvaz University of Medical Sciences. This study was conducted in fall season. Children with history of previous abdominal surgery, any systemic illness including sickle cell anemia were excluded. Children with constipation were placed in case group. Subjects without constipation were placed in control group. Subjects without exclusion criteria were examined by physician who is blind to aim of the study. Careful history and physical examination was done. Demographic features, history of gastrointestinal problem, duration of abdominal pain, defecation habit, stool consistency (loose, hard), and results of physical examination were recorded. Rome III criteria was used for definition of constipation. Abdominal x-ray was ordered for each patients. Abdominal radiography was reviewed by radiologist. Barr, Leach, and Blethyn scores were calculated for each case. Results - In this study 102 children with functional constipation and 102 children without constipation as a control were included. Mean ±SD for case and control group was 68.39±34.88 and 69.46±32.60 (P=0.82).Leech score (mean ±SD) was 11.05±2.177 and 5.67±3.228 for case and control group respectively (P<0.0001). Barr score (mean ±SD) was 14.86±3.54 and 7.16±5.59 for case and control group respectively (P=<0.0001). Blethyn (mean ±SD) score was 1.97±0.667 and 1.04±0.900 for case and control group respectively (P=0.000). Sensitivity and specificity of Barr score was 83% and 79% respectively. Sensitivity and specificity of Leech score was 92% and 80% respectively. Sensitivity and specificity of Blethyn score was 79% and 92% respectively. Conclusion - Barr, Blethyn and Leech scores were significantly higher in children with abdominal pain and constipation in contrast to children with abdominal pain and without constipation. Sensitivity of Leech score was more than Barr and Blethyn scoring systems. Specificity of Blethyn score was more than Barr and Leech score
Comparison of Classic Sweat Test and Crystallization Test in Diagnosis of Cystic Fibrosis
Objective: Sweat chloride measurement is considered a standard
diagnostic tool for cystic fibrosis (CF). This study was performed to
compare sweat chloride values obtained by quantitative pilocarpine
iontophoresis (classic test) with sweat crystallization detected by
direct observation of a drop of perspiration under light microscopy in
patients with and without CF. Methods: The tests using both techniques
were performed simultaneously in patients with and without CF. Cutoff
values of ≥60 mmol/L of chloride concentration for the classic
sweat test was considered for diagnosis of CF. In crystallization
method, observation of typical dendritic forms of salt crystals under
light microscopy was interpreted positive. Findings: Sixty patients
suspected to CF (31 males and 29 females) with age range of 9 months to
2 years underwent the sweat test using both techniques. Median sweat
chloride values was 26.13+10.85 in group with negative and 72.76+12.78
mmol/L in group with positive sweat test, respectively. All the
patients who had positive sweat test in classic method showed typical
dendritic forms of salt crystal in sweat crystallization test, which
provided the test with 100% sensitivity (95%CI: 93.1-100). Only one of
the 31 subjects with negative results for classic sweat test had
positive result for crystallization sweat test, which provided the test
with 96.7% specificity (95%CI: 92.9-100). Time spent to perform the
crystallization test was significantly shorter than the classic method
whereas its cost was also lower than the second method. Conclusion:
There was a good correspondence between two studied methods of sweat
test. These results suggested the sweat crystallization test as an
alternative test for detecting CF disease with high sensitivity and
specificity