Skin reactivity to allergens in Rabigh area, Kingdom of Saudi Arabia

This study determined the pattern of skin prick test reactivity to allergens in patients with airway allergy residing in Rabigh Area, based on data analysis of skin prick test results. Skin prick tests of 160 Saudi attended Al Nakheel Polyclinic between July, 2012 and April, 2013. Allergen extracts set was used to test them. Out 160 patients, 114 [71%] reacted to one or more allergens, who were 73 [64%] adults and 41 [36%] children. The majority of adults [17.8%] reacted to six allergens and children [19.5%] reacted to five ones. The most frequently reacting allergen was house dust mites followed by Candida albicans then Cladosporium spp. The maximum number of positive tests per patients was 13 in adults, compared to 10 in children. A significantly higher proportion of adults were reacting to house dust mites, Aspergillus and Penicillium. Sensitivity to allergens was common in patients with airway allergy residing in Rabigh area

role of thrombocytopenia as an independent predictor of cardiovascular and renal damage in patients with systemic lupus erythematosus

Systemic lupus erylhematosus [SLE] is an auioimmunc disorder in which the body's immune system incorrectly attacks the body's own tissues and organs, leading to inflammation and damage. Thrombocylopenia [defined as platelet count less than 100 x 10[9]/liter] is rather common in SLE. The incidence ranges from 15-50% and it represents a predictor of a worse prognosis. To study the role of thrombocytopenia as an independent predictor of organ damage [renal and cardiac] in SLE patients. Our study was conducted on 40 SLE Patients from Ain Shams University Hospitals, classified into 2 groups; group I including 20 patients with thrombocytopcnia and group II including 20 patients without thrombocytopenia. All patients were subjected to medical history, clinical examination, laboratory investigations including, scrological markers antinuclear antibody [ANA], anti-double stranded DNA [anti ds-DNA], renal biopsy. Transthoracic echocardiography for assessment of cardiac affection, evaluating cardiac function, valvular lesion and presence of any pericardial disease. We found that there was no significant statistical difference between the two groups as regard their ages. Echocardiography was done for all patients, there were significant cchocardiographic findings in group 1 compared to group II [p. value 0.027]. As 40% of the patients in group 1 had pericardial effusion, 35% had mitral regurgitation, 10% had mitral stenosis, 20% had aortic regurgitation and 15% hadtricuspid regurgitation. Among the patients in group H, 20% had pericardial effusion, 25% had mitral regurgitation, 10% had tricuspid regurgitation and no one of them had aortic valve disease. As regard renal damage, we found that 50% of thrombocytopenic SLE patients had proteinuria >3.5 gm/24h, in contrast to non thrombocytopenic patients in which only 25% of them had proteinuria. Also in thrombocytopenic patients 5% had ESRD, while no ESRD was found between non thrombocytopenic groups. While comparing the two groups regarding the pathological pattern of kidney affection assessed by renal biopsy according to WHO classification system, we found no significant statistical differences among the two groups [p.value=0.38]. We concluded that thromhocytopenia emerged as one of the most important predictors of damage also it is a qualitative marker of impending damage in lupus patients and that thrombocytopenic SLE patients are at high risk of developing protcinuria, pericardial and valvular disease

Sequential application of long pulsed dye/Nd-YAG lasers is a superior method for management of infantile hemangiomas

To evaluate the efficacy of sequential application of long Pulsed dye/Nd-YAG lasers in the management of skin and mucous membrane infantile hemangiomas. Management of infantile hemangiomas may be a challenge. Different laser systems have been reported to be of great help for such cases with variable results. In this study we present a unique sequential laser system which deliver pulsed dye laser PDL 595nm followed by Nd-YAG 1064nm to be superior than other reported techniques. Twenty five cases of infantile hemangiomas in the head and neck region were selected to he enrolled in this study. Assessment for progress was achieved clinically. We achieved excellent results in eighteen patients [72%] out of the treated 25 patients, with no recurrence after 6 months follow-up. Laser application from skin and mucous membrane sides [sandwich technique] decreased number of sessions. The sequential PDL followed by Nd-YAG laser can be considered as one of the superior methods for management of infantile hemangiomas specially in the head and neck region, due to its excellent cosmetic results with fewer number of treatment sessions

Comparative evaluation between rapid antigen detection test for streptococcal pharyngitis and throat culture in children

