Characterization of the complete mitochondrial genome of Acanthogyrus (Acanthosentis) bilaspurensis Chowhan, Gupta & Khera, 1987 (Eoacanthocephala: Quadrigyridae), the smallest mitochondrial genome in Acanthocephala, and its phylogenetic implications

The phylum Acanthocephala is an important group of parasites with more than 1,300 species parasitizing intestine of all major vertebrate groups. However, our present knowledge of the mitochondrial genomes of Acanthocephala remains very limited. In the present study, we sequenced and annotated the complete mitochondrial genome of Acanthogyrus (Acanthosentis) bilaspurensis (Gyracanthocephala: Quadrigyridae) for the first time based on the specimens recovered from the intestine of common carp Cyprinus carpio Linnaeus (Cyprinidae) in Pakistan. The mitochondrial genome of A. bilaspurensis is 13,360 bp in size and contains 36 genes, representing the smallest mitogenome of acanthocephalans reported so far. The mitogenome of A. bilaspurensis also has the lowest level of overall A+T contents (59.3%) in the mitogenomes of Eoacanthocephala, and the non-coding region 3 (NCR3) lies between trnS2 and trnI, which is different from all of the other acanthocephalan species. Phylogenetic analyses based on concatenating the amino acid sequences of 12 protein-coding genes using maximum likelihood (ML) and Bayesian inference (BI) methods revealed that the family Pseudoacanthocephalidae is a sister to the Arhythmacanthidae rather than the Cavisomatidae, and the families Rhadinorhynchidae and Cavisomatidae showed sister relationships.

Clinical and Genetic Description of Hereditary Chronic Pancreatitis in Pakistani Children

BACKGROUND/AIMS

The purpose of this study was to identify the spectrum and frequency of pathogenic variants as well as the clinical and genetic insight of hereditary chronic pancreatitis in Pakistani children.

MATERIALS AND METHODS

The deoxyribonucleic acid of affected probands of 44 unrelated Pakistani families, having hereditary chronic pancreatitis-affected children, were subjected to massive parallel sequencing for candidate reported genes (SPINK1, PRSS1, CFTR, CPA1, CTRC, CBS, AGL, PHKB, and LPL). Data were analyzed using different bioinformatics tools for the variants and in-silico analysis. All the identified variants were validated by direct sequencing of the targeted exons in the probands and their parents.

RESULTS

There were 50 patients included in this study with confirmed hereditary chronic pancreatitis. Nine known mutations in SPINK1, PRSS1, CFTR, CTRC, CBS, and AGL genes, and 10 novel variants in LPL, CFTR, CTR, and PHKB genes were identified. The identified variants were found in heterozygous, compound heterozygous, and trans-heterozygous forms, with rare allele frequency in the normal population. The novel variants were [c.378C>T(p.Lys126Asn) and c.719G>A(p.Arg240Gln) in CTRC, c.586-3C>A and c.763A>G(p.Arg255Gly) in CPA1, c.1160_1161insT(p.Lys387Asnfs*26), c.784C>T(p.Gln262*), c.1139+1G>A, c.175G>A(p.Gly59Arg) in LPL, c.388C>G(p.leu130val) in CFTR, and c.2327G>A(p.Arg776His in PHKB)]. The phenotypic characteristics were variable and correlated with the relevant variant.

CONCLUSIONS

The genetic composition plays a significant role in the predisposition of hereditary chronic pancreatitis. The clinical presentation varies with the genetic determinant involved. This information would help in building up a diagnostic algorithm for our population that can be used for genetic screening services in affected cohorts.

Assessment of Quality of Life Among Children with Inflammatory Bowel Disease

Objective: To evaluate the quality of life among children with inflammatory bowel disease (IBD) by the inflammatory bowel disease questionnaire. Study Design: Cross-sectional study. Place and Duration of the Study: Department of Pediatric Gastroenterology, Children's Hospital and Institution of Child Health, Lahore Pakistan, from Nov 2020 to Apr 2021. Methodology: A total of 60 cases (Crohn's disease or ulcerative colitis) were enrolled in the study. Quality of life was measured according to the Modified IMPACT-III questionnaire. Results: There were 38(63.3%) males and 22(36.7%) female children. The mean age was 9.57±3.40 years, while 33(55.0%) children were above ten years. The mean maternal age was found to be 37.10±4.09 years. There were 36(60.0%) children with Crohn's disease, while 24(40.0%) had ulcerative colitis. Children with Crohn's disease were found to have a significantly low quality of life compared to children in the ulcerative colitis group in the social domain (p<0.05). In addition, children with ulcerative colitis had a significantly low quality of life with regard to bowel symptoms (p<0.05). Conclusion: Overall scores showed a low quality of life among children with IBD. Children with Crohn's disease had significantly low social QoL, while children with ulcerative colitis showed significantly low QoL regarding bowel symptoms.

Disparities in the Use of Mechanical Thrombectomy Alone Compared with Adjunctive Intravenous Thrombolysis in Acute Ischemic Stroke in the United States

BACKGROUND AND PURPOSE

For patients with large-vessel occlusion, mechanical thrombectomy (MT) without IV-tPA is a proved strategy. The relative benefit of direct MT versus MT+IV-tPA for patients with indications for IV-tPA is being actively investigated. We used a national inpatient database to assess trends in use and patient profiles after MT+IV-tPA versus mechanical thrombectomy alone.

