Cow\u27s Milk Protein-Induced Villous Atrophy and Elevated Celiac Autoimmunity in Children with Celiac Disease on a Glutten-Free Diet: A Report of Three Cases

Objective: To describe the serologic and histologic response of three patients with celiac disease who had persistent autoimmunity and villous atrophy despite a strict gluten-free diet, to the elimination of cow\u27s milk protein

All tTG positive patient do not have celiac disease

Tissue transglutaminase antibody IgA level (tTG) is an excellent screening test for celiac disease in the presence of adequate IgA levels. Most labs while screening for Celiac disease (CD) will do the IgA levels automatically. However the serological test is not a diagnostic test

Parent Satisfaction with Outpatient Pediatric Endoscopy Procedures at University of New Mexico Children\u27s Hospital

As a part of endoscopy quality improvement (EQI) project, we decided to measure parent satisfaction about pediatric endoscopy service at University of New Mexico Children\u27s Hospital

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Unveiling Celiac Disease

43-45Celiac Disease (CD) is an autoimmune disease wherein the body fights its own tissue when it encounters glute

Immunization coverage and its determinants among 12-23 months old children of Lucknow

Context:Roughly three million children die each year of vaccine preventable diseases (VPDs) with a significant number of these children residing in developing countries. Aims: The present study was conducted to assess the immunization status of 12-23 months old children and its determinants in Lucknow. Settings and Design: List of all villages in rural area and mohallas in urban area of Lucknow district was procured. Eight villages and eight mohallas were selected by simple random sampling. A community based cross sectional study was done among 450 children aged 12-23 months. Materials and Methods: A pre-designed and pre-tested questionnaire was used to elicit information on family characteristics, bio social characteristics, and housing characteristics. The immunization status of the child was assessed by vaccination card and by mother′s recall, where vaccination card was not available. Statistical Analysis: Data were analyzed using statistical package for social services (SPSS) version 11.5. Chi-square test will be used to find out the significant association. Results: Overall, 62.7% children were fully immunized, 24.4% children were partially immunized, and 12.9% children were not immunized. The various determinants of immunization status of the child the place of residence, religion, socio economic status, father′s education and father′s occupation, source of information regarding immunization, registration of pregnancy, number of ante natal visits, iron and folic acid tablets consumed by the mother, tetanus toxoid received by the mother, place of delivery and the attendant who conducted the delivery. Conclusion: More awareness should be generated among the people living in rural and urban area, to immunize their children and to prevent the morbidity and mortality from six lethal vaccine preventable diseases

Reasons for failure of immunization: A cross-sectional study among 12-23-month-old children of Lucknow, India

Background: Roughly 3 million children die every year of vaccine preventable diseases and a significant number of these children live in developing countries. The present study was conducted to assess the reasons for failure of immunization among 12-23-month-old children of Lucknow city in India. Materials and Methods: Out of all villages in rural areas and mohallas in urban areas of Lucknow district, eight villages and eight mohallas were selected by simple random sampling. A community based cross-sectional study was done among 450 children aged 12-23 months. The immunization status of the child was assessed by vaccination card and by mother′s recall. A pre-designed and pre-tested questionnaire was used to elicit information on reasons for failure of immunization. Data was analysed using statistical package for social services (SPSS) version 11.5. Chi square test was used to find out the significant association. Results: Overall, 62.7% children were fully immunized, 24.4% children were partially immunized, and 12.9% children were not immunized. The major reasons for failure of immunization were postponing it until another time, child being ill and hence not brought to the centre for immunization, unaware of the need of immunization, place of immunization being too far, no faith in immunization, unaware of the need to return for 2 nd and 3 rd dose, mother being too busy, fear of side reactions, wrong ideas about immunization, and polio was considered only vaccine, and others. Conclusion: More awareness should be generated among the people living in rural and urban areas to immunize their children