Seafood Allergy: Causes, Prevention Modalities, and Treatment Guidelines in the Indian Scenario

Seafood allergy is a hypersensitivity disorder with growing prevalence. Allergy to shellfish is among the leading cause of food allergyin adults, and the most common cause of food allergic emergency department visits. Seafood allergy is immunologic response toproteins in these foods and include IgE antibody-mediated allergy. Allergies can occur at any age but are common in adults andadolescents than in children. While figures vary from country to country, approximately 1–2% of the adult population and <1% ofchildren are affected. In most patients tolerance develops to food antigens, however, when tolerance fails to develop, hypersensitivityreaction occurs. Food allergy affects up to 8% of the children below 5 years of age and approximately 3.5% in the general population.Adults with shellfish allergies should be aware of how to use this on themselves or their child if child is suspected shellfish allergy.It is also recommended for such individuals to wear medical alert bracelet necklace or carry USB drive so that health care workercan be aware of their condition in emergency. Effective and accurate diagnostic workup is essential for clinicians and patients. Thisarticle summarizes about seafood allergy cause, diagnostic approaches, and management in case of life-threatening emergencies.

Central Line Induced Pneumothorax: A Case Report

Central venous catheter insertion is a commonly performed procedure. We report a case of central venous catheterization induced pneumothorax in a 45 years old male patient who underwent a surgery for sub-arachnoid hemorrhage and post-surgery, developed tension pneumothorax during internal jugular vein catheterization.

Auditory Event Related Potential and PennCNP Neuropsychological Test Battery to Measure Aspects of Cognition in Young Adults

Introduction: There are a number of ways to assess cognitive functions. The two most important androutinely done tests are neuropsychological battery and event related potentials. The present study examinedthe relationship between conventional neuropsychological tests assessing various domains of cognition andan event related potential (P300).Methods: Subjects were 60 neurologically normal healthy adults 20-30 years old with no history of neurological,neurosurgical, or psychiatric disorders. We administered a neuropsychological test battery (Penn CNP)assessing reaction time, visual memory and logical reasoning and recorded event related potential, P300using auditory oddball paradigm in all subjects.Results: A correlation test was run and pearson’s analysis revealed that there was a positive correlationbetween reaction time on neuropsychological test battery and P300 wave latency. No relationship was foundbetween other tests on neuropsychological test battery and P300 wave characteristics i.e., latency oramplitude.Conclusion: We therefore conclude that P300 measurements cannot be replaced by neuropsychologicaltests or vice versa; rather, higher cortical functions should be evaluated by both methods.

Knowledge, Attitude and Practices of Saudi Pediatricians Regarding Newborn Hearing Screening in Saudi Arabia

Background: Late detection of permanent congenital and early and onset-hearing loss (PCEHL) severely affectslinguistic, cognitive, and educational development in children. Routine newborn hearing screening (NHS) hasprovided opportunities for children under the DHH category to be identified shortly after birth. Pediatricianshave the biggest role in undertaking the assessment and physical interventions on hearing among newborns.Methods: For this study, the participants who took part in the survey were Saudi pediatricians. The study designwas based on a cross-sectional approach where convenience sampling was adopted as a technique for datacollection. Questionnaires were used as the only tool for data collection. Results: From the study, the majority ofrespondents were male, registering up to 57.9%. From the survey, documenting the state of the NHS program inSaudi Arabia, it turns out that it is important to have a typical screening protocol, regarding the working nationalpolicy. Up to 47.7% of the respondents replied that hearing screening instigates parental concern and anxiety,contradicting other studies that assert the opposite. The respondents, however, articulated concerns aboutrequiring additional information on some of the particular details that are related to NHS. However, majority ofthem (44.4%) were confident in explaining the process to the parents of the newborns. Conclusion: The study canbe seen to shed light on the attitudes, existing knowledge, and practice levels amongst pediatricians in SaudiArabia. It shows that any NHS program is considered profitable if timely and appropriate referrals can be madeto ensure follow-ups.

Maternal and fetal outcomes in women undergoing caesarean section under general and spinal anesthesia

Background: Both spinal and general anaesthesia used for caesarean section have certain advantages and disadvantages and there is no method which is completely ideal. The most important factors for choice of anaesthesia are; pregnant systemic problems and wishes, the urgency of the operation, and the surgeon and the anesthetists experience

Aim of the Work: These studies aimed at comparing maternal and fetal outcomes in women undergoing elective caesarean section and have spinal anaesthesia with those having general anaesthesia

Subjects and Methods: This study was carried out at Ain Shams University Maternity Hospital during the period from December 2017 to August 2018 after approval of the hospital health ethical committee. It included 186 patients who had C.S and were subdivided into 2 groups according to a randomization scale. On the day of the operation, each randomly received a closed opaque envelope for the selection of the procedure [spinal versus general]

Results: We noted that the mean haemoglobin and haematocrit values at the 24th hour were higher in the spinal anaesthesia group. The estimated blood loss volume was significantly higher in the general anaesthesia group. The median apgar score at the first and the fifth minutes were significantly higher, and the time that elapsed until the first requirement for analgesia was significantly longer in the spinal anaesthesia group

