Frequency Of Clinical Symptoms Research Articles

Analysis of pollen sensitization characteristics of artemisia allergic rhinitis in three urban and rural areas of Inner Mongolia

Objective: To investigate the distribution rules of artemisia pollen and the clinical sensitization characteristics of allergic rhinitis (AR) induced by artemisia pollen in three urban and rural areas of Inner Mongolia. Methods: From March to October 2019, in 3 central cities (Chifeng, Hohhot, Ordos) and rural areas of Inner Mongolia, an epidemiological investigation method combining multi-stage stratified random sampling and face-to-face questionnaire survey was adopted to screen suspected AR patients, and skin prick test (SPT) was applied for diagnosis. At the same time, pollen monitoring was carried out in 3 areas to analyze the distribution and clinical sensitization characteristics of artemisia pollen.SPSS26.0 statistical software was used to process all the data. Chi-square test was used to compare rates among different age, sex, region and nationality, Spearman test was used to describe correlation analysis, and pairwise comparison of positive rates among multiple samples was used Bonferroni method. Results: Among the 6 393 subjects, 1 093 cases were diagnosed with AR, and the prevalence of AR was 17.10% (1 093/6 393). Among them, pollen-induced allergic rhinitis, the prevalence of PiAR was 10.97% (701/6 393), accounting for 64.14%(701/1 093).The highest incidence was in the youth group (20-39 years old), accounting for 46.94% (329/701).The diagnosed prevalence was higher in females than in males (11.35% vs. 10.64%, χ2 value 12.304, P<0.001).The prevalence rate of ethnic minority was higher than that of Han nationality (13.01% vs. 10.65%, χ2 value 6.296, P=0.008).The prevalence in urban areas was also significantly higher than that in rural areas (18.40% vs. 5.50%, χ2 value 10.497, P<0.001).There was significant difference in prevalence rate among the three regions in Inner Mongolia (6.06% in Chifeng, 13.46% in Hohhot, 16.39% in Ordos, χ2 value 70.054, P<0.001).The main clinical symptoms of artemisia PiAR were sneezing (95.58%), nasal congestion (91.73%) and nasal itching (89.30%).Allergic conjunctivitis accounted for 79.60% (558/701), chronic sinusitis for 55.63% (390/701), asthma for 23.25% (163/701).The pattern of artemisia pollen sensitization was mainly multiple sensitization, and the frequency of clinical symptoms and clinical diseases induced by hypersensitization with other allergens accounted for more than that caused by single artemisia pollen. The spread period of Artemisia pollen in the three regions was from June to October, and the peak state was in August in summer. The peak time of clinical symptoms in artemisia PiAR patients was about 2 weeks earlier than the peak time of pollen concentration, and the two were significantly positively correlated (R=0.7671, P<0.001). Conclusion: Artemisia pollens are the dominant pollens in late summer and early autumn in Inner Mongolia, and the prevalence of artemisia PiAR is high. Controlling the spread of Artemisia pollens is of great significance for the prevention and treatment of AR.

Effectiveness of allergen-specific immunotherapy in children with bronchial asthma sensitized to house dust mites

Background. The only method of treatment that can change the natural course of allergies is allergen-specific immunotherapy, which allows reducing the sensitivity of the child’s body to the causative allergen and decreasing the activity of chronic inflammation. The evidence base for the effectiveness of allergen-specific immunotherapy in the treatment of bronchial asthma (BA) has significantly expanded recently. However, the truly important results remain too limited to make clinically useful conclusions about the efficacy of sublingual allergen-specific immunotherapy (SLIT) in people with BA and further evidence is needed. The purpose of the study is to evaluate the effectiveness of SLIT as an additional treatment for atopic BA of varying severity in children sensitized to house dust mites. Materials and methods. The main group consisted of 80 children with BA aged from 5 to 17 years, they were divided into three groups according to the severity of the disease: group 1 — 20 children with mild intermittent asthma, group 2 — 30 children with mild persistent asthma, group 3 — 30 children with moderately severe persistent asthma. Thirty practically healthy children without BA were also examined as a control group. For SLIT, a sublingual ORALTEK spray produced by Inmunotek (Spain) was used, a mixture of house dust mite allergens Dermatophagoides pteronyssinus 50 %/Dermatophagoides farinae 50 %, 1 ml of the solution contains 30,000 IU of natural allergen extract. To assess the effectiveness of the treatment, we conducted an analysis of the total score of clinical manifestations of asthma and allergic rhinitis and the degree of asthma control according to the Asthma Control Test. We also analyzed the state of cellular and humoral immunity in the dynamics of therapy. These indicators were evaluated within 1 month before the beginning and a month after the end of the one-year course of therapy. To assess the validity and reliability of the obtained results, statistical data processing was carried out using Microsoft Excel 2016 and Statistica for Windows 10 programs. The Student’s t-test was applied to assess the reliability of the results. The difference between the compared values was considered statistically significant at p &lt; 0.05. Results. The results of the statistical analysis confirmed a significant improvement in the control indicators of patients who received SLIT: reduction in the total score of clinical manifestations, the frequency of clinical symptoms and the use of emergency drugs (p &lt; 0.05). By the end of the study, the dynamics of a decrease in these indicators compared to the data before the start of treatment (according to the above list) was as follows: in patients of group 1 — 82.5, 91.8, 94.5 %, in patients of group 2 — 80.5, 88.4, 92.7 %, in patients of group 3 — 76.7, 85.3, 91.2 %. After treatment with the addition of SLIT to the basic therapy, a reliable increase in IgE and sIgA was observed, an increase in the spontaneous proliferative response of T-lymphocytes to the mitogen in all three groups to the level of the controls, a probable decrease in eosinophilic inflammation and an improvement in indicators of the cellular and humoral immunity (p &lt; 0.001). Conclusions. The prescription of SLIT to children with mild intermittent BA, mild persistent BA and perennial allergic rhinitis, moderate persistent BA and perennial allergic rhinitis provides an opportunity to obtain stable control of the disease, reduces the number of visits to the doctor and justifies the wide use of this method in clinical allergy practice.

