388 Detection of Cytomegalovirus Infection in Infants with Biliary Atresia: A Meta-analysis

Introduction

Biliary atresia (BA) is the most common indication of liver transplantation in children. Several reports attributed BA to both prenatal and perinatal aetiologies, including a viral infection-induced auto-immune response that targets the bile ducts. Cytomegalovirus (CMV) remains the most common virus being linked to BA. This meta-analysis estimates to what extent CMV infection is detected in patients with BA.

Method

This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE/PubMed, WHO-Virtual Health Library (VHL), ScienceDirect, and Google Scholar were used for the systematic search. Random effects model was used to estimate the pooled prevalence estimate with the corresponding 95% confidence interval (CI) using StatsDirect statistical software.

Results

A total of 13 studies (covering 419 patients) that fulfilled the eligibility criteria were included in the meta-analysis. The pooled overall prevalence of CMV infection in patients with BA was 24.5% (95% CI 11.9 %– 33.9%).

Conclusions

The available data demonstrate that the detection of CMV infection is common in infants with BA. There is still a need for large studies with appropriate controls to examine various aspects of the association between CMV infection and BA.

Psychotropic medication for challenging behavior in people with learning disabilities in Qatar

Introduction

Challenging behavior is a common reason for referral to psychiatric service. Psychotropic medications widely used to modify behaviors, even when no evidence of diagnosable mental illness. However, literature show little evidence that benefits outweigh the risks in their prescription. Monitoring using International guidelines may help improving the outcomes. We audit current practice against known standards.

Objectives

- To assess adherence within the Qatar Mental Health Services to National guidelines on using medication to manage behavior problems in adults with a learning disability. - To identify strengths and weaknesses in current practice. - To Make recommendations to improve LD patient care

Methods

Patients with LD attending psychiatric clinic screened using selection and exclusion criteria and data collected and analyzed using format from the International standards.

Results

102 patients screened, 85 selected and 17 cases excluded Age range 18 to 50 years. 27% mild, 29% moderate and 44% severe LD, Autism 40% Psychiatric Diagnosis 55% Challenging behavior 45% Antipsychotic prescribing: 79% Rationale documented in 74%, Capacity assessment in 81%, Review of side effects in 53% Safety of medication in 61%, Medication discontinuation in 66%, Reasons for discontinuation in 36%

Conclusions

Antipsychotics use (79%) is high with several combinations of IM and oral or more than 2 drugs. There is need for improvement across all standards. Rationalising the prescribing for LD patients to improve the outcomes for the safety of these patients. The audit indicate need for specialist service to monitor prescribing and apply standards of care in clinical service.

Disclosure

No significant relationships.

Newly Explored Electrical Properties of Normal Skin and Special Skin Sites / Neue Untersuchungen zu elektrischen Eigenschaften normaler Haut und spezieller Hautpunkte

Skin impedance measurements at various skin sites yield different impedance loci for normal skin and special skin sites. The results of skin impedance measurements taken at such sites with a two-electrode measurement system are presented herein. Some of these sites can be identified as acupuncture points. Data from 4 volunteers were acquired by means of a data acquisition board and a measuring system consisting of the measurement circuit, including several electrode types, and a power supply. The Cole model is a model for an equivalent electrical circuit of the skin-electrode system. The system was used to derive skin-typical parameters from the Bode plot of the whole system. These parameters are the fractional power a, the pseudo-capacity K, the parallel resistance Rp, and the serial resistance Rs of the equivalent electrical circuit. The results show that the measured parameters differ between normal skin and special skin sites. These effects have not previously been discovered by other authors, since there has been no systematic investigation of many acupuncture points to date, and there has been no apparent need for such an investigation. A number of necessary criteria for acupuncture point detection can be derived from the results obtained.

Signalprocessing in transmission pulse hemometry

Supplying organs and body tissues with sufficient oxygen is one of the most important vital human functions. Commercial pulse oximeters compute the functional oxygen saturation from relative values (reduced hemoglobin and oxyhemoglobin). Methemoglobin (MetHb) and carboxyhemoglobin (COHb) are not taken into account, since they are considered to be reduced hemoglobin and oxyhemoglobin (RHb, HbO2). The total hemoglobin concentration is not included, and is determined by invasive methods. In this work, a non-invasive pulse oximeter is developed, which finds the entire hemoglobin concentration photometrically, and measures the fractional oxygen saturation and pulse rate. The signal of transmitted light I is processed according to the Lambert-Beer-law. The signal decays exponentially with the thickness d of the irradiated sample and its absorption coefficient alpha (I = I0 e -alpha d), where I0 is the incident light intensity.

[Ritual circumcision. A medicosocial problem]

Circumcision is one of the oldest and most common operations, which has been practised for thousands of years by Moslems, Jews and various tribes in Africa, America, and Australia. Unfortunately, complications may occur during and after circumcision, ranging from trivial to tragic. Our investigation shows a higher incidence of complications when performed by a non-qualified surgeon. We therefore recommend that the operation should only be done by a surgeon in the public health service.

[Circumcision performed by a hairdresser--formerly a circumciser]

A case of circumcision undertaken by the newborn boy's grandfather is described.

Study on the morphology of the gall-bladder of the goat

200 gall-bladders of goat were studied for histology and histochemistry. The lining epithelium is tall columnar with striated border. The glands are mucous and serous, and the secretion of both surface and glands is a polyssaccharide-protein complex. The regional differences at neck, body and fundus of the gall-bladder are described. Few enterochromaffin cells with granules, which are PAS-positive and contain 5-hydroxytryptamine, are encountered at the wedge between the granular epithelial cells and the cells lining the crypts. The relationship between these cells and lymphocytic infiltration is discussed. The thick circular muscle layer at the neck region is considered a sphincter of the gall-bladder.