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Bitar R, Azaz A, Rawat D, Hobeldin M, Miqdady M, Abdelsalam S. Advances and challenges of gastrostomy insertion in children. World J Gastrointest Surg 2023; 15:1871-1878. [PMID: 37901743 PMCID: PMC10600771 DOI: 10.4240/wjgs.v15.i9.1871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/13/2023] [Accepted: 07/18/2023] [Indexed: 09/21/2023] Open
Abstract
When oral feeding cannot provide adequate nutritional support to children, enteral tube feeding becomes a necessity. The overall aim is to ultimately promote appropriate growth, improve the patient's quality of life and increase carer satisfaction. Nasogastric tube feeding is considered appropriate on a short-term basis. Alternatively, gastrostomy feeding offers a more convenient and safer feeding option especially as it does not require frequent replacements, and carries a lower risk of complications. Gastrostomy tube feeding should be considered when nasogastric tube feeding is required for more than 2-3 wk as per the ESPEN guidelines on artificial enteral nutrition. Several techniques can be used to insert gastrostomies in children including endoscopic, image guided and surgical gastrostomy insertion whether open or laparoscopic. Each technique has its own advantages and disadvantages. The timing of gastrostomy insertion, device choice and method of insertion is dependent on the local expertise, patient requirements and family preference, and should be individualized with a multidisciplinary team approach. We aim to review gastrostomy insertion in children including indications, contraindications, history of gastrostomy, insertion techniques and complications.
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Affiliation(s)
- Rana Bitar
- Pediatric Gastroenterology, Sheikh Khalifa Medical City, Abu Dhabi 767451, United Arab Emirates
- Faculty of Medicine, Khalifa University, Abu Dhabi 767451, United Arab Emirates
| | - Amer Azaz
- Pediatric Gastroenterology, Sheikh Khalifa Medical City, Abu Dhabi 767451, United Arab Emirates
- Faculty of Medicine, Khalifa University, Abu Dhabi 767451, United Arab Emirates
| | - David Rawat
- Pediatric Gastroenterology, Barts Health NHS Trust, London E1 1BB, United Kingdom
| | - Mohamed Hobeldin
- Pediatric Surgery, Sheikh Khalifa Medical City, Abu Dhabi 767451, United Arab Emirates
| | - Mohamad Miqdady
- Pediatric Gastroenterology, Sheikh Khalifa Medical City, Abu Dhabi 767451, United Arab Emirates
- Faculty of Medicine, Khalifa University, Abu Dhabi 767451, United Arab Emirates
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Bitar R, Elghoudi AA, Rawat D, Azaz A, Miqdady M, Narchi H. COVID-19-induced liver injury in infants, children, and adolescents. World J Clin Pediatr 2023; 12:57-67. [PMID: 37342451 PMCID: PMC10278079 DOI: 10.5409/wjcp.v12.i3.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/07/2022] [Accepted: 03/17/2023] [Indexed: 06/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) typically presents with fever and respiratory symptoms in children. Most children develop an asymptomatic and mild illness, with a minority requiring specialist medical care. Gastrointestinal manifestations and liver injury can also occur in children following infection. The mechanisms of liver injury may include infection following direct viral hepatic tissue invasion, immune response, or medication effects. Affected children might develop mild liver dysfunction which has a benign course in most children with no pre-existing liver disease. However, the presence of non-alcoholic fatty liver disease or other pre-existing chronic liver disorders is associated with a higher risk of developing severe COVID-19 illness with poor outcomes. On the other hand, the presence of liver manifestations is associated with the severity of COVID-19 disease and is considered an independent prognostic factor. Respiratory, hemodynamic, and nutritional supportive therapies are the mainstay of management. Vaccination of children at increased risk of developing severe COVID-19 disease is indicated. This review describes the liver manifestations in children with COVID-19, detailing its epidemiology, basic mechanisms, clinical expression, management, and prognosis in those with and without pre-existing liver disease and also children who have had earlier liver transplantation.
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Affiliation(s)
- Rana Bitar
- Division of Pediatric Gastroenterology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Ahmed A Elghoudi
- Department of Pediatric, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- Department of Pediatric, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - David Rawat
- Division of Pediatric Gastroenterology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Amer Azaz
- Division of Pediatric Gastroenterology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Mohamad Miqdady
- Division of Pediatric Gastroenterology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Hassib Narchi
- Department of Pediatric, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Bitar R, Syed A, Azaz A, Rawat D, Hobeldin M, Miqdady M, Abdelsalam S. Is endoscopy beneficial in pediatric laparoscopic gastrostomy insertion; A 9-year comparative study. Front Pediatr 2022; 10:950867. [PMID: 36034566 PMCID: PMC9402975 DOI: 10.3389/fped.2022.950867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Advancements in pediatric percutaneous endoscopic gastrostomy placement (PEG), laparoscopic-assisted gastrostomy (LAG) technique, and laparoscopic-assisted percutaneous endoscopic gastrostomy (LAPEG) procedure have opened up new options for gastrostomy tube placement. LAPEG utilizes endoscopy and laparoscopy for gastrostomy insertion. This review compares the outcomes and complications of LAG and LAPEG techniques in children. Methods All LAG and LAPEG gastrostomy tube placements in children from September 2010 to September 2019 were reviewed retrospectively. Patient demographic, along with procedural and 1-year complication data, were collected. Results In total, 92/181 of gastrostomies were LAG and 89/181 were LAPEG. The mean age, weight and patient characteristics were comparable. Conversion rate was 1% in both groups (p = 0.74), there was no peritoneal leak in either group, a minor serosal injury to the stomach was seen in 1 patient in LAG with no bowel injury in LAPEG cohort (p = 0.51), need for re-operation was 1 and 2% in LAG and LAPEG, respectively (p = 0.49), early tube dislodgement was in 8 (9%) patients in LAG and 7 (6%) in LAPEG (p = 0.53) and wound infection was 13/92 in LAG and 11/89 in LAPEG (p = 0.8). The median operative time for LAPEG was less than LAG (p < 0.001) by 11 min but the median length of hospital stay was not significantly different (p < 0.096). Conclusion Both LAG and LAPEG techniques in children are safe with comparable complication rates and length of hospital stay, the addition of endoscopy to LAG allowed for shorter operative time in the LAPEG technique.