Clinical and laboratory features of COVID-19 in newborns. Analysis of a severe clinical case

Background. Since the onset of the coronavirus disease 2019 (COVID-19) epidemic until January 1, 2024, more than 5.5 million confirmed cases of COVID-19 have been detected in Ukraine according to official data, approximately 6 % of them among children under 18 years old. Aim: to improve the management of newborns based on studies of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with different course. Materials and methods. Eleven newborns (7 boys and 4 girls) diagnosed with SARS-CoV-2 confirmed by polymerase chain reaction were observed. Disease progression, results of laboratory and instrumental studies were analyzed. Results. An analysis of clinical data and the results of laboratory and instrumental investigations are presented, as well as treatment outcomes in newborns with confirmed COVID-19. It was found that in all cases, children were infected from mothers with SARS-CoV-2. The frequency of clinical symptoms is provided, revealing discrepancies between respiratory symptoms and changes identified on lung ultrasound. Most children exhibited anemia, elevated D-dimer levels in the blood, yet experienced a mild course of the disease. The average duration of illness prior to hospitalization was 3.70 ± 1.48 days, with a hospital stay of 4.01 ± 1.22 days. An exception was in case of patient N., characterized by a severe condition necessitating prolonged oxygen therapy, mechanical ventilation, and administration of remdesivir. This particular case is detailed in the article. Conclusions. In most infants under one month of age observed in this study, the course of ­COVID-19 caused by SARS-CoV-2 was characterized by symptoms such as lethargy, hyperthermia, nasal congestion, diarrhea, and changes detected only through laboratory and instrumental stu­dies: anemia, abnormalities in the coagulation system, and increased lung parenchymal density. Ho­wever, the disease course in infants of this age can also be very severe, with lung parenchymal involvement, pneumonia, COVID-19-associated coagulopathy, complicated by generalized bacterial infection, as presented in the clinical case.

Efficacy of a standardised herbal formulation in Helicobacter pylori positive patients with gastritis or peptic ulcer: a triple-blind randomised clinical trial

IntroductionPistacia atlantica subsp. kurdica and Quercus brantii are traditionally used for various gastrointestinal disorders. This study aimed to evaluate the effects of herbal formulation from these two herbs on Helicobacter pylori infection, as well as undertake phytochemical analysis. MethodsA total of 78 H pylori-infected patients were enroled in this triple-blind randomised clinical trial and divided into two equal groups. The intervention and control groups received herbal formulation and placebo capsules once a day besides conventional therapy for 2 weeks, respectively. Patients were asked regarding their clinical symptoms at baseline, 2 weeks, and 3 months after the start of treatment. Also, the urea breath test was applied to assess the effects of herbal formulation 3 months after the start of treatment, which showed a significantly higher rate of H pylori eradication in the intervention group. ResultsWe found that the frequency of clinical symptoms was significantly lower in the intervention group 2 weeks after the start of the study. As well, the standardisation of the herbal formulation was performed according to volatile and nonvolatile compounds by GCMS/FID (gas chromatography mass spectrometry/flame ionization detector) and HPLC-PDA (high pressure liquid chromatography/photodiode array). ConclusionsGenerally, our results confirm the beneficial effects of herbal formulation on H pylori infection in line with its local application. Trial registrationIRCT20120215009014N233.

Clinical symptoms of SARS-CoV-2 breakthrough infection during the Omicron period in relation to baseline immune status and booster vaccination-A prospective multicentre cohort of health professionals (SURPRISE study).