Conclusion and Recommendations: General anaesthesia could be thought the quickest anaesthesia method in an emergency since it avoids the possibility of a failed regional block. Meanwhile, it is associated with higher possibility of blood loss and low Apgar score. Thus, using spinal anaesthesia for elective caesarean section is recommended provided that adequate maternal hydration is established and sparing general anaesthesia for emergency caesarean sections or whenever spinal anaesthesia is contraindicated [e.g. coagulopathy, sever thrombocytopenia, anticoagulation or sever degree of malformation of spine]

prevalence of glucose-6-phosphate dehydrogenase deficiency in people visiting health care center, KFU, Al-Hasa

Objective: To determine the prevalence of G6PD deficiency in people visiting Health Care Center of King Faisal University [KFU], Al-Hasa

Study Design: Observational / Descriptive study

Place and Duration of Study: This study was conducted at the Health Care Center, KFU, Al-Hasa, from August 2014 to April 2015

Materials and Methods: Patients presenting with weakness and anemia were included in the study. Total 214 patients, consisting of 116 children [age 3 to 14 years] and 98 adults [age 15 to 50 years], were screened. The blood samples were analyzed by using [G6P-DH Fluorescence Screening Test]

This kit detects fluorescence under U/V lamp if the sample has G6PD activity

Results: Total 36 [16.8%] of the 214 patients, tested, were deficient for G6PD. Among those deficient patients, 15 [7%] were children [11 males and 4 females], and 21 [9.8%] were adults [13 males and 8 females]. The highest prevalence of G6PD-deficiency occurred among adults, particularly males

A Comparison of Rheumatoid Arthritis Patients in Kuwait with Other Populations: Results from the KRRD Registry.

Objective: Data on rheumatoid arthritis (RA) in Kuwait and The Middle East is scarce. Available data from Western countries may not be representative of the region. We describe RA patients in Kuwait and compare them with other RA populations and with Kuwaiti general population. Methods: Adult RA patients from Kuwait Registry for Rheumatic Diseases (KRRD), the first RA registry in The Middle East, were studied from February 2013 through February 2015. Demographic, clinical and serologic data were compared with other RA populations and with Kuwaiti general population. Results: 835 patients were enrolled, 62.3% female. Mean age 50.6±12 years and disease duration 6.1±6 years. RA was diagnosed at a mean age of 44.9±12 years. 17.1% had family history of autoimmune rheumatic diseases. 3.1% had rheumatoid nodules. Rheumatoid factor (RF) and anti-citrullinated peptide (ACPA) were detected in 75.6% and 57.8%, respectively. Both were positive in 49% (r=0.287, p=0.001). ANA was positive in 19.1%. Both ACPA and a combination of positive RF and ACPA were more in males (p=0.017, 0.004 respectively), whereas ANA was more in females (p=0.01). One third of male patients were smokers versus 1.9% of females. Smoking was correlated to RF (p=0.009) and ACPA (p=0,002). Difference in ACPA between genders was statistically explained by the predominance of smoking in males. Comorbidities included diabetes mellitus (DM) (20.8%), hypertension (20.2%), hyperlipidemia (10.5%) and coronary artery disease (CAD) (3.1%). 4 cases of cancer were reported. Conclusion: RA population in Kuwait includes less women than other RA populations but more than Kuwaiti general population. Family history is more common. A higher positive ACPA in males was explained by smoking difference. Hypertension and hyperlipidemia were less reported than in both Kuwaiti general population and other RA populations. CAD was similar to other RA populations. DM was more reported, reflecting its high background prevalence in Kuwait.

Living on the Extreme Margin: Social Exclusion of the Transgender Population (Hijra) in Bangladesh.

The transgender people (hijra), who claim to be neither male nor female, are socially excluded in Bangladesh. This paper describes social exclusion of hijra [The term is used in this abstract both in singular and plural sense] focusing on the pathway between exclusion and sexual health. In an ethnographic study, 50 in-depth interviews with hijra, 20 key-informant interviews, and 10 focus-group discussions (FGDs), along with extensive field observations, were conducted. The findings revealed that hijra are located at the extreme margin of exclusion having no sociopolitical space where a hijra can lead life of a human being with dignity. Their deprivations are grounded in non-recognition as a separate gendered human being beyond the male-female dichotomy. Being outside this norm has prevented them from positioning themselves in greater society with human potential and security. They are physically, verbally, and sexually abused. Extreme social exclusion diminishes self-esteem and sense of social responsibility. Before safer sex interventions can be effective in a broader scale, hijra need to be recognized as having a space on society’s gender continuum. Hijra, as the citizens of Bangladesh and part of society’s diversity, have gender, sexual and citizenship rights, that need to be protected.

Successful resuscitation of prolonged hyperkalemic cardiac arrest following succinylcholine administration in possibly undiagnosed myopathy

We report a 3 years old male with undiagnosed myopathy, who developed cardiac arrest secondary to hyperkalemia following succinylcholine administration.The patient underwent prolonged cardiopulmonary resuscitation [CPR], which ended successfully after applying external pace maker. He was discharged home eleven days after the cardiac arrest for follow up of his myopathy