Acute hemiplegia as a rare presentation of infantile Guillain-Barre syndrome

Guillain-Barre syndrome [GBS] usually presents in a symmetrical ascending fashion of weakness. We present a 6-month-old male infant who presented to our emergency room with acute left-sided limb weakness and head lag 3 days after a febrile upper respiratory tract infection. A diagnosis of GBS was established by confirming high cerebrospinal fluid protein, motor nerve reduced amplitude, and prolonged conductions, and MRI T2 high signal intensity affecting the ventral roots of the spinal cord. He showed remarkable clinical and neurophysiological improvement after intravenous immunoglobulin and intensive physiotherapy. The occurrence of infantile acute hemiplegia as a presentation of GBS is rare. This report highlights the importance of considering GBS in the differential diagnosis so that early effective treatment may be started

Comparison between quantiferon-TB-gold test and tuberculin skin testing in diagnosis of both latent and active tuberculosis infections

Introduction: Tuberculosis [TB] is an infectious disease affecting mostly the respiratory system with or without affection of other organ-systems caused mainly by infection with Mycobaterial tuberculosis [MTB]. However, not all cases of infection with any of the TB bacilli are converted to active or manifested infection and most cases are called latent tuberculosis infection [LTBI] which can be later on converted to active infection. There are several factors that underline the conversion from latent to active TB infections. Previously LTBIs was diagnosed by tuberculin skin testing [TST] but now there is new test formats which measures the released interferon-y [INF-y] after stimulation ofT-cells contained in whole patient blood by specific antigens obtained from MTB. These tests are called interferon gamma release assays [IGRAs] which are more sensitive and specific than TST one of these tests is the QuantiFERON-TB Gold In-Tube [QFT-G] which measures the released IFN-y by ELISA method

Aim of study: The aim of the current study was to compare the TST and QFT-G in diagnosing LTBIs in some groups of participants including TB contacts, HIVpatients, HCWs, prisoners in comparison to patients with active TB infection

Materials and methods: the study included 163 of close contacts to household TB cases, 32 healthcare workers in King Saud Chest hospital, 52 prisoners from Riyadh region, 25 HIVpatients, and 158 patients with active TB as a control group. History and general examination was done to all participants. Then TST was done using 2 IV by intradermal injection using Mantoux technique. Whole blood samples were taken for measuring the released interferon y using Quantiferon TB Gold In Tube [QFT-G] method

Results: TST was positive in 52.8% of TB contacts, 21.9% of HCWs, 34.6% of prisoners, 28% in HIV patients and in 97.5% of active TB patients, while QFT-G was positive in 56.4%, 12.5%, 57.7%, 24%, and 98.7% in previous groups respectively. The overall mean results for QFT-G [67%] were higher than that for TST [63.3%] with statistically insignificant results

Conclusion: QFT-G is more sensitive than TST in diagnosing LTBIs and further studies upon larger population number is need to investigate it specificity

Serum TGF-beta, serum mmp-1, and HOMA-IR as non-invasive predictors of fibrosis in Egyptian patients with NAFLD

Non-alcoholic fatty liver disease [NAFLD] is an increasingly prevalent cause of chronic liver disease worldwide. A number of these patients progress to nonalcoholic steatohepatitis [NASH] which carries significant morbidity and mortality. The aim of this study is to evaluate the diagnostic value of serum levels of transforming growth factor beta-1 [TGF- beta 1] matrix metalloproteinase-1 [MMP-1], and insulin resistance as predictors of fibrosis in Egyptian NAFLD patients. Fifty patients with NAFLD and different stages of fibrosis were studied. Serum levels of TGF- beta 1, MMP-1, and fasting serum insulin were measured; calculation of the homeostasis model assessment for insulin resistance [HOMA-IR] was done. TGF- beta 1 gives a sensitivity of 100% and specificity of 94.4% for stage 1 fibrosis, 100% and 93.9%, respectively, for stage 2 fibrosis, and 97.7% and 100%, respectively, for stage 3 fibrosis. MMP-1 showed sensitivity and specificity of 88% and 81.8%, respectively, for stage 2 fibrosis, 90.9% and 55.56%, respectively, for stage 3 fibrosis, but it is of no diagnostic value in stage 1 fibrosis. Serum TGF- beta 1, MMP-1, and insulin resistance [HOMA-IR] proved to be potentially useful noninvasive markers in predicting fibrosis in NASH patients.

Cognitive and behavioral development profile of a Saudi girl with Fragile X syndrome

This report presents an ideal case of a girl with Fragile X syndrome. There is positive family history of the same condition. The analysis revealed low average IQ with attention deficit, shyness, and social withdrawal. The report shows that girls with Fragile X might have only mild cognitive deficits that enable them to adapt and succeed in society

Microcephaly, retinal dysplasia, pedal edema, mental retardation, and short stature

Microcephaly, retinal dysplasia, pedal edema syndrome is a rare syndrome and possibly under diagnosed. We could find less than 25 cases reported in the literature. Patients were initially categorized as having either microcephaly and lymphedema or microcephaly and chorioretinal dysplasia. The existence of the 3 criteria in the same patients is reported. Other features such as mental retardation and short stature were noticed in other patients. In the Pediatric Department of the Armed Forces Hospital Southern Region, Kingdom of Saudi Arabia, we report a case with all clinical manifestations described in the above-related syndromes. The girl has microcephaly, retinal dysplasia, pedal edema, short stature, mental retardation, and some other dysmorphic features. The parents are not relatives, but both have retinal dysplastic changes. This report documents the existence of all different features reported in the literature in one patient, suggesting that different clinical features of reported patients are possibly the variable expression of the same syndrome

Helicobacter pylori infection. Is it a risk factor in the pathogenesis of coronary heart disease?

To determine whether H. pylori infection is associated with an increased risk of coronary heart disease, 100 men with myocardial infarction and/or ischaemia [mean age 52.6 +/- 6.9 years] and 100 healthy control subjects matched for age, sex and BMI were included in this study. All patients and control subjects were assessed clinically and by resting electrocardiograms. Fasting venous blood samples were analyzed for H. pylori specific IgG antibodies by ELISA, plasma fibrinogen, serum cholesterol, triglycerides and total leucocytic count. 28% of patients with coronary heart disease were seropositive to H. pylori infection versus 61% seropositive in control group [P < 0.05]. Plasma fibrinogen levels were significantly elevated in seropositive patients and control subjects when compared with seronegative groups [cholesterol levels, triglyceride levels and total leucocytic count]. There was no significant difference in the rates of H. pylori infection between patients with myocardial infarction and patients with angina In conclusion, H. pylori infection was significantly associated with the increased risk of coronary heart disease. This risk can be explained in part by elevated fibrinogen levels in seropositive patients and control subjects