The effects of different types of pre-existing immunity on the frequency of clinical symptoms caused by the SARS-CoV-2 breakthrough infection were prospectively assessed in healthcare workers during the Omicron period. Among 518 participants, hybrid immunity was associated with symptom reduction for dizziness, muscle or limb pain and headache as compared to vaccination only. Moreover, the frequencies of dizziness, cough and muscle or limb pain were lower in participants who had received a booster vaccine dose. Thus, hybrid immunity appeared to be superior in preventing specific symptoms during breakthrough infection compared to vaccination alone. A booster vaccine dose conferred additional symptom reduction.

Omicron COVID-19 variant outcomes and vaccination in non-severe and non-critical patients at admission.

The clinical data of patients infected with the Omicron variant virus in Zhejiang Province from January to 14 May 2022 were collected retrospectively. We analyzed the differences in symptoms, clinical categories of COVID-19, length of hospital stay, and time for clearance of Omicron variant viral RNA in the sputum among the groups receiving a different number of vaccine doses. The analysis showed that as the number of vaccine doses increased, the frequency of clinical symptoms, such as fever and fatigue, decreased and the frequency of patients with moderate infections gradually decreased. At the same time, the length of hospital stay was significantly shortened. Based on the multivariate analysis, one vaccine dose [odds ratio (OR): 0.21, 95% confidence interval (CI): 0.08-0.56, p = 0.002], two vaccine doses (OR: 0.54, 95% CI: 0.33-0.88, p = 0.013), and three vaccine doses (OR: 0.40, 95% CI: 0.24-0.64, p < 0.001) shortened the length of hospitalization than those with no vaccination. The persistence of the virus in the sputum was significantly shortened with one vaccine dose (OR: 0.36, 95% CI: 0.15-0.89, p = 0.027), two vaccine doses (OR: 0.46, 95% CI: 0.27-0.78, p = 0.004), and three vaccine doses (OR: 0.38, 95% CI: 0.22-0.64, p < 0.001) than those with no vaccination. Therefore, we concluded that vaccination was an effective way to protect people against infection with the Omicron variant. Indeed, on the premise of the current routine recommendation of vaccination, three vaccines were necessary for people to be protected against the Omicron variant.

004 Systemic autoinflammatory diseases: a multicenter cohort study

BackgroundSystemic autoinflammatory diseases (SAIDs) are a group of hereditary diseases characterized by inflammatory attacks accompanied by clinical findings such as fever, skin rash, abdominal pain, and musculoskeletal symptoms and with high acute phase response.ObjectivesThis study sought to define the characteristics, to report 24-month follow-up of children with SAIDs and to compare the performances of both the previously validated classification criteria Federici and new Eurofever/PRINTO classification criteria in a multicentre cohort under real-life conditions.MethodThe medical charts of 60 children diagnosed with SAIDs (CAPS, TRAPS and HIDS) who were followed up regularly every 1–3 months between 2010 and 2021 in 6 pediatric rheumatology centers in Turkey were retrospectively analyzed. Demographic data, clinical findings, laboratory results and treatments were recorded. All patients were analyzed by NGS panel containing 16 genes.ResultsA total of 60 patients with SAID were evaluated. Among them 30 (50%) were male and 30 (50%) were female. The median age at disease onset and diagnosis were 22 (0–193) months and 72 (2–213) months, respectively. The current age was median 10.3 (1.7–20.4) years. All patients were follow-up with a median 31 (6–97) months. Among 60 patients, 22 were diagnosed with CAPS, 8 with TRAPS and 30 with HIDS. The frequency of clinical symptoms was 95%, arthralgia 63.3%, gastrointestinal complaints 58.3%, urticarial rash 56.7%, myalgia 48.3%, lymphadenopathy 33.3%, respectively.Urticarial rash (86.4%), cold induced rash (45.5%) and arthritis (50%) were significantly higher in CAPS patients compared with other two groups (p< 0.05). Lymphadenopathy (46.7%) was more common in HIDS patients (p = 0.03).When we applied the diagnostic/classification criteria to our cohort, 71.7% met the Federici criteria, 53.3% fulfilled the Eurofever/PRINTO classification criteria. When performance of two diagnostic criteria (Federici and Eurofever/PRINTO criteria) was compared, the proportion of patients fulfilling the Eurofever/PRINTO criteria higher in TRAPS patients compared with other groups (p = 0.008).Statistically significant decreases were found in AIDAI scores, CRP, ESR levels from the 1st month and in the leucocyte counts from the 6th month of the treatment in CAPS patients (p = <0.001, p = 0.035, p = 0.03 and p = 0.006, respectively). In addition, AIDAI scores were correlated with CRP values (p = 0.047).In HIDS patients, there was a statistically significant decrease in AIDAI scores and ESR levels from the 1st month, CRP levels from the 3rd month, and leucocyte counts from the 12th month of treatment (p = <0.001, p = 0.003, p = <0.001 and p = 0.034, respectively). In addition, ESR values were correlated with CRP (p = 0.006). In TRAPS patients, on the other hand, there was a statistically significant decrease in AIDAI scores from the 1st month of treatment (p = 0.018).At the last visit, 93.3% of the patients were receiving anti-IL-1, 5% anti-IL-6, and 1.7% were receiving colchicine. Ninety percent of the patients were in complete remission.ConclusionWe showed that the diagnostic/classification criteria may not always be sufficient to make the diagnosis, and there is still low agreement between clinical diagnoses and molecular analyzes. Anti-IL-1 treatments have been found to be quite effective in the treatment from the early period.

