Correlation of tissue transglutaminase antibody with duodenal histologic marsh grading

Recent guidelines have proposed that there is a correlation between tissue transglutaminase [tTG] antibody titers and degrees of duodenal biopsy, and that duodenal biopsy can be omitted in some patients with high levels of tTG antibody. Using data of registered patients in a gastrointestinal clinic we aimed to assess the correlation between tissue transglutaminase antibody with duodenal histologic Marsh grading in Iranian patients with celiac disease. We retrospectively reviewed hospital files of registered patients in the gastrointestinal clinic of Firoozgar Hospital, Tehran, Iran. Demographic, laboratory, and histology data of those who had tTG titer and pathology reports of duodenal biopsy based on the modified Marsh classification were extracted and used for the study. 159 patients with available tTG titer and pathology reports were enrolled in our study. Mean +/- SD of the patients was 35.6 +/- 15.2 and 100 [62.9%] of them were women. 133 out of 153 patients had villous atrophy [Marsh IIIa-IIIc]. Anemia was the most common sign and bloating, abdominal pain, and diarrhea were the first three common symptoms in these patients. Mean tTG titers was significantly higher in patients graded as Marsh III [p for trend=0.003]. Our results showed that tTG titer more than 9 folds higher than the kit's cut-off value was about 97.2% sensitive for Marsh II and more duodenal damage. There was a correlation between tTG titers and degrees of duodenal damage in patients with celiac disease. Duodenal biopsy is not always necessary for diagnosing celiac disease and when tTG level is more than 9 folds higher than the manufacture's recommended cut-off value it can be avoided. Meanwhile in case of high clinical suspicion, low tTG levels do not exclude diagnosis of celiac disease and further investigations including small intestinal biopsy should be considered

[Effects of cochlear implantation and associated rehabilitation services on the development of verbal and non-verbal intelligence of 6-9 years old deaf children with cochlear implants]

Children with profound sensorineural hearing loss are at risk for language delays that can impact their academic and social development. A suitable way to develop speech and language of deaf children is cochlear implantation [CI]. The main propose of this study is the evaluation of child's development in language skills like information, similarities, arithmetic, vocabulary and comprehension after CI surgery and rehabilitation. This quasi - experimental study was conducted in Shiraz CI center during 2008-2009. For this reason we did the Raven test on all of the CI children of Fars CI center, who were at least 6 years old and had finished their rehabilitation program about 3 years ago. After that we selected 23 cases that had the selection criteria for answering the verbal part of Wechsler intelligence scale for children [WISC -R]. For statistical analysis we used SPSS software version 11.5. The verbal intelligence quotient [IQ] developed after surgery and rehabilitation program of CI children, but was not the same as normal children of their age. The most important factors that affect this, is child's age and family education. Also there was no significant relation between verbal and non-verbal IQ. Although CI is a suitable way to increase verbal IQ, and cognitive development, for better results, it's recommended in children under 3 years

The Relationship Between Serum 25 Hydroxy Vitamin D Levels and Asthma in Children

PURPOSE: Asthma and other allergic disorders have increased over the past decades in nearly all nations. Many studies have suggested the role of vitamin D deficiency in both T-helper1 and T-helper2 diseases; however, the association between vitamin D, allergy, and asthma remains uncertain. In this study, the associations of 25-hydroxy vitamin D3 levels with asthma and with the severity of asthma were evaluated. METHODS: This cross-sectional study was conducted on 50 asthmatic children and 50 healthy controls aged 6-18 years. Serum 25-hydroxy vitamin D3 levels were determined and compared between the two groups. The relationship between serum vitamin D levels and pulmonary function test outcomes and eosinophil counts were examined in asthmatic patients. RESULTS: Univariate analysis of the relationship between asthma and vitamin D showed that decreased vitamin D levels were associated with significantly increased odds of asthmatic state (P=0.002). In a multivariate analysis after adjustment for age, body mass index, and sex, the relationship between vitamin D and asthma increased. In asthmatic patients, 25-hydroxy vitamin D levels had direct and significant correlations with both predicted FEV1 (R2=0.318; P=0.024) and FEV1/FVC (R2=0.315; P=0.026). There were no associations between vitamin D level and eosinophil counts, duration of disease, and the number of hospitalization or unscheduled visits in the previous year (P>0.05). CONCLUSIONS: These results showed that serum 25-hydroxy vitamin D levels were inversely associated with asthma, and there was a direct and significant relationship between vitamin D levels and pulmonary function test outcomes in asthmatic children. An interventional study in asthmatic patients with low serum vitamin D concentration may establish a causal relationship between asthma and vitamin D.