MATERIALS AND METHODS

The National Inpatient Sample was queried between 2013 and 2018 for patients undergoing mechanical thrombectomy for acute ischemic stroke. Patients who received mechanical thrombectomy alone were compared with those who underwent MT+IV-tPA. The Cochran-Armitage test was conducted to assess the linear trend of use of mechanical thrombectomy alone among the entire cohort and between admissions involving non-White and White patients. All estimates were nationalized using discharge weights.

RESULTS

A total of 89,645 weighted admissions were identified pertaining to mechanical thrombectomy for acute ischemic stroke from 2013 to 2018. Of these, 59,935 (66.9%) admissions involved mechanical thrombectomy alone. There was an increase in the trend toward the use of mechanical thrombectomy alone (trend: 3.26%; P < .001) per year. Multivariable regression analysis regarding patient profiles indicated that patients who identified as Black (OR = 0.83, P = .001) or Hispanic (OR = 0.79; P < .001) were more likely to undergo mechanical thrombectomy alone compared with those who identified as White. There was no statistically significant difference in the slope between non-White and White populations receiving mechanical thrombectomy alone (trend: +0.93% in favor of non-White; P = .096).

CONCLUSIONS

Our results indicated that mechanical thrombectomy alone was used more frequently than MT+IV-tPA among patients with acute ischemic stroke. The disparity between those who identify as White and non-White persisted across the years, though it is closing.

Spectrum of Clinical Presentation of Celiac Disease in Pediatric Population

Background

Classic form of celiac disease (CCD) presents with diarrhea and is traditionally taught as malabsorption syndrome. This form of CD is diagnosed with ease but non-classical form presenting without diarrhea is often missed and heavily underdiagnosed.

Objective

To determine the clinical spectrum of patients with CD.

Methods

This study was conducted in the Department of Gastroenterology & Hepatology at the Children’s Hospital, Lahore. Confirmed CD children according to NASPGHAN (North American Society of Pediatric Gastroenterology, Hepatology & Nutrition) criteria were enrolled in this study from June to September, 2020. Initial positivity followed by small bowel biopsy with Modified Marsh 2 and above is considered consistent with the diagnosis of CD.

Results

A total of 90 patients were selected according to NASPGHAN criteria, 77 (85.6%) patients had CCD whereas 13 (14.4%) patients had non-classical CD (NCCD). The mean ± SD age at diagnosis of CCD was 2.6 ± 2.3 years whereas mean ± SD in NCCD was 9 ± 1.8 years. Females clearly predominate in our cohort in general. Chronic diarrhea followed by failure to thrive (85%) were the most common symptoms in CCD whereas short stature (69%) was the most frequent feature in NCCD. Among CD patients, tissue transglutaminase-​immunoglobulin A (TTG-IgA) titre was significantly high (>10 times) in 80% of CD patients and the rest had positivity but not up to 10 times. There was no significant difference in titre of anti-TTG between CCD and NCCD.

Conclusion

Classical CD is still the most common in developing countries like Pakistan. High index of suspicion of CD should be maintained for patients who present with short stature, recurrent abdominal pain and refractory anemia.

Vitamin D Intoxication In 7-Month-Old Infant With Recommended Daily Intake Of Vitamin D

Over the past decade there is increased use of vitamin D supplementation because of its benefits on bone health. It is a fat-soluble vitamin and cannot be excreted from the body. There is need for monitoring 25-hydroxyvitamin D levels in infants and children who receive long-term vitamin D supplementation at or above the upper level intake that is currently recommended. Vitamin D intoxication can present from mild ignorable to severe life-threatening symptoms. We present a 7- month-old infant with vitamin D intoxication at recommended daily doses of vitamin D.

Could It Be Schistosomiasis?

Schistosomiasis may cause diverse symptoms and it is usually not considered as a cause of disease especially in patients with normal immune system. We are reporting an eleven-year-old child who was initially diagnosed as a case of lymphoma but later on proved to be a case of acute schistosomiasis.

Synthesis and characterization of nanoparticle thin films of a-(PbSe)100-xCdx lead chalcogenides

We report the synthesis of amorphous (PbSe)100-xCdx (x = 5, 10, 15, and 20) nanoparticle thin films using thermal evaporation method under argon gas atmosphere. Thin films with a thickness of 20 nm have been deposited on glass substrates at room temperature under a continuous flow (50 sccm) of argon. X-ray diffraction patterns suggest the amorphous nature of these thin films. From the field emission scanning electron microscopy images, it is observed that these thin films contain quite spherical nanoparticles with an average diameter of approximately 20 nm. Raman spectra of these a-(PbSe)100-xCdx nanoparticles show a wavelength shift in the peak position as compared with earlier reported values on PbSe. This shift in peak position may be due to the addition of Cd in PbSe. The optical properties of these nanoparticles include the studies on photoluminescence and optical constants. On the basis of optical absorption measurements, a direct optical bandgap is observed, and the value of the bandgap decreases with the increase in metal (Cd) contents in PbSe. Both extinction coefficient (k) and refractive index (n) show an increasing trend with the increase in Cd concentration. On the basis of temperature dependence of direct current conductivity, the activation energy and pre-exponential factor of these thin films have been estimated. These calculated values of activation energy and pre-exponential factor suggest that the conduction is due to thermally assisted tunneling of the carriers.