The substantiation of differentiated therapy of the combined disgormonal pathology of reproductive organs in women of reproductive age with comorbid conditions

The objective: substantiation of differentiated therapeutic approaches to the treatment of combined dyshormonal pathology of the reproductive organs, taking into account the comorbidity of patients.Materials and methods. 300 women of reproductive age (20–42 years, mean age – 29.9±5.6 years) with dyshormonal pathology of reproductive organs were examined: the main group included 180 patients who were prescribed complex differentiated pharmacotherapy for the treatment of combined dyshormonal pathology of the reproductive organs with correction of comorbid conditions, and the comparison group included 120 patients who received a standard set of measures. The control group included 50 healthy women without somatic and gynecological pathology. All women had ultrasound examination of the pelvic organs, mamma glands, thyroid gland, determination of the levels of pituitary tropic hormones and steroid ovary hormones, thyroid hormones, antibodies to thyroperoxidase, and the level of 25 (OH) D in blood serum. Results. Obesity of various degrees was observed in 31.0% of examined patients with dyshormonal pathology of the reproductive system, the prevalence of autoimmune thyroiditis in patients was 36.0%, and subclinical hypothyroidism was diagnosed in 21.3%. Among women with autoimmune thyroiditis, the frequency of subclinical hypothyroidism was 59.3% with 3.7% of manifest hypothyroidism. Vitamin D insufficiency was found in 34.0% of patients with dyshormonal pathology, vitamin D deficiency – in 44.3%, severe deficiency – in 21.7%. Treatment of patients in the main group led to the normalization of the menstrual cycle in 97.2% of cases, in the comparison group – in 73.3%, to a reduction of pain syndrome severity – in 94.7% and 60.6%, respectively, cyclic mastodynia – in 93.9% and 43.9%, manifestations of vegetative-vascular and non-specific symptoms – in 94.8±3.9% and 24.3±16.7% of cases, contributed to achieving the desired pregnancy – in 64.1% and 30.6% of patients, respectively, and also there was a reducing the frequency of relapses during 6 months of observation from 14.5% to 4.1%.Conclusions. The use of complex differentiated pharmacotherapy for the treatment of combined dyshormonal pathology of the reproductive organs with the correction of comorbid conditions makes possible to achieve higher efficiency, which is manifested in a greater reduction in the frequency of clinical symptoms and disease relapses compared to the usual practice.

Frequency of Clinical Symptoms in Post Cholecystectomy Syndrome Patients our Hospital Experience: A Cross-Sectional Study

Aim: To determine the frequency of different clinical symptoms in (PCS) Post Cholecystectomy Syndrome patients, at a secondary care facility Study Design: A cross-sectional study Place and Duration: This study was conducted at Liaquat University of Medical Health Sciences Jamshoro, Pakistan from May 2020 May 2021. Methodology: For the purpose of this study, 100 patients were selected. Only those individuals were selected who qualified against an inclusion criterion which was set based on the patients’ history of cholecystectomy. For this purpose, a questionnaire was made. The patients that were selected had to go through CT (computed tomography) scans and sonographic tests. Blood testing was also done and sera were prepared for in-depth laboratory tests. Data from the research were analyzed by using SPSS version 19. Results: Most common clinical symptom after post-surgery was right upper quadrant pain (114 patients). Epigastric discomfort was present in 97 patients. Fever was third in line (73 patients) with jaundice being fourth (23 patients). Abdominal tenderness (19 patients) was followed by bile leakage (7 patients), fluid in the peritoneal region (19 patients), CBD dilation (39 patients), recurrent stone in CBD (12 patients), retained stone in CBD (19 patients), dysfunctioning of Oddi sphincter (37 patients) and remnants of the cystic duct stump was present in 41 patients. Conclusion: The results of this study show that post cholecystectomy symptoms and conditions vary among patients and all of them need to be kept in while proposing proper follow-up treatment Keywords: post cholecystectomy syndrome, bile leak, sonography, CT scan

