Bone Mineral Density in Patients with Pediatric Inflammatory Bowel Disease Using Dual Energy X-Ray Absorptiometry

Background@#Inflammatory bowel disease (IBD) is a chronic inflammatory immune-mediated condition that affects the gastrointestinal system and alters bone growth and bone mineral density (BMD). Here we aimed to study the prevalence and predictors of a low BMD in pediatric patients with IBD. @*Methods@#This retrospective cross-sectional analytical study included pediatric patients with IBD in whom BMD was evaluated using dual energy X-ray absorptiometry of the total body and lumbar spine. Osteoporosis was defined as a BMD Z-score ≤-2, osteopenia as -2 to -1, and normal as >-1. Clinical and laboratory findings were compared between patients with and without osteoporosis. @*Results@#Of the 48 patients, 30 (62.5%) were males, 35 (72.9%) had Crohn’s disease, and 13 (27.1%) had ulcerative colitis. The mean age at diagnosis was 9.9±2.8 years. The median age at the time of the BMD scans was 11.9 (interquartile range, 9.9–14.3) years. Total body BMD scans identified 13 (27.1%) and 16 (33.3%) patients with osteoporosis and osteopenia, respectively. Spinal BMD scans revealed that 17 (39.5%) and 14 (32.6%) patients had osteoporosis and osteopenia, respectively. A low body mass index (BMI) Z-score (p=0.038), ileocolonic disease location (p=0.008), and a low calcium level (p=0.008) were significant predictors of osteoporosis on the total body BMD scans. A low BMI Z-score (p=0.039), decreased hemoglobin level (p=0.018), low calcium level (p=0.033), and infliximab use (p=0.019) were significant predictors of osteoporosis on the spinal BMD scans. @*Conclusions@#This study showed a high prevalence of low BMD among pediatric patients with IBD. A low BMI, ileocolonic disease location, low hemoglobin and calcium levels, and infliximab use were significantly associated with osteoporosis.

EGFR and HER-2/neu expression in gallbladder carcinoma: an institutional experience

Background: Gallbladder cancer [GBC] is the most common malignancy of the biliary tract in India. Despite the recent advancement in the understanding of the cancer biology, the disease still remains a therapeutic challenge with poor prognosis and low survival. Surgery is the primary modality of treatment and rest of the modalities are basically adjuvant in nature. This study was performed to evaluate the epidermal growth factor receptor [EGFR] and human epidermal growth factor receptor-2 [HER-2/neu] expression in GBC

Methods: The present study was prospective and done in tertiary super-specialty institute of northern India. This was a pilot study, and at the time of completion, 29 samples were found suitable which were later submitted for EGFR and HER-2/neu evaluation. The sample includes both cases of GBC [n=18] and cholecystitis [n=11] as control. [Table 1] After performing necessary processing, slides were incubated with primary antibody [EGFR] ready to use [RTU] BioGenex, India and HER-2/neu dilution 1: 600, Dakopatts [Denmark]. Then slides were incubated with secondary antibody [Real Envision Detection Kit, Dakopatts, Denmark]. Finally in mounted slides, cell membrane staining was used to assess positivity for EGFR and HER-2/neu

Results: EGFR was positive in 21/29 [72.41%] overall, out of which 14/18 [77.78%] positive in cases and 7/11 [63.64%] positive in control. [Table 1, 3][Figure 2]. For HER-2/neu, it was positive in 21/29 [72.41%] overall, just like in EGFR mentioned above, but positive 12/18 [66.67%] in cases and 9/11 [81.82%] in control respectively. [Table 1, 3][Figure 3]

Conclusion: Despite the efforts by many investigators, GBC continues to represent a major challenge in oncology. Surgical resection remains the only curative treatment for this disease. The roles of radiation, chemoradiation, and chemotherapy in neoadjuvant and adjuvant settings remained to be defined in prospective studies. With further studies based on molecular understanding and developing new targeted therapies, we will be in better position to manage GBC and increase the survival rate

level of mite dermatophagoides' allergens [Der-p 1 and Der-f 1] in Birjand

House dust mite allergens especially pyroglyphid species are among the most important indoor allergens and have an important role in development of asthma and allergies. In current study, the level of two main allergens from mites including Der-p1 and Der-f 1 in dust of 28 homes in Birjand city was measured by ELISA method. All samples were negative for Der-p1. Low leverl of Der-f 1 was detected in one sample. Prevalence of asthma, rhinitis and rhinoconjunctivitis was 2%, 28% and 15% respectively. The results of this study suggest that House dust mites could not grow in Birjand climate

Effect of magnesium supplementation on physical activity of overweight or obese insomniac elderly subjects: a double-blind randomized clinical trial

Strategies for weight reduction often promote lifestyle changes like encouraging participation in physical activity. Also there is some evidence suggesting an association between insomnia and physical activity level and probable beneficial effect of magnesium supplementation on insomnia. The objective of this study was to determine the effect of magnesium supplementation on physical activity level in insomniac elderly subjects. A double blind randomized clinical trial was conducted in 46 overweight or obese subjects, randomly allocated into the magnesium or the placebo group and received 500 mg magnesium or placebo daily for 8 weeks. Questionnaires of insomnia severity index [ISI], physical activity and sleep-log were completed and serum magnesium measured at baseline and after the intervention period. Anthropometric confounding factors, daily intake of magnesium, calcium, potassium, caffeine, calorie form carbohydrates, fat, protein and total calorie intake, were obtained using 24-hrs recall for 3- days. Statistical analyses were performed using SPSS-19 software. No significant differences were observed in assessed variables between the two groups at the baseline. According to our research magnesium supplementation significantly increased sleep indices and physical activity level, also resulted in significantly decrease of total calorie intake in magnesium group. Although serum magnesium concentration and weight did not show any differences. In the present study magnesium supplementation resulted in improvement of sleep indices and physical activity level in elderly subjects. Although according to our short term intervention no significant beneficial effect was observed on subject's weight

Pattern of injuries in trauma patients presenting in accident and emergency department of Jinnah Hospital, Lahore

To observe the pattern of injuries in patients involved in different kinds of trauma presenting to the Accident and Emergency Department of Jinnah Hospital Lahore. A prospective descriptive epidemiological study. Accident and emergency department of Jinnah Hospital Lahore. From 1st April 2005 to 30th September 2005. The study included patients presenting with different kinds of trauma to the emergency department of Jinnah Hospital, Lahore. They were further categorized into trauma of different regions of the body i.e. upper limb, lower limb, abdomen, head and neck, thorax and perineum. Then frequency of different types of trauma was determined. During this period [1st April2005 to 30th September 2005], 111'413 patients presented in accident and emergency department and 4680 patients had traumatic injury. 1404 patients [30%] had blunt trauma, 134[2.86%] had penetrating firearms injury, 2433[51.99%] had penetrating sharp injury an d 709 patients [15.15%] had crush injury. Most patients got upper limb, lower limb, head and neck and abdominal injuries, in that order. Most patients received multiple injuries. 3340 patients [71.36%] got only minor surgery like stitching under local anaesthesia and 468 patients [10%] had no surgery at all. 872 patients [18.63%] underwent some kind of major surgical procedure like amputation, exploratory laparotomy, or stitching under GA etc. Trauma is a leading cause of morbidity and mortality among all age groups. Most of the trauma victims receiving minor injuries can be treated at primary heath care centers. This can decrease the load of tertiary care hospitals. Maximum impact in reducing the burden of trauma must come from injury prevention strategies

Maternal mortality: a 10-year study at Nishtar-Hospital Multan

To analyse causes of maternal deaths and to identify preventable causes leading to this tragedy in our setup. An analytical, hospital-based study. Department of Obstetric and Gynaecology, Nishter Hospital Multan from June-August 2005. During the study period retrospective data was collected for period of 10 year from January 1995 to December 2004. This data was analyzed in order to determine the Maternal Mortality Rate [MMR], causes of death and characteristics of the mothers who died including her age, parity and whether they were booked or unbooked. A total numbers of 30031 deliveries took place during the study period and there were 178 maternal deaths with maternal mortality rate of 593/100,000 LB [live births]. 7[3.9%] patients were below the age of 20, 74[41.5%] were in the age group of 21-30 and 82[46%] in 31-40 years age range. 15[8.42%] were above the age of 40. Most of them [69%] were grand multiparas [Parity >5]. The major causative factors were haemorrhage 63[35.4%], eclampsia 41[23.03%], sepsis 25[14.04%], anaemia 18[10.1%], hepatic encephalopathy 14[7.9%], abortion 11[6.2%]. Majority of the patients were unbooked and presented in the hospital very late. A high proportion of potentially preventable maternal deaths indicate the need for improvements in education for both patient and health care provider. The provision of skilled care and timely management of complications can lower maternal mortality in our setup