Pediatric air gun shot injury

Air guns [AGs] use air or another compressed gas to propel a projectile. Different injuries may occur in children due to their body structure, which is lessresistant with thin soft tissue coverage that can be easily penetrated by an AG shot. We present 3 cases of pediatric AG shot injury. The first-case had right lumber deep tissue penetration of AG pallet without internal damage, the second-case had a complex course of pellet into the perineum, and the third-case was shot in the left shoulder. All cases were accidentally shot. The shooters were all children, and relatives of the victims. All patients were generally stable on arrival. Two cases were operated, and one received conservative management. On follow up, no complications were noted. At first sight, AGs and air rifles may appear relatively harmless, but they are potentially lethal and children should not be allowed to play with them.

Study of non-organ specific antibodies in children with genotype 4 chronic hepatitis C

Adult studies established a relationship between hepatitis C virus [HCV] infection and the presence of non-organ specific antibodies [NOSAs]. Most studies were carried out on genotypes 1 and 2. Only a few studies addressed that issue in pediatrics. No studies have been carried out on autoimmunity and genotype 4 in children. We aim to investigate NOSAs in 80 Egyptian children with chronic HCV infection along with studying the underlying genotype of HCV, and correlating autoimmunity with the epidemiological, clinical, biochemical, and virological features. HCV RNA was assayed by the polymerase chain reaction and viral genotypes were determined. NOSAs were measured and liver biopsies were taken for histopathological examination. Genotype 4 was the only detected genotype in the included 80 patients. Anti-smooth muscle antibodies [ASMA] were the only detected antibodies in 32 [40%] patients, always with V specificity [vessels only] at titers ranging from 1:20 and 1:160. Anti nuclear antibodies [ANA] and liver-kidney microsomal antibodies 1 [LKMA 1] were not detected in any of our patients. Epidemiologic and clinical features did not significantly differ between autoantibody positive and negative patients. Among biochemical features, significantly high levels of total bilirubin, albumin, immunoglobulins, alkaline phosphatase, and gamma glutamyl transpeptidase were found in the antibody positive group. Genotype 4 HCV is the prevailing genotype in Egyptian children with chronic HCV infection. A consistent proportion of these children with chronic HCV infection circulate non-organ specific autoantibodies. The prevalence of ASMA and the absence of ANA and LKMA 1 might be related to the unique situation in Egypt with unique prevalence of genotype 4. More studies are warranted on larger pediatric population to validate these findings.