Haemorrhoidal artery ligation with and without Doppler guidance in the treatment of haemorrhoidal disease: a single-centre randomized study

Aim. To evaluate the efficacy of haemorrhoidal artery ligation (HA) with a preliminary palpatory determination of its localization supplemented by mucopexy of haemorrhoids as a new surgical method in the treatment of haemorrhoidal disease (HD) and to compare it with HAL-RAR technology.Materials and methods. The randomized controlled clinical trial included patients over 18 years old with Goligher's grade II, III or IV symptomatic HD. We operated on patients in the study group (n = 75) using palpatory determination of the localization of HA and subsequent mucopexia. In the control group (n = 75) we used HAL-RAR. The primary endpoint (25-30 days after surgery): recurrence rate of HD symptoms. Secondary endpoints: postoperative complication rate, pain intensity on a visual-analogue scale from 1 to 10 points, patient satisfaction with the treatment results on a 10-point scale.Results. According to the initial characteristics (age, gender, body mass index, stage of HD, frequency of clinical symptoms), the groups did not differ. Anal bleeding relapse developed: study group - 11%, control group -14%; relapse of haemorrhoids prolapse: 3% and 5% respectively (p &gt; 0.05). Postoperative complications were noted in 6 (8%) in the study group and 4 (5%) in the control group (p &gt; 0.05). The intensity of pain on the 2nd and 25-30 days after surgery was 6.3 [4.8; 7.4] and 1.2 [0.6; 2.5] points in the study group and 6.5 [4.9; 7.3] and 2.1 [1.9; 4.1] in the control group, respectively (p &gt; 0.05). Patient satisfaction with the treatment results after 12 months was estimated at 8.7 [7.9; 9.2] and 9.4 [8.2; 9.6] in the study and control groups, respectively (p &gt; 0.05).Conclusion. HA ligation with a preliminary palpatory determination of its localization and supplemented with mucopexy of haemorrhoids is no less effective than HAL-RAR in preventing haemorrhoidal bleeding and prolapse of the nodes.

The Development of Large Radicular Cysts in Endodontically Versus Non-Endodontically Treated Maxillary Teeth.

Background and Objectives: Large radicular cysts of the maxilla present a clinical challenge, as they may cause recurrent infection, severe alveolar bone loss and disruption of the nasal and maxillary sinus floors. The aim of this study was to evaluate the effect of previous root canal treatment on the clinical presentation of large maxillary radicular cysts. Materials and Methods: All cases of radicular cysts treated at the Oral and Maxillofacial Surgery Department of a tertiary public hospital over a period of six years (2012–2018) were evaluated. Histologically confirmed radicular cysts of the maxilla with a maximal dimension of over 15 mm were included. Demographic data of the patients, clinical presentation and radiographic features of the lesions were analyzed. Results: A total of 211 inflammatory cysts were treated in the study period, of these 54 histologically diagnosed radicular cysts in the maxilla were found to have a maximal dimension of over 15 mm. The mean age of patients with large maxillary radicular cysts was 43.3 years, 57.6% of which were male and 42.4% female. The lateral incisor was the most common tooth affected (46.3%). The mean size of the large radicular cysts was 25 mm. Then, 83.8% of the cysts were observed in teeth with previous endodontic treatment. Teeth without endodontic treatment presented clinically with significantly fewer acute symptoms in comparison to teeth with previous endodontic treatment. Conclusions: the vast majority (83.8%) of large maxillary radicular cysts were associated with endodontically treated teeth. Previous endodontic treatment was correlated to increased frequency of clinical symptoms.

Intestinal Colonization with Tropheryma whipplei-Clinical and Immunological Implications for HIV Positive Adults in Ghana.

Background: Recent studies demonstrated higher prevalence rates of Tropheryma whipplei (T. whipplei) in HIV positive than in HIV negative subjects. However, associations with the immune status in HIV positive participants were conflicting. Methods: For this cross-sectional study, stool samples of 906 HIV positive and 98 HIV negative individuals in Ghana were tested for T. whipplei. Additionally, sociodemographic parameters, clinical symptoms, medical drug intake, and laboratory parameters were assessed. Results: The prevalence of T. whipplei was 5.85% in HIV positive and 2.04% in HIV negative participants. Within the group of HIV positive participants, the prevalence reached 7.18% in patients without co-trimoxazole prophylaxis, 10.26% in subjects with ART intake, and 12.31% in obese participants. Frequencies of clinical symptoms were not found to be higher in HIV positive T. whipplei carriers compared to T. whipplei negative participants. Markers of immune activation were lower in patients colonized with T. whipplei. Multivariate regression models demonstrated an independent relationship of a high CD4+ T cell count, a low HIV-1 viral load, and an obese body weight with the presence of T. whipplei. Conclusions: Among HIV positive individuals, T. whipplei colonization was associated with a better immune status but not with clinical consequences. Our data suggest that the withdrawal of co-trimoxazole chemoprophylaxis among people living with HIV on stable cART regimen may inadvertently increase the propensity towards colonization with T. whipplei.