Acute upper respiratory tract infections in children may result in overuse of antibiotics as throat culture cannot be performed in every setting and results cannot be obtained early. The sensitivity of a rapid antigen-detection test [RADT] for group A streptococcal [GAS] pharyngitis is critical to whether the test is cost-effective arid to whether a confirmatory throat culture is needed. To assess the diagnostic value of rapid antigen detection test [RADT] for streptococcal pharyngitis in children and to compare it with throat culture. 600 children with signs and symptoms of acute upper respiratory tract infections were included in the study. Throat culture and RADT were performed and prevalence of GAS pharyngitis was assessed. Diagnostic value of RADT was determined. Their mean ages was 5.4 +/- 4.1 years [ranges: 8 months-18 years, median: 8 years]. The patients were subdivided into four groups according to their ages-group 1: 0-4 years [n = 152]; group 2: 5-9 years [n = 236] and group 3: 10-14 years [n = 157] and group 4: 15 years and older [n = 55]. The prevalence of GAS pharyngitis was 45.1% [n = 270/600] with RADT, and was 34.1% [n = 205/600] with throat culture. With respect to the distribution of positive cases by age, the greatest level of occurrence was between 10-14 [51%] years of age and lowest in children between 0-4 [22.1%] years. Considering the culture as the "gold standard" and considering all patients, the RADT showed a sensitivity of 87.9%, a specificity of 93%, a positive predictive value or 90.9% and a negative predictive value of 90.7%. Symptoms like scarletiform rash, tonsiller exudate and absence of cough were more frequent among the subset of children with positive RADT, with statistical significance [p < 0.001]. Diagnostic value of RADT is high and can be used safely in populations where streptococcal pharyngitis is common and a negative RADT result in our pediatric practice still requires a confirmatory throat culture

Growth measures, IGF-1 and IGFBP-3 before and after adenotonsillectomy

Adenotonsillar hypertrophy [ATH] is associated with growth interruption during childhood. Its pathophysiological mechanism is unclear. The purpose of this prospective study was to evaluate whether surgical treatment of adenotonsillar hypertrophy affects the circulating concentrations of insulin-like growth factor-1 [IGF-1] and IGF-binding protein 3 [IGFBP-3] along with their standard deviation scores [SDS] adjusted to age which are more important in evaluating growth in childhood. Prepubertal children [15 males and 10 females] aged 4-10 years [mean age 6.2 +/- 3.2 years] who had chronic recurrent hypertrophic adenotonsillitis with obstructive symptoms and 25 healthy children [12 boys and 13 girls] [range 3-10 years] with a mean age of 7.4 +/- 2.5 years as control had the same measurements including Weight, height, body mass index BMI [kg/m2], IGF-1 and IGFBP-3 levels and their standard deviation scores were evaluated before and 12 months after adenotonsillectomy but once during the first examination in the control group. All parameters showed significant difference between control and studied group except weight, BMI and IGFBP-3. Both weight and height SD scores of healthy children were higher than those of children with ATH before adenotonsillectomy [P < 0.05 for both], and were also significant after adenotonsillectomy. The preoperative and postoperative serum levels of IGF-I and IGFBP-3 were compared. There was highly significant increase in IGF-I. The mean serum IGF-1 level increased from 273.1 +/- 301.3 to 659.3 +/- 402 ng/ml [p < 0.001]. Mean pre- and postoperative IGFBP-3 levels did not differ between the control and study groups. Adenotonsillectomy is a curative way to treat children with faltering growth caused by ATH

Comparison of the safety and efficacy of intravaginal misoprostol [prostaglandin E1] with those of dinoprostone [Prostaglandin E2] for cervical ripening and induction of labor in Bab El-Shaariah hospital

This clinical trial was to evaluate and to compare the effectiveness, safety, and side effects of intravaginal misoprostol [prostaglandin E1] with vaginal dinoprostone for cervical ripening and labor induction in Bab El-Shaariah Hospital. Women with Biopsy score 6 or less admitted for labor induction at term were eligible for this randomized controlled trial. Exclusion criteria were multiple pregnancy, breech, fetal distress, or previous uterine scar. The allocation to the intravaginal micoprostol group [145 patients] [20 micro g given every 2 hours increased to 40 micro g depending on uterine contractions] or to the vaginal dinoprostone group [81 patients] [2mg twice, 6 hours apart] from March 2004 to February 2006. The mean time to delivery was significantly shorter with misoprostol [19.8 +/- 10.4 hours] than with prostaglandin E2 [31.3 +/- 13.0 hours, p<0.001]. Delivery within 24 hours of induction was significantly more frequent with misoprostol [71.9% of subjects vs 31.3%, p<0.001]. There was no difference in the cesarean delivery rate with misoprostol [25.6% Vs 22.2%, p<0.67]. The incidence of uterine hyper-stimulation was higher with prostaglandin E2 [7.4% Vs 0.7%, p<0.007]. There were no uterine ruptures with both groups. There was no difference in neonatal outcome. Compared with prostaglandin E2, misoprostol is more effective in cervical ripening and induction of labor, is as safe for patients who do not have a history of cesarean birth

Long-Term results of clean intermittent catheterization

The aim of this study was to determine the outcome of clean intermittent catheterization [CIC] and the prevalence of associated urinary tract problems in patients who had been using the technique for a long time. This study included 94 patients [88 men and 6 women] whose mean age +/- SD was 38 +/- 18.2 years and the mean duration of using clean intermittent catheterization [CIC] was 11 years [range 7-13 years]. Based on the results of urodynamics, the patients were divided into two groups: Group I comprised 68 patients with hyperreflexic bladder, dyssynergic external sphincter and high post-void residual urine and group II comprised 26 patients with an underactive detrusor. At the end of follow-up period, the patients were evaluated and the two groups were compared for continence, bacteriuria, symptomatic urinary tract infections, upper tract changes and other complications related to the procedure. Clean intermittent catheterization is a safe and effective method for managing patients with different voiding dysfunction