New benefits of hydroxychloroquine in pregnant women with systemic lupus erythematosus: a retrospective study in a tertiary centre

Abstract Objective: To determine pregnancy outcomes in women with systemic lupus erythematosus (SLE) who were treated with hydroxychloroquine in a tertiary center. Methods: A retrospective study involving pregnant women with SLE who had antenatal follow-up and delivery in between 1 January 2007 and 1 January 2017. All participants were retrospectively enrolled and categorized into two groups based on hydroxychloroquine treatment during pregnancy. Results: There were 82 pregnancies included with 47 (57.3%) in the hydroxychloroquine group and 35 (42.7%) in the non-hydroxychloroquine group. Amongst hydroxychloroquine users, there were significantly more pregnancies with musculoskeletal involvement (p = 0.03), heavier mean neonatal birthweight (p = 0.02), and prolonged duration of pregnancy (p = 0.001). In non-hydroxychloroquine patients, there were significantly more recurrent miscarriages (p = 0.003), incidence of hypertension (p = 0.01) and gestational diabetes mellitus (p = 0.01) and concurrent medical illness (p = 0.005). Hydroxychloroquine use during pregnancy was protective against hypertension (p = 0.001), and the gestational age at delivery had significant effect on the neonatal birthweight (p = 0.001). However, duration of the disease had a significant negative effect on the neonatal birthweight (p = 0.016). Conclusion: Hydroxychloroquine enhanced better neonatal outcomes and reduced adverse pregnancy outcomes and antenatal complications such as hypertension and diabetes.

A study of Nerve conduction in patients with chronic renal faillure

Background: Many patients with chronic renal failure have abnormalities in central and nervous system function. The majority of patients are asymptomatic, requiring electrophysiologic testing to confirm the abnormality. Slowingof nerve conduction velocity frequently occurs without signs and symptoms of neurophysiological changes of the peripherial nerves in patients with chronic renalfailure. Methods: A Study of motor and sensory conduction in median and ulnar nerves was done on 22 patients, five males and seventeen femal (age range 18-75 years), with chronic renal failure. Inclusion criteria for this study were known cases of chronic renal failure, from Renal Medical Unit, Mandalay General Hospital, with persistent high serum ureas level more than 10mmo/L (at least 2 weeks apart) and ultrasonographic changes. Twenty-five normal subjects of comparable ageserved as controls. Results: Ten of the patients had clinical signs and symptomsof early peripheral neuropathy, such as decreased deep tedon reflexes or minimunsensory loss in lower and upper extremities. In patients with chronic renal failure, values of median and ulnar MNCV were found tp be 48.46+-4.1m/sec and 51.17+-4.28 m/ sec respectively. Nerve conduction velocities, motor as well as sensorywere found to be significantly reduced in chronic renal failurw patients compared to those of normal subjects (p<0.001). There was significant negative correlation between serum creatinine and motor and sensorry conduction velocities of both nerves in chronic renal failure patients. But,no significant correlation was foud between blood urea and nerve condiuction velocities.

Maturation of foetal thyroid hormone synthesis and regulation

A total of 343 pairs of maternal serum and foetal cord serum samples were assayed for thyroxine (T4), triiodothyronine (T3) and thyrotropin (TSH) levels. Foetal serum total T4 levels showed a positive correlation not only with gestational age(r=0.14) but also with maternal serum T4 levels (r=0.42). Although these correlations were not very strong, they were statistically significant. Foetuses were found to be T3 deficient for all gestational age groups in the study. Despite these deficient levels, there was still a significant positive correlation between foetal serum T3 levels and the maternal serum T3 levels (r=0.24). Foetal serum TSH levels were about three times higher than the corresponding maternal levels for all gestational age groups. High TSH levels in the face of deficient T3 levels for all gestational age groups in the study indicated that the function of the foetal hypothalamic-pituitary feedback control system of the thyroid gland has been well established even before the foetal maturity.

Etiologic agents, clinical and laboratory characteristics of acute versus persistent diarrhoea in children who attended the Yangon Children's Hospital

To identify the etiologic agents, clinical and laboratory characteristics of acute and persistent diarrhoea in children less than 12 years of age, a hospital based prospective study was carried out for 18 months in Yangon Children's Hospital. A total of 487 children, 327 with acute and 160 with persistent diarrhoea participated in the study. Intestinal pathogens including bacterial agent 31 per cent, viral agent 6.3 per cent and protozoa 33 per cent were detected in 71 per cent of persistent diarrhoea cases, whereas in acute diarrhoea cases intestinal pathogens were identified in 64 per cent, among which bacterial, viral and protozoal agents were 28 per cent, 11.5 per cent and 25 per cent respectively. More than one enteric pathogen was detected in 13.7 per cent and 16.5 per cent of persistent and acute diarrhoea cases respectively. male children who suffered from diarrhoea were more than females and peak incidence of acute and persistent diarrhoea occurred in the 2-11 month age group. fever and vomiting were found more frequent in persistent than acute diarrhoea during second week of illness and differences were statistically significant. Shigella species, ETEC and e. histolytica were equally isolated from both acute and persistent diarrhoea whereas rota virus was found more ofter in acute than persistent diarrhoea. The presence of leucocytes and reducing substances in the stool was equally frequent.