Estimates of COVID-19 Risk Factors among Social Strata and Predictors for a Vulnerability to the Infection.

Coronavirus disease 2019 (COVID-19) has emerged as a potentially severe disease, especially for individuals presenting with certain underlying medical conditions. We analyzed the rates of comorbidities and symptoms to reveal the potential severity of the pandemic in Volos, one of the most air-polluted cities in Greece. Environmental and health-related predictors for SARS-CoV-2 infection were investigated. A web-based questionnaire was disseminated through social media in the first half of March 2021 during a five-month strict lockdown. Sociodemographic data, preexisting medical conditions, frequency of clinical symptoms, and COVID-19 information were recorded. The study population consisted of 2000 responders. Four-fifths of the participants reported comorbidities that could increase vulnerability to severe COVID-19. Respiratory symptoms were reported from the unemployed and from retirees, and cold-related symptoms were reported in the education sector and in undergraduates. Women and younger generations shaped social vulnerability to respiratory infections similar to the elderly. SARS-CoV-2 infection was reported in 3.7% of the study population. Common headache (OR 2; CI 1189–3013; p = 0.007) and prior pneumonia (OR 1.9; CI 1024–2898; p = 0.04) were significant predictors for susceptibility to SARS-CoV-2 infection. The importance of monitoring society through community-based questionnaires is highlighted, for predicting and preventing future widespread transmission of infectious diseases.

SURVEY THE FREQUENCY OF CLINICAL SYMPTOMS ACCORDING TO TRADITIONAL MEDICINE IN PATIENTS WITH LOW BACK PAIN

Background: Low back pain is a very common disease in daily life and clinical, which affects much to the health. Traditional medical symptoms of low back pain are very diverse and clinically difficult to diagnose. So we conduct this study to contribute to the standardization of symptoms according to traditional medicine and initially contributed to the improvement of diagnosis and treatment of diseases. Objectives: to survey the frequency of clinical symptoms according to traditional medicine in patients with low back pain and find out some factors related to the frequency of clinical types of the disease. Subjects and Methods: Including 92 patients were diagnosed with low back pain and treatment at the Traditional Medicine department of Hue Central Hospital and Thua Thien Hue Traditional Medicine Hospital. Research methodology is descriptive cross-sectional. Results: The symptoms of the tongue: 65.2% pale red tongue, 6.5% bluish purple tongue, 37.0% enlarged tongue, 8.7% thin tongue. About the tongue fur: 68.5% white fur and 31.5% yellow fur, 42.4% moist fur, 4.3% sticky slimy fur, 58.7% thin fur and 41.3% thick fur. The symptoms of the pulse: 17.4% floating pulse, 69.6% sunken pulse, nmoderate pulse 43.5%, powerful pulse 84.8%, weak pulse 15.2%. Among the patients have 33.7% constipation, 45.7% nocturia, 34.8% inability to sleep, 17.4% night sweating 12.0% spontaneous sweating. Conclusion: Symptoms: pale red tongue, white fur, moist fur, thin fur, constipation, nocturia, inability to sleep, sunken pulse, moderate pulse, powerful pulse have high rate; Symptoms have low rate such as bluish purple, the thin tongue, sticky slimy fur. There were significant relationships between clinical types and age, tongue color, tongue fur color, pain properties and pulse frequency (p &lt; 0.05). Key words: Low back pain, symptoms, traditional medicine.

Esophageal-gastrointestinal-diaphragmatic murmur - a new objective sign of diaphragmatic hernias

Aim. To present a description and scientific substantiation of a new objective sign in patients with hiatal hernias. Methods. The study included 127 patients with diaphragmatic hernia, who made up the group of patients, including 65 women and 62 men, mean age 56.2±11.4 years. The control group was represented by the results of a survey of 100 practically healthy people: 55 women and 45 men, the average age of 52.6±2.3 years. All patients included in the study group, underwent upper endoscopy and fluoroscopy of the esophagus and stomach with a suspension of barium sulfate, the results of which were compared with the data of auscultation of the chest. Results. The description and scientific substantiation of the physical sign of diaphragmatic hernias was presented, which is pathological peristalsis at four points of auscultation on the thorax. The factors that led to the choice of localization of the points at which auscultation of esophageal-gastrointestinal-diaphragmatic murmur is carried out in this pathology, are presented. Pathophysiological mechanisms causing the appearance of pathological peristalsis of the esophagus and stomach, which is the essence of the proposed symptom of hiatal hernia, were found and substantiated. Sensitivity and specificity of a new method of detecting diaphragmatic hernia were calculated, the positive and negative predictive values were determined. High efficiency of auscultation of abnormal motility as a diagnostic method was demonstrated. The frequency of clinical symptoms in patients with hiatal hernia and their comparison with the world experience of observation of patients with this pathology are shown. Conclusion. The proposed objective sign, which has a very high sensitivity and specificity, is an attempt to fill the currently existing «diagnostic gap» between the subjective sensations of a patient with diaphragmatic hernia and instrumental diagnostic methods that have certain limitations in application.