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Affiliation(s)
- Rana Bitar
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
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Bitar RR, Alattas B, Azaz A, Rawat D, Miqdady M. Gastrointestinal manifestations in children with COVID-19 infection: Retrospective tertiary center experience. Front Pediatr 2022; 10:925520. [PMID: 36619504 PMCID: PMC9811669 DOI: 10.3389/fped.2022.925520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The majority of pediatric severe acute respiratory syndrome coronavirus 2 (COVID-19) cases demonstrate asymptomatic, mild or moderate disease. The main symptoms in children with COVID-19 are respiratory symptoms but some patients develop gastrointestinal symptoms and liver injury. We aim to review gastrointestinal symptoms and liver injury in children with confirmed COVID-19 infection. METHOD This is a retrospective case note review of children with positive COVID-19 nasal Polymerase Chain Reaction aged 0-18 years admitted to a tertiary pediatric hospital from March 1st till June 1st 2020. RESULTS 180 children were identified. Mean age was 5 years (Range: 0.01-17), the majority of patients were school aged (30%). Patients were mainly from East Asia 81 (45%) and Arabs 67 (37%). Gastrointestinal symptoms were encountered in 48 (27%) patients and 8 (4%) patients had only Gastrointestinal symptoms with no associated fever or respiratory symptoms. Liver injury was seen in 57 (32%) patients. Patients with fever and cough were more likely to have gastrointestinal symptoms (P = <0.001 and 0.004 respectively). Fever was more likely to be associated with liver injury (P = 0.021). Children with abdominal pain were more likely to have elevated C-Reactive Protein (P = 0.037). Patients with diarrhea and vomiting were more likely to have elevated procalcitonin (P = 0.034 and 0.002 respectively). Children with Gastrointestinal symptoms were not more likely to be admitted to Pediatric Intensive Care Unit (P = 0.57). CONCLUSION COVID-19 infection in children can display gastrointestinal symptoms at initial presentation. Additionally, gastrointestinal symptoms can be the only symptoms patients display. We demonstrated that children with gastrointestinal symptoms and liver injury can develop more severe COVID-19 disease and are more likely to have fever, cough, and raised inflammatory markers. Identifying children with gastrointestinal manifestations needs to be part of the initial screening assessment of children.What is known?• Pediatric COVID-19 cases mostly demonstrate asymptomatic, mild or moderate disease.• The symptoms in children are mainly respiratory but some display gastrointestinal symptoms.• Children with COVID-19 display increased gastrointestinal symptoms when compared to adults.What is new?• Children with COVID-19 displaying gastrointestinal symptoms are more likely to have fever, cough and elevated inflammatory markers.• Children with liver injury are more likely to develop fever.• Children with gastrointestinal involvement in COVID-19 are more likely to demonstrate more severe disease but are not more likely to be admitted to PICU.
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Affiliation(s)
- Rana R Bitar
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Bushra Alattas
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Amer Azaz
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - David Rawat
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Mohamad Miqdady
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
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Alattas B, Azaz A, Rawat D, Midday M, Bitar R. Clinical manifestations and outcome in children with COVID-19 infection in Abu Dhabi: a retrospective single-centre study. BMJ Paediatr Open 2021; 5:e001219. [PMID: 34841090 PMCID: PMC8609498 DOI: 10.1136/bmjpo-2021-001219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/03/2021] [Indexed: 01/02/2023] Open
Abstract
We conducted a retrospective cohort review of 180 patients aged 0-18 years with positive COVID-19 nasal PCR swab admitted to the only designated paediatric COVID-19 hospital in Abu Dhabi from 1 March to 1 June 2020. 60 (33%) patients were asymptomatic, 117 (65%) patients had mild or moderate symptoms and 3 patients required intensive care with no mortality reported. Symptoms at presentation were fever in 84 patients, cough in 62 patients and gastrointestinal symptoms in 48 patients.
