RESUMO
Objective: To determine the clinical and immunological characteristics and short-term outcome of children with systemic lupus erythematosus [SLE]. Study Design: A descriptive cohort study. Place and Duration of Study: Paediatric Rheumatology Clinic, The Aga Khan University Hospital, Karachi, from January 2011 to December 2015
Methodology: Clinical and immunological profile and short-term outcome of children less than 16 years of age admitted in the paediatric ward, with the diagnosis of SLE was studied. Demographic data, clinical presentation, laboratory findings, immunological profile and treatment regimens of these children were evaluated
Results: Thirty-two children, satisfying the criteria of American College of Rheumatology [ACR] for SLE, were enrolled during the study period of five consecutive years. A female predominance was observed with 28 [87.5%] patients being female [F:M 7:1]. Mean age at symptom onset was 10.5 +2.7 years; and 8.8 +2.1 years in females and males, respectively. The mean age at diagnosis was 11.3 +2.8 years in females and 9.4 +1.9 years in males. Prolonged fever was the most common non-specific symptom found in 27 [84%], followed by pallor in 13 [41%] patients. Twenty-two [69%] children were found to be anemic and 18 patients [56%] having signs of arthritis at presentation. Renal involvement was observed in 15 [47%] patients. The most common laboratory finding was anemia, found in 22 [69%] of cases. The most common immunological markers were serum anti-neutrophil antibodies [ANA], positive in 28 [88%] patients, followed by anti double-stranded DNA antibodies, raised in 26 [81%] of cases. Out of 32, 12 patients were lost to follow-up. Of the remaining 20 children who were followed for four years, ten [50%] went into remission
Conclusion: Childhood-onset SLE encompasses a wide variety of manifestations with a female preponderance. Fever, arthralgia and pallor are the most frequent clinical manifestations among the children. Hemolytic anemia [HA] is the most common laboratory abnormality, with ANA and anti ds-DNA antibodies positivity in the majority of padiatric patients
RESUMO
Disinfectants are chemical agents used to eradicate, deactivate or kill microorganisms. Chemical disinfectants especially chlorine compound are extensively used for water sanitization. Among these calcium hypochlorite and chloramines are commonly used now a day. Large number of chemical compounds, drugs and endogenous substances are metabolized by hepatic enzymes known as cytochrome P450 enzyme system. Many chemicals are capable of enzyme induction. Enzyme induction may change the metabolism of other drugs and endogenous substances which may alter the plasma concentration of these chemicals. To evaluate the enzyme inducing ability of calcium hypochlorite and chloramine, sleeping time induced by sodium pentobarbital was noted in mice. Normal saline was taken as negative control. Rifampicin, chloramphenicol and grapefruit juice were taken as positive control group. On completion of dosing after 4 weeks, alteration in sleep induction and recovery times was noted and compared. Histological evaluation of liver was observed. Asignificant decrease in sleeping time was observed in calcium hypochlorite and chloramine treated groups. Both calcium hypochlorite and chloramine caused a significant change in liver enzymes and in the values of complete blood count.In histological evaluation both caused fat deposition in the hepatocytes. It was concluded from the study that both calcium hypochlorite and chloramine were hepatic microsomal enzyme inducer