Malaria Vector Abundance and the Incidence of Malaria Parasite amongst Students Living in Nnamdi Azikiwe University Hostels

Introduction: Malaria remains an important public health disease in both tropical and subtropical countries of Africa where transmission is mainly through the bite of an infected female Anopheles mosquito.&#x0D; Aim: The main aim of this study was to determine the prevalence of malaria parasite and the abundance of malaria vectors in and around the university hostels. &#x0D; Place and Duration of Study: The study was carried out in some selected hostels of Nnamdi Azikiwe University, Awka, from the month of March to September, 2018.&#x0D; Methodology: One hundred and fifty (150) students which volunteered from the selected hostels were tested for malaria parasite. Questionnaire on the frequency of clinical symptoms were distributed to these students. Indoor resting mosquitoes were collected through pyrethrum spray-sheet collection (PSC).Larval sampling was carried out for the immature stages of mosquitoes.&#x0D; Results: Of the students examined for malaria parasite, 135 (90%) showed positivity to the parasite. From the questionnaire distributed, 30 (20%) of the students were treated for malaria every 3months, 20(13.3%) every 6 months, 24 (16%) before resuming school, and 76(50.7%) only treated when they developed clinical malaria. Two hundred and two (202) mosquito larvae were collected from their breeding habitats during larval sampling and two hundred and four (204) adult mosquitoes of different species were collected indoors. However there was no significant difference between the number of rooms sampled and the number of mosquitoes collected at 5% level of significance (x2tab &gt; x2cal; 9.488 &gt;6.307).&#x0D; Conclusion: The study revealed that the students living in the hostels were highly exposed to malaria infection and a host of other mosquito borne diseases. The abundance of Anopheles gambiae sensu lacto in the university environment and the high prevalence rate of malaria is an indication of continuous transmission in the area. Therefore re-echoed awareness campaigns on the danger of malaria infection and its prevention and control through personal and environmental management should be carried out to educate all students especially those who attended medical check-ups during registration.

Frequency of Clinical symptoms of Gastroesophageal Reflux Disease in Asthmatic Patients

Abstract:&#x0D; Background: Gastroesophageal reflex is known as an acid reflex, is long term condition where stomach contents back into the oesophagus resulting in either symptoms or complications. GERD disease is caused by weakness or failure of the lower oesophageal sphincter. Symptoms include the acidic taste behind the mouth, heart burn, chest pain, difficult breathing and vomiting. Complication includes esophagitis, oesophageal strictures and barrettes oesophagus.&#x0D; Objective: The aim of this research was to introduce the symptoms of GERD disease in asthmatic patients and how these symptoms worsen the symptoms of asthma disease and what clinical pictures present with the asthmatic disease.&#x0D; Methodology: A designed performa was used to collect the data and after filling the performa, results were drawn and conclusion through the facts and the information given by patients.&#x0D; Results: In the present study among all 164 asthmatic patients, 70 (42.7%) patients showed dyspepsia, 58 (35.4%) were with chest burning, 23 (14%) were asking about chest pain, with acidic mouth taste were 39 (23.8%), 22 (13.4%) were feeling sore throat and 44 (26.8%) showed regurgitation reflex. Among these 164 patients 16 (9.8%) were smokers and 148 (90.2 %) were non-smokers. 47 (28.7%) were males and 117 (71.3%) were females.&#x0D; Conclusion: It is concluded that gastroesophageal reflux disease in asthmatic patients present symptoms of acidic mouth taste, chest burning, chest pain, dyspepsia, regurgitation reflex and sore throat.

Correlation of CYP2C19 genotypes and Helicobacter pylori infection in children

Objective To evaluate CYP2C19 genotypes distribution in children with Helicobacter pylori (Hp) infection and to know its correlation with gender, age, severity and frequency of clinical symptoms, pathological classification of gastric antral mucosa. Methods Antral mucosas of 214 Hp infection patients who were hospitalized at Beijing Children′s Hospital of Capital Medical University from July 2013 to December 2015 were collected.Genotypes were determined by PCR-sequence specific primer method, which were classified as homozygous extensive metabolizer (HomEM), heterozygous extensive metabolizer (HetEM) and poor metabolizer (PM). The differences in CYP2C19 genotype distribution in gender, age, severity and frequency of clinical symptoms, pathological classification of gastric antral mucosa were analyzed. Results (1)Among 214 Hp infected children, the percentage of HomEM was 48.1%(103/214 cases), HetEM was 46.3%(99/214 cases), and PM was 5.6%(12/214 cases). PM in the CYP2C19 infection patients was lower than that in the normal Han nationality in China, and the difference was statistically significant (P 0.05). (3)There was no statistical difference in severity and frequency of clinical symptoms of CYP2C19 genotypes(all P>0.05). (4)In HomEM group, according to pathological classification of gastric mucosa, there were 14 cases of mild injury, 36 cases of moderate injury and 53 cases of severe injury, respectively.In HetEM group, there were 17 cases of mild injury, 29 cases of moderate injury and 53 cases of severe injury, respectively.In PM group, there were 2 cases of mild injury, 3 cases of moderate injury and 7 cases of severe injury, respectively.There was no statistical difference in the pathological degree of inflammation changes in gastric antral mucosa of CYP2C19 genotypes(all P>0.05). (5)Thirty-five cases didn′t receive treatment, 78 cases received Hp eradication one time and failed, 101 cases received no less than 2 times of unsuccessful Hp eradication.The number of Hp unsuccessful eradications were positively correlated with the degree of pathological inflammation changes(r=0.219, P<0.01). There was obvious difference between the number of Hp unsuccessful eradication and the pathological degree of inflammation changes in gastric antral mucosa (χ2=12.414, P<0.05). Conclusions There was no statistical difference in CYP2C19 genotypes distribution as for different gender, age, severity and frequency of clinical symptoms, pathological classification of gastric antral mucosa and CYP2C19 genotypes.The number of Hp unsuccessful eradication was positively correlated with the degree of pathological inflammation changes. Key words: Helicobacter pylori; CYP2C19 gene; Child

A study on clinicoradiological characteristics and pregnancy outcomes of reversible posterior leukoencephalopathy syndrome in preeclampsia or eclampsia.

Reversible posterior leukoencephalopathy syndrome (RPLS) is a critical maternal complication in preeclampsia or eclampsia during pregnancy. However, studies regarding the clinicoradiological and outcome differences between RPLS and non-RPLS pregnancies are scarce. We aimed to explore the incidence of RPLS, and summarize the clinicoradiological characteristics and pregnancy outcomes. We consecutively collected a total of 100 patients who were diagnosed with preeclampsia or eclampsia, and examined via magnetic resonance imaging (MRI) among 21 872 women between 2013 and 2016. All patients were grouped into RPLS (n=49) and non-RPLS (n=51) groups according to their MRI results. Information about clinicoradiological features and pregnancy outcomes was collected retrospectively to explore the differences between the groups. The incidence of RPLS in pregnant women was 0.22% (49/21 872). The frequency of clinical symptoms, such as headache, vision change, seizure and consciousness disorders, and blood pressure conditions, such as severely elevated hypertension, systolic and diastolic pressure and mean arterial pressure levels, was increased in the RPLS group compared with that in the non-RPLS group (P<0.05). The occipital lobe was the most frequently affected area (93.88%) in RPLS patients. The cesarean section rate in RPLS group was higher than the non-RPLS group (P<0.05), whereas the 1 min Apgar score was lower (P<0.05). These results suggest that the incidence of RPLS was high. Information about clinical symptoms and blood pressure was useful in predicting RPLS. In addition, RPLS was significantly associated with the delivery mode and pregnancy outcomes. The most frequently affected area was the occipital lobe.

Clinical findings and diagnosis in genetic prion diseases in Germany.

To describe the clinical syndrome and diagnostic tests in patients with genetic prion diseases (gPD) in Germany. Clinical features, MRI, EEG, and CSF markers were studied in 91 patients (28 D178N, 20 E200K, 17 inserts, 13 V210I, 8 P102L, 5 E196K). Dementia (35 %) and ataxia (29 %) were the most common initial symptoms and signs. A wide variety and high frequency of neurological/psychiatric symptoms and signs was found during disease course in all patients independently of the type of the mutation. Psychiatric manifestations were frequent (87 %). Neuropsychological abnormalities were observed in 67 %, and aphasia was the most common disturbance (45 %). In E200K, V210I and D178N patients, visual/oculomotor deficits were followed by ataxia early in the disease. Dementia followed by ataxia at onset was common in patients with insert and E196K mutation. P102L patients had isolated ataxia over a longer time period followed by pyramidal signs. Dementia was present only late in the disease course. All clinical routine tests such as MRI, EEG and CSF tests were less sensitive than in sporadic CJD. We provide the first detailed analysis of clinical signs and symptoms in a large group of patients with gPD. Frequency of clinical symptoms and signs was similar in different mutations in a later disease course, but the sequence of occurrence may be of great diagnostic importance. CSF markers were shown to be more sensitive than MRI and EEG.