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Affiliation(s)
- Bushra Alattas
- General Paediatric Department, Sheikh Khalifa Medical City, Abudhabi, UAE
| | - Amer Azaz
- Pediatric Gastroenterology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - David Rawat
- Pediatric Gastroenterology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Mohamad Midday
- Pediatric Gastroenterology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Rana Bitar
- Pediatric Gastroenterology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
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Wan JWY, Griffiths E, Rabone R, Zuhair Z, Londt Z, Rawat D, Maginnis J, Elzubair A, Pigott A, Thomson M, Narula P. Measuring patient and carer experience related to paediatric gastrointestinal endoscopy: multicentre questionnaire study. Frontline Gastroenterol 2020; 11:448-453. [PMID: 33101623 PMCID: PMC7569525 DOI: 10.1136/flgastro-2019-101303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/05/2019] [Accepted: 12/18/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The Paediatric Endoscopy Global Rating Scale (P-GRS) is a quality improvement tool used in the UK. An important aspect of this includes regular surveys on the patient and/or carer's endoscopy experience. The aim of our study was to design and implement a patient/carer experience questionnaire. METHODS This questionnaire was designed to obtain feedback on patient and/or carer satisfaction with their endoscopy experience. Question selection was based on relevant measures in the endoscopy Global Rating Scale, with input from clinical governance, Patient Advice and Liaison Service and a hospital youth forum. This was distributed to patients and/or carers in three UK paediatric endoscopy services during six surveys between 2013 and 2018. Data were then collated and analysed on Microsoft Excel for Office 365 MSO (16.0.11901.20070). RESULTS Overall, 830 endoscopic procedures occurred during the six survey periods. 270 questionnaires were returned. Feedback from the questionnaires were mostly positive (overall satisfaction rated 'excellent' or 'good' was seen in 87% of responses) but also identified areas of improvement, such as in managing postprocedure pain and having a separate space for adolescents for preprocedure discussions. Improvements in satisfaction scores were noted in one unit over time, particularly in preprocedure preparation (from 86% to 100%), and overall satisfaction with endoscopy experience (81%-100%). CONCLUSION All three paediatric endoscopy services found this questionnaire useful in identifying areas needing improvement and in demonstrating compliance with measures within the P-GRS quality of patient experience domain. Further work includes exploring ways to increase response rates, as well as developing age-appropriate and electronic versions.
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Affiliation(s)
- Jessica Wai Yan Wan
- Department of Paediatric Gastroenterology, Sheffield Children's Hospital, Sheffield, South Yorkshire, UK
| | - Elizabeth Griffiths
- Department of Paediatric Gastroenterology, Sheffield Children's Hospital, Sheffield, South Yorkshire, UK
| | - Rosalind Rabone
- Department of Paediatric Gastroenterology, Sheffield Children's Hospital, Sheffield, South Yorkshire, UK
| | - Zahmeena Zuhair
- Department of Paediatric Gastroenterology, Sheffield Children's Hospital, Sheffield, South Yorkshire, UK
| | - Zuzana Londt
- Department of Paediatric Gastroenterology, Royal London Hospital, London, UK
| | - David Rawat
- Department of Paediatric Gastroenterology, Royal London Hospital, London, UK
| | - Janis Maginnis
- Department of Paediatric Gastroenterology, Royal Stoke University Hospital, Stoke-on-Trent, Staffordshire, UK
| | - Amal Elzubair
- Department of Paediatric Gastroenterology, Royal Stoke University Hospital, Stoke-on-Trent, Staffordshire, UK
| | - Anna Pigott
- Department of Paediatric Gastroenterology, Royal Stoke University Hospital, Stoke-on-Trent, Staffordshire, UK
| | - Mike Thomson
- Department of Paediatric Gastroenterology, Sheffield Children's Hospital, Sheffield, South Yorkshire, UK
| | - Priya Narula
- Department of Paediatric Gastroenterology, Sheffield Children's Hospital, Sheffield, South Yorkshire, UK
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Miqdady M, Al Mistarihi J, Azaz A, Rawat D. Prebiotics in the Infant Microbiome: The Past, Present, and Future. Pediatr Gastroenterol Hepatol Nutr 2020; 23:1-14. [PMID: 31988871 PMCID: PMC6966216 DOI: 10.5223/pghn.2020.23.1.1] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/23/2019] [Indexed: 12/26/2022] Open
Abstract
The latest definition of a prebiotic is "a substrate that is selectively utilized by host microorganisms conferring a health benefit"; it now includes non-food elements and is applicable to extra-intestinal tissues. Prebiotics are recognized as a promising tool in the promotion of general health and in the prevention and treatment of numerous juvenile diseases. Prebiotics are considered an immunoactive agent, with the potential for long-lasting effects extending past active administration of the prebiotic. Because of its extremely low risk of serious adverse effects, ease of administration, and strong potential for influencing the composition and function of the microbiota in the gut and beyond, the beneficial clinical applications of prebiotics are expanding. Prebiotics are the third largest component of human breast milk. Preparations including galactooligosaccharides (GOS), fructooligosaccharides (FOS), 2'-fucosyllactose, lacto-N-neo-tetraose are examples of commonly used and studied products for supplementation in baby formula. In particular, the GOS/FOS combination is the most studied. Maintaining a healthy microbiome is essential to promote homeostasis of the gut and other organs. With more than 1,000 different microbial species in the gut, it is likely more feasible to modify the gut microbiota through the use of certain prebiotic mixtures rather than supplementing with a particular probiotic strain. In this review, we discuss the latest clinical evidence regarding prebiotics and its role in gut immunity, allergy, infections, inflammation, and functional gastrointestinal disorders.
