• Title/Summary/Keyword: Clinical presentation

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Celiac disease in children: increasing prevalence and changing clinical presentations

  • Isa, Hasan M.;Farid, Eman;Makhlooq, Jaafar J.;Mohamed, Afaf M.;Al-Arayedh, Jumana G.;Alahmed, Fawzeya A.;Medani, Shima
    • Clinical and Experimental Pediatrics
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    • v.64 no.6
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    • pp.301-309
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    • 2021
  • Background: Celiac disease (CD) is a chronic autoimmune enteropathy. It results from genetic predisposition and exposure to gluten-containing food. The prevalence and presentation of CD vary among populations. Purpose: This study aimed to describe the prevalence and clinical characteristics of CD in children in Bahrain. Methods: We retrospectively reviewed the medical records of children diagnosed with CD in the pediatric department, Salmaniya Medical Complex, Bahrain, in 1988-2018. Their clinical, biochemical, serological, and histopathological findings were documented. Adherence to the recommended gluten-free diet (GFD) was assessed. Results: Of 86 patients with CD, 67 were included. The CD prevalence was 0.02%. A significant increase in prevalence in the last decade was observed (P<0.0001). Thirty-eight patients (56.7%) were males. The median (interquartile range) age at presentation was 4.45 (1.5-7.3) years. A family history of CD was positive in 13 out of 43 patients (30.2%). Pallor and failure to thrive were the most common presentations. The most frequent associated disease was iron-deficiency anemia in 23 patients (69.7%). Positive serology was found in 32 of 45 patients (71.1%). Marsh-Oberhuber type III was found in 16 of 35 patients (45.7%). Seropositive patients were significantly older (P=0.025) and had more severe duodenal histology (P=0.002). Adherence to GFD was poor in 27 patients (64.3%). Conclusion: This study revealed a significant increase in CD prevalence over the last decade. Atypical presentations were frequent. Most patients had poor adherence to GFD.

Risk factors and screening timing for developmental dysplasia of the hip in preterm infants

  • Jeon, Ga Won;Choo, Hye Jung;Kwon, Yong Uk
    • Clinical and Experimental Pediatrics
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    • v.65 no.5
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    • pp.262-268
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    • 2022
  • Background: The delayed diagnosis of developmental dysplasia of the hip (DDH) requires complex treatment and sometimes progresses to hip osteoarthritis. Purpose: This study aimed to evaluate the risk factors and screening time for DDH in preterm infants. Methods: A total of 155 preterm infants with a gestational age <32 weeks screened for DDH with ultrasonography were enrolled in this retrospective chart review. Results: The incidence of DDH was 6.45% (10 of 155). Gestational age, birth weight, sex ratio, and breech presentation did not differ significantly between infants treated for DDH (n=10) and nontreated infants (n=145) (gestational age, 29.2±1.4 weeks vs. 29.6±2.0 weeks, P=0.583; birth weight, 1,240±237 g vs. 1,295±335 g, P=0.607; female sex, 7 of 10 (70.0%) vs. 77 of 145 (53.1%), P=0.346; and breech presentation, 5 of 10 (50.0%) vs. 43 of 145 (29.7%), P=0.286, respectively). Performing the first ultrasonography earlier than 38 weeks of postmenstrual age (PMA) increased the risk of an abnormal finding by 3.76 times compared to performing it at ≥38 weeks of PMA. These abnormal findings on ultrasonography resolved spontaneously. Breech presentation increased the risk of minor abnormal findings on the first ultrasonography by 3.11 times versus nonbreech presentation and resolved spontaneously. DDH in preterm infants did not occur predominantly on the left side or in infants born with breech presentation. Conclusion: Performing ultrasonography screening earlier than 38 weeks of PMA caused unnecessary subsequent ultrasonography and overtreatment. Breech presentation was not a risk factor for DDH in preterm infants. However, breech presentation could increase the risk of minor abnormal findings at the 1st ultrasonography compared to nonbreech presentation, which resolved spontaneously. The etiology and risk factors for DDH in preterm infants are somewhat different from those for DDH in term infants.

Presentation of Retinoblastoma Patients in Malaysia

  • Subramaniam, Shridevi;Rahmat, Jamalia;Rahman, Norazah Abdul;Ramasamy, Sunder;Bhoo-Pathy, Nirmala;Pin, Goh Pