Awareness of the Public about Celiac Disease in Children in Saudi Arabia

Background: Celiac disease is a chronic immune-mediated enteropathy that affects the small intestine of genetically predisposed individuals and is precipitated by the ingestion of food containing gluten. Treatment consists of a glutenfree diet to control the signs and classic symptoms of the disease and prevent complications. Objective: To determine the awareness of the public about celiac disease in children in Saudi Arabia. Methods: A cross-sectional communitybased study conducted during the period from 1st May to 31st July 2019. A systematic random sampling technique was used. The study included 1619 participants. Data collected using a pre-designed online questionnaire distributed among parents of children and adolescents. The questionnaire includes about 18 items that guide us to the awareness of the public about celiac disease in children. Results: Half of participants (50.1%) think that Celiac diseases are a form of allergy to wheat products. Less than half (46.7%) of cases think that there is a correlation between the presence of celiac and disease and other immunological diseases and 33.7% don’t know. The majority of participants 59.9% think that family history has a role in the occurrence of celiac diseases and 62.4% think that it affects humans at any age. Only 28.8% of participants think that celiac disease is more prevalent in the Middle East than in any other region and the majority 49.8% don’t know. The majority (35.2%) of participants don’t know if there was a relation between cough and asthma with celiac disease. About third (31.6%) of the participants agreed that CD is linked to diabetes and 26.3% think that the CD associated with genetic diabetes than acquired diabetes. More than half of participants 51.5% think that psychological disorders are among the causes of celiac disease but, 39% of them don’t think that pregnancy and childbirth are among the causes of CD and 40.6% don’t know if surgical operations are among the causes or not. The majority of participants 59% think that CD is treatable disease, and 49.7% think that a patient with CD should have food that is completely free of wheat and its products. More than half (52.3%) participants think that colon cancer is one of the consequences of CD. Conclusion: The general population of Saudi Arabia, has reasonable knowledge about celiac diseases in children. We recommend health education sittings to raise the awareness of the public about the disease.

Histopathological spectrum and short-term outcome of treatment with cyclophosphamide in relapsing steroid-sensitive nephrotic syndrome

Objective: To determine the short-term outcome of cyclophosphamide [CPO] course in children with relapsing steroid sensitive nephrotic syndrome [SSNS] with different histopathological lesions

Study Design: Descriptive, observational study

Place and Duration of Study: Pediatric Nephrology Department, Sindh Institute of Urology and Transplantation, Karachi, from January 2012 to December 2014

Methodology: All children with relapsing steroid-sensitive nephrotic syndrome, who underwent renal biopsy and received cyclophosphamide therapy, were included and followed up for 2 years. Histopathological features in renal biopsy, duration of treatment, duration of complete remission and complication frequency was noted

Results: Of the total 74 patients, 47 [63.5%] were males and 27 [36.5%] females. Median age with Interquartile range [IQR] at presentation was 5 years [4-7 years]. Minimal change disease [MCD] was the most common histopathological diagnosis [n=54, 73%] followed by focal segmental glomerulosclerosis [FSGS] [n=13, 17.5%], mesangioproliferative glomerulonephritis [MesPGN] [n=6, 8.1%], IgA nephropathy [n=1, 1.4%]. The median number of glomeruli included in each biopsy sample was 15. The median duration of treatment with CPO was 11 weeks [9 to 13 weeks], whereas the median duration of complete remission post-therapy was 13 months [7-23 months]. A median timeframe of 17 months [13-24.2 months] lapsed between establishing the diagnosis of NS and initiating CPO treatment. Leucopenia was noted in six [8.1%] patients

Conclusion: The short-term outcome of relapsing SSNS can be improved with CPO and steroids, with minimum short-term side effects

Eimeria griseus m sp [apicomplexa: emeriidea] from the gray monitor, varanus griseus in Saudi Arabia

Eimeria griseus n. sp. is described from the gallbladder of the gray monitor, Varanus griseus. The sporulated oocysts are ellipsoid in shape, measuring 32.8 x 23.0 [30.0-38.3 x 20.0-25.0] mum with smooth yellowish bi-layered wall, 1.2 [0.9-1.3] mum thickness. Micropyle, polar granule and oocyst residuum are absent. Sporocysts are ellipsoid, measuring 11.8 x 8.5 [10.7-12.6 x 7.5-9.0] mum. Sporocyst residuum is present. Sporocysts lack a Stieda body. Sporozoites are banana-shaped blunt at one end and slightly tapered at the second. Eimeria species from Varanus hosts were compared in this study