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Affiliation(s)
- Mohamad Miqdady
- Department of Pediatric, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | | | - Amer Azaz
- Department of Pediatric, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - David Rawat
- Department of Pediatric, Sheikh Khalifa Medical City, Abu Dhabi, UAE
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Mutalib M, Rawat D, Lindley K, Borrelli O, Perring S, Auth MKH, Thapar N. BSPGHAN Motility Working Group position statement: paediatric multichannel intraluminal pH impedance monitoring-indications, methods and interpretation. Frontline Gastroenterol 2017; 8:156-162. [PMID: 28839903 PMCID: PMC5558281 DOI: 10.1136/flgastro-2016-100796] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/18/2017] [Accepted: 02/23/2017] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Combined pH-impedance monitoring has been suggested as the investigation of choice for diagnosing gastro-oesophageal reflux in children. Although it is superior to oesophageal pH monitoring in detecting all types of reflux episodes (acid, weakly acidic and alkaline) with the ability to evaluate symptom association with reflux events, it is still limited by the lack of true paediatric normal value and the high cost involved (equipment and personnel). OBJECTIVE To produce a position statement on behalf of the Motility Working Group of the British Society of Paediatric Gastroenterology, Hepatology and Nutrition on the indications and practical application of combined oesophageal pH-impedance monitoring in children. METHODS Up-to-date review of available evidence. RESULTS This document provides a practical guide to clinician on indications, methods and results interpretation of paediatric multichannel intraluminal impedance pH (MII-pH). CONCLUSIONS MII-pH is increasingly used by paediatricians as the diagnostic tool for assessing gastro-oesophageal reflux disease and symptom association. There is wide variation in paediatric practice and a need for standardised practice.
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Affiliation(s)
- Mohamed Mutalib
- Paediatric Gastroenterology Department, Evelina London Children's Hospital, London, UK
| | - David Rawat
- Paediatric Gastroenterology Department, Royal London Hospital, London, UK
| | - Keith Lindley
- Paediatric Gastroenterology Department, Great Ormond Street Hospital, London, UK
| | - Osvaldo Borrelli
- Paediatric Gastroenterology Department, Great Ormond Street Hospital, London, UK
| | - Steve Perring
- Department of Medical Physics, Poole Hospital, Poole, UK
| | - Marcus K H Auth
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Nikhil Thapar
- Paediatric Gastroenterology Department, Great Ormond Street Hospital, London, UK
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Bharathan B, Backhouse L, Rawat D, Naik S, Millar M. An unusual case of seronegative, 16S PCR positive Brucella infection. JMM Case Rep 2016; 3:e005050. [PMID: 28348782 PMCID: PMC5343140 DOI: 10.1099/jmmcr.0.005050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/19/2016] [Indexed: 12/01/2022] Open
Abstract
Introduction: Brucella is a zoonotic infection commonly diagnosed by isolation of the organism from blood culture or positive serological testing. It is an uncommon cause of a pyrexia of unknown origin in the United Kingdom. Case presentation: We describe the case of a 14-year-old girl with no history of travel who presented with pyrexia, weight loss, arthralgia, multiple splenic abscesses and a subsequent pleural effusion, the latter of which isolated a Brucella species on 16S rRNA PCR. The patient responded well to initiation of treatment for brucellosis and on repeat imaging, after 3 months, the splenic abscesses had resolved. Conclusion: This unique case demonstrates uncommon complications of brucellosis and the challenges of diagnosing the organism, the latter of which can be alleviated by the utilization of molecularbased technologies. This patient had a negative serology result for brucellosis, which highlights the need to interpret serology results with caution in non-endemic regions for brucellosis.
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Affiliation(s)
- Binutha Bharathan
- Department of Infection, Bart's Health , 80 Newark Street, Whitechapel , London, E1 2ES, UK
| | - Lucy Backhouse
- Department of Paediatrics, Bart's Health , Royal London Hospital, Whitechapel Road , London, E1 1BB, UK
| | - David Rawat
- Department of Paediatrics, Bart's Health , Royal London Hospital, Whitechapel Road , London, E1 1BB, UK
| | - Sandhia Naik
- Department of Paediatrics, Bart's Health , Royal London Hospital, Whitechapel Road , London, E1 1BB, UK
| | - Michael Millar
- Department of Infection, Bart's Health , 80 Newark Street, Whitechapel , London, E1 2ES, UK
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Bharara T, Bhalla P, Rawat D, Garg VK, Sardana K, Chakravarti A. Rising trend of antimicrobial resistance among Neisseria gonorrhoeae isolates and the emergence of N. gonorrhoeae isolate with decreased susceptibility to ceftriaxone. Indian J Med Microbiol 2016; 33:39-42. [PMID: 25560000 DOI: 10.4103/0255-0857.148374] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
CONTEXT Gonorrhoea is one of the most common sexually transmitted infections (STI) in developing countries and is a global health problem. AIMS To analyze the trend of antimicrobial susceptibility of Neisseria gonorrhoeae isolates over the years, in a tertiary care hospital of North India. SETTINGS AND DESIGN The study population comprised males with urethritis and females with endocervicitis attending STI clinic of our hospital. MATERIALS AND METHODS In our STI laboratory, all gonococcal isolates are subjected to antimicrobial susceptibility testing by disc diffusion method as per CLSI guidelines. β-Lactamase production is determined by chromogenic cephalosporin test. Minimum Inhibitory Concentration (MIC) for ceftriaxone is determined by E-test. STATISTICAL ANALYSIS USED Data were expressed as percentages. The differences in percentages were tested for statistical significance by using χ2 test and P values were determined. RESULTS The percentage of penicillinase producing N. gonorrhoeae (PPNG) increased from 8% in 1995-96 to 20% in 2004-05 and 88% in 2011-2013. Quinolone-resistant N. gonorrhoeae (QRNG) showed a significant increase from 12% in 1995-96 to 98.3% in 2004-05, while 84% isolates were found to be QRNG by 2011-2013. In January 2013 we detected our first gonococcal isolate with decreased susceptibility to third-generation cephalosporins; Ceftriaxone, Cefixime and Cefpodoxime (MIC for ceftriaxone = 0.19 μg/ml). CONCLUSIONS The results of our study highlighted an alarming increase in the percentage of PPNG and QRNG strains over the years. Emergence of N. gonorrhoeae isolates with decreased susceptibility to third-generation cephalosporins is a cause of concern and thus emphasises the importance of antimicrobial susceptibility testing.
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Affiliation(s)
| | - P Bhalla
- Department of Microbiology, Maulana Azad Medical College, New Delhi, India
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Bhattar S, Bhalla P, Rawat D, Tripathi R, Kaur R, Sardana K. Asymptomatic reproductive tract infections/sexually transmitted infections among HIV positive women. Indian J Med Microbiol 2016; 33:410-2. [PMID: 26068345 DOI: 10.4103/0255-0857.158568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
This study aims to highlight the importance of screening all HIV positive women for various reproductive tract infections/sexually transmitted infections (RTIs/STIs) irrespective of symptoms and to determine its occurrence in asymptomatic HIV positive women. Relevant specimens were collected for diagnosis of various RTIs/STIs. STIs were diagnosed in nearly one-third of the HIV positive asymptomatic patients which is quite high. The national strategy for STIs/RTIs control misses out large number of asymptomatic RTIs/STIs in HIV positive women which is responsible for silently transmitting these infections in the community. So this strategy should be modified to include screening of all HIV positives women irrespective of symptoms of STIs/RTIs.
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Affiliation(s)
| | - P Bhalla
- Department of Microbiology, Maulana Azad Medical College, Delhi University, New Delhi, India
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Simmonds J, Ninis N, Chase J, Meadows N, Rawat D, Watson T. Interferential for slow transit constipation in children with Ehlers Danlos Syndrome – Hypermobility Type: a novel service development. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bharara T, Bhalla P, Garg V, Chakravarti A, Sardana K, Rawat D, Patwardhan V. P5.101 Rising Trend of Antimicrobial Resistance Among Neisseria Gonorrhoeae Isolates in a Central Delhi Tertiary Care Hospital. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bharara T, Rawat D, Bhalla P, Garg VK, Sardana K, Patwardhan V. P3.026 Low Prevalence of Chlamydia Trachomatis Infection: Fact or Missed Diagnosis? Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Patwardhan V, Bhalla P, Garg VK, Chakravarti A, Sardana K, Rawat D, Sethi S, Bharara T. P5.068 Role of Type Specific Herpes Simplex Virus Serology in Diagnosis of Primary and Recurrent Genital Herpes- a Study in the Indian Population. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Abstract
PURPOSE Ofloxacin (OFX) is one of the potent fluoroquinolone (FQ) recommended to treat MDR-TB. Over a decade, the preexposure of this drug for the treatment of other bacterial infections has resulted in acquisition of FQ resistance among Mycobacterium tuberculosis strains. Considering this possibility, a study was undertaken in a tertiary care center in the capital city (India) to assess the drug resistance trends of OFX among susceptible and multidrug resistant (MDR) strains of M. tuberculosis. MATERIALS AND METHODS A total of 102 M. tuberculosis isolates (47 susceptible to first-line drugs and 55 MDR isolates) were screened for susceptibility testing of OFX with a critical concentration of 2 μg/ml by Lowenstein Jensen (LJ) proportion method. RESULTS The results showed 40 (85.1%) isolates among 47 susceptible isolates and 34 (61.8%) isolates among 55 MDR isolates, were found to be susceptible to OFX. Fisher's exact test showed significant P-value (0.0136) demonstrating 1.377 fold (95% confidence interval) increased risk to become resistant to OFX than susceptible isolates. These finding shows decreased OFX susceptibility is not only limited to MDR isolates but also increasingly seen in susceptible strains as a result of drug abuse. CONCLUSIONS Our finding were not alarming, but highlights the general risk of acquiring resistance to OFX, jeopardizing the potential for these drugs to be used as second-line anti-TB agents in the management of drug-resistant TB and creating incurable TB strains .
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Affiliation(s)
- J S Verma
- Department of Microbiology, VMMC and Safdarjung Hospital, New Delhi, India
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Verma JS, Rawat D, Manzoor N, Deb M, Nair D. Evaluation of nucleic acid probe for rapid identification of Mycobacterium tuberculosis complex in extra-pulmonary culture isolates. J Commun Dis 2011; 43:11-15. [PMID: 23785877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Patients infected with Non-tuberculous mycobacteria (NTM) usually do not respond to conventional anti-tubercular treatment and are misdiagnosed as infection with multi-drug resistant strains of mycobacterium tuberculosis (M.tb) due to lack of correct species identification, particularly in the developing countries like India. One of the challenges faced by clinicians in the treatment of tuberculosis is the absence of an easy, reliable and rapid identification tool that can accurately differentiate disease caused by M.tb complex from NTM. Keeping this in consideration, the performance of species specific nucleic acid probe i.e. Accuprobe was assessed and compared with conventional niacin production, nitrate reductase assay techniques for identification of M.tb complex in 80 mycobacterial isolates obtained from different extra-pulmonary sites. Accuprobe identified 62 isolates (77.5%) as M. tuberculosis complex and remaining 18 isolates (22.5%) as NTM whereas 64 isolates (80%) were identified as M.tb and rest 16 (20%) were interpreted as NTM by conventional biochemical techniques. The overall agreement between both techniques was 96.9% The sensitivity, specificity, positive predictive value(PPV) and negative predictive value (NPV) shown by accuprobe were 96.9%, 100%, 96.9%, and 88.9% respectively. Thus, accuprobe has showed impressive sensitivity and specificity giving results in < 3 hrs from culture-positive isolates and have sure edge over conventional biochemical methods which are, nonetheless, labour intensive and cumbersome to perform thus delaying prompt mycobacterial identification.
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Affiliation(s)
- J S Verma
- Department of Microbiology, VMMC & Safdarjung Hospital, New Delhi, India
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Thomson M, Rao P, Rawat D, Wenzl TG. Percutaneous endoscopic gastrostomy and gastro-oesophageal reflux in neurologically impaired children. World J Gastroenterol 2011; 17:191-6. [PMID: 21245991 PMCID: PMC3020372 DOI: 10.3748/wjg.v17.i2.191] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Revised: 12/31/2009] [Accepted: 01/07/2010] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the effects of percutaneous endoscopic gastrostomy (PEG) feeding on gastro-oesophageal reflux (GOR) in a group of these children using combined intraluminal pH and multiple intraluminal impedance (pH/MII).
METHODS: Ten neurologically impaired children underwent 12 h combined pH/MII procedures at least 1 d before and at least 12 d after PEG placement.
METHODS: Prior to PEG placement (pre-PEG) a total of 183 GOR episodes were detected, 156 (85.2%) were non-acidic. After PEG placement (post-PEG) a total of 355 episodes were detected, 182 (51.3%) were non-acidic. The total number of distal acid reflux events statistically significantly increased post-PEG placement (pre-PEG total 27, post-PEG total 173, P = 0.028) and the mean distal pH decreased by 1.1 units. The distal reflux index therefore also significantly increased post-PEG [pre-PEG 0.25 (0-2), post-PEG 2.95 (0-40)]. Average proximal pH was lower post-PEG but the within subject difference was not statistically significant (P = 0.058). Median number of non-acid GOR, average reflux height, total acid clearance time and total bolus clearance time were all lower pre-PEG, but not statistically significant.
CONCLUSION: PEG placement increases GOR episodes in neurologically impaired children.
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Verma JS, Rawat D, Hasan A, Capoor MR, Gupta K, Deb M, Aggarwal P, Nair D. The use of E-test for the drug susceptibility testing of Mycobacterium tuberculosis - a solution or an illusion? Indian J Med Microbiol 2010; 28:30-3. [PMID: 20061760 DOI: 10.4103/0255-0857.58725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To evaluate E-test as a tool for rapid determination of drug susceptibility against the conventional LJ method focusing on reliability, expense, ease of standardization and performance of the technique in low resource settings. MATERIALS AND METHODS A total of 74 clinical isolates (2004-2005) of Mycobacterium tuberculosis were tested using E-test for susceptibility to streptomycin (STM), isoniazid (INH), rifampicin (RIF) and ethambutol (EMB) by E-strip and LJ (LJPM) proportion methods. RESULTS The LJPM method, the gold standard, detected resistance against STM in 16.2%, INH in 40.5%, RIF in 18.9% and EMB in 27% cases. In comparison, the resistance values showed by E-test was 66.67% for STM, 57.14% for INH 71.43% for RIF and 80% for EMB. The susceptible correlation was 90.32% for STM, 73.91% for INH, 93.33% for RIF and 59.26% for EMB. E-test correctly identified only eight of the 12 (66.6%) MDR isolates and wrongly identified four isolates which were not MDR. The overall agreement between the two methods was only 48.6%. Resistant isolates showed false positive resistance observed while using E-strip towards all the drugs. CONCLUSION E-strips are not quite feasible as a replacement for LJ-proportion method on a large scale due to high risk of cross contamination, laboratory infection, expense associated with it and high false positive resistance observed to all first line drugs. However, the good correlation observed for RIF between the two methods indicates that E-test could contribute to the role in rapid screening of MDR TB isolates as rifampicin mutations are invariably observed in MDR TB isolates.
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Affiliation(s)
- J S Verma
- Department of Microbiology, Vardhaman Mahavir Medical College and Safdarjang Hospital, New Delhi - 110 070, India
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20
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Corda L, Pacilli M, Clarke S, Fell JM, Rawat D, Haddad M. Laparoscopic oesophageal cardiomyotomy without fundoplication in children with achalasia: a 10-year experience: a retrospective review of the results of laparoscopic oesophageal cardiomyotomy without an anti-reflux procedure in children with achalasia. Surg Endosc 2009; 24:40-4. [PMID: 19495877 DOI: 10.1007/s00464-009-0513-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2008] [Revised: 04/09/2009] [Accepted: 04/20/2009] [Indexed: 01/01/2023]
Abstract
BACKGROUND Oesophageal achalasia is a rare disorder in childhood. Common treatments in adults include oesophageal cardiomyotomy (laparoscopic or open) with fundoplication. We aimed to assess the results of laparoscopic oesophageal cardiomyotomy without fundoplication for treatment of achalasia in children. METHODS We reviewed the results of laparoscopic oesophageal cardiomyotomy between January 1998 and June 2008. Patients below the age of 18 years, who had undergone laparoscopic oesophageal cardiomyotomy without an anti-reflux procedure by a single surgeon, were identified. Data were collected from patient notes. Results are reported as median (range). RESULTS There were 20 patients (13 males and 7 females). Median age at surgery was 12 years (5-15 years) and weight was 38 kg (15-53 kg). Median duration of symptoms before surgery was 2.4 years (1.5-5 years). Duration of surgery was 96 min (60-160 min). Four patients (20%) required conversion to the open technique. In the remaining 16 children, fluids were started at a median of 7 h (6-8 h) post-operatively, and solid feeds were commenced at 22 h (20-24 h). Median length of hospital stay was 3 days (1-5 days). Median length of follow-up was 60 months (8-114 months). None of the patients had evidence of gastro-oesophageal reflux post-operatively. Five patients (25%) continued to experience dysphagia, with one of them also experiencing vomiting. Two patients were found to have oesophageal stricture and three patients were found to have oesophageal dysmotility. The remaining patients are asymptomatic. CONCLUSIONS These results suggest that laparoscopic oesophageal cardiomyotomy is a valid treatment in children with achalasia. In our experience, an adjunctive anti-reflux procedure is not required, as there was no evidence of post-operative gastro-oesophageal reflux in all patients. Oesophageal stricture and dysmotility account for residual post-operative symptoms.
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Affiliation(s)
- Larisa Corda
- Department of Paediatric Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
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21
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Kukreti H, Mittal V, Rautela R, Chhabra M, Chaudhary A, Bharadwaj M, Rawat D, Lal S, Rai A. Usefulness of NS1 Gene in Molecular Subtyping of Recent Indian Isolates of Dengue Virus Type 3 (DENV-3). Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
Four cases of concomitant tuberculosis and cryptococcosis infection in HIV-positive patients are described. As the HIV pandemic progresses and the proportion of patients with end-stage disease increases, a high suspicion of incidence and unusual forms of infections must always be kept in mind.
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Affiliation(s)
- D Rawat
- Department of Microbiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi 110029, India
| | - M R Capoor
- Department of Microbiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi 110029, India
| | - D Nair
- Department of Microbiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi 110029, India
| | - M Deb
- Department of Microbiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi 110029, India
| | - P Aggarwal
- Department of Microbiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi 110029, India
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Capoor MR, Rawat D, Nair D, Deb M, Aggarwal P. Evaluation of Glucose-Methylene-Blue-Mueller-Hinton Agar for E-Test Minimum Inhibitory Concentration Determination in Candida spp. Indian J Med Microbiol 2007. [DOI: 10.1016/s0255-0857(21)02077-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nair D, Deb M, Aggarwal P, Rawat D, Capoor MR, Hasan A. Combining vital staining with fast plaque: TB assay. Indian J Med Microbiol 2007; 25:426-7. [DOI: 10.4103/0255-0857.37359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Capoor MR, Rawat D, Nair D, Deb M, Aggarwal P. Evaluation of glucose-methylene-blue-mueller-hinton agar for E-test minimum inhibitory concentration determination in Candida spp. Indian J Med Microbiol 2007; 25:432-3. [DOI: 10.4103/0255-0857.37366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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26
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Del Buono R, Wenzl TG, Rawat D, Thomson M. Acid and nonacid gastro-oesophageal reflux in neurologically impaired children: investigation with the multiple intraluminal impedance procedure. J Pediatr Gastroenterol Nutr 2006; 43:331-5. [PMID: 16954955 DOI: 10.1097/01.mpg.0000232333.77805.94] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The diagnosis of gastro-oesophageal reflux (GOR) is more difficult in children with neurological impairment because symptoms are often less interpretable and frequently go undetected. The use of combined pH and multiple intraluminal impedance allows for the detection of both acid (pH < 4) and nonacid (pH > 4) GOR episodes, in addition to the height of the refluxate and the total acid and bolus clearance time in this cohort. METHODS Sixteen neurologically impaired children (9 were fed nasogastrically, 7 were fed orally) underwent 12-hour combined pH and multiple intraluminal impedance. RESULTS There were a total of 425 reflux episodes during the study period, of which 239 (56.2%) were nonacid. The median of reflux episodes per hour was 1.8 (range, 0.2-6.3/h). The median height of the refluxate was 1.5 channels (range, 1.1-2.9); and 71.3% of reflux episodes reached the upper oesophagus, of which 52.4% were nonacid reflux events. On average there were more GOR events (both acid and nonacid) in the children who were fed via a nasogastric tube, and the median height of refluxate was also higher in this group. However, the median acid clearance time was longer (both proximal and distal) in the children who were fed orally (28.6 s vs 16.2 s proximally; 67.9 s vs 38.3 s distally). The median acid clearance time (21.7 s proximally; 39.5 s distally) was longer when compared with bolus clearance (14.9 s). CONCLUSIONS More than half of the reflux events in neurologically impaired children are nonacidic and would therefore go undetected by conventional pH metry. There are more reflux events in children fed nasogastrically than oral-fed children.
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Affiliation(s)
- Raffaele Del Buono
- Centre for Paediatric Gastroenterology, Royal Free and University College Medical School, London, United Kingdom
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Abstract
The purpose of this study was to determine the age wise prevalence of Hepatitis B virus (HBV) in children under five years and to analyze the relative importance of horizontal or vertical transmission. This study included 400 children in the age group of less than five years attending the outpatient department of pediatrics with minor complaints. History of HBV immunization was taken as the exclusion criteria. All the samples were tested for Hepatitis B surface antigen (HBsAg) and anti HBs using commercial ELISA kits. Liver function tests were performed on all the HBsAg positive patients. Hepatits B nucleocapsid antigen (HBeAg) was detected in few HBsAg positive mothers. Overall HBsAg positivity in children below five years was 2.25%. There was no statistically significant difference in HBsAg positivity in the different age groups by chi square test. HBsAg positivity in mothers was 4.25%. However only in three cases the pair of mother and child were both positive for HBsAg. The mean anti HBs positivity in children was 23.75%. There was no statistically significant difference in the anti HBs positivity in different age groups of children. The observation that there is no statistically significant difference in the prevalence of HBV infection (HBsAg and HBs) amongst different age groups of children below five years signifies that a large proportion of HBV infection in children of this age is acquired via vertical transmission. It is also indicated that this mode of disease transmission is responsible for the majority of chronic carriers. Universal immunization of all infants is desirable to decrease the carrier pool and it is inferred from the present study that Hepatitis B immunization should begin at birth to have greater impact.
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Affiliation(s)
- A Chakravarti
- Department of Microbiology, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi - 110 019, India.
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Abstract
The aim of this study was to evaluate enzyme linked immunosorbent assay (ELISA) as a testing strategy for detection of antibodies against measles virus from microquantities of blood soaked onto filter paper. We studied 165 healthy children in the age group of 1 to 2 years, attending the outpatient department of pediatrics. Two sets of samples were collected from each child. One by venipuncture and the other on Whatman filter paper-3 discs of 20 mm size by finger or heel prick so that each strip is completely soaked with blood on both sides. These were tested for measles virus antibodies by ELISA using Melotest measles IgG commercial ELISA kit manufactured by Melotec S. A. (Barcelona, Spain). The resulting sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the filter paper (FP) ELISA compared to serum ELISA was 100, 90, 97.8, and 100%, respectively. The correlation coefficient r = 0.93% (p < 0.001) and the agreement between the two techniques was 98% as calculated by the Kappa statistical method. The present study has found filter paper testing by ELISA to be a promising qualitative technique for detection of immunity against measles.
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Affiliation(s)
- A Chakravarti
- Department of Microbiology, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
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Rawat D, Chakravarti A, Yadav S. Study of measles antibody in children. Indian Pediatr 2001; 38:1286-9. [PMID: 11721070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- D Rawat
- Departments of Microbiology and Pediatrics, Maulana Azad Medical College, New Delhi 110 002, India
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Rawat D, Chakravarti A, Yadav S. Comparison of two blood collection techniques for measles antibody detection in children. Indian J Med Res 2001; 114:117-20. [PMID: 11921832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND & OBJECTIVES Though several seroprevalence and seroconversion studies have been conducted for measles using the filter paper haemagglutination inhibition (FPHAI), very few studies have compared the conventional serum HAI with the FPHAI. The present study was aimed at the evaluation of whole blood samples on filter paper as an alternative to serum specimens for detection of antibodies to measles virus. METHODS Serum and whole blood samples soaked on filter paper were collected from 165 randomly selected healthy children in the age groups of 1-2 yr. HAI test was performed on both sets of samples and the results compared. RESULTS Ninety samples that gave a titre of 8 or more by serum HAI also had titres of > or = 8 by FPHAI showing 100 per cent agreement between the two assays. Seventeen samples that had a serum HAI titre of 2 and 4 were missed by FPHAI due to the starting dilution of 8 of the latter. However, FPHAI gave no false positive results compared with serum HAI. INTERPRETATION & CONCLUSION Collection of the FP samples by finger prick is more acceptable and requires less expertise than venepuncture. Thus, in spite of the small percentage of missed cases by the filter paper method, this technique of sampling was found to be a convenient and reliable alternative to venepuncture, for detection of measles virus antibody especially in large scale seroepidemiological studies.
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Affiliation(s)
- D Rawat
- Department of Microbiology, Maulana Azad Medical College, New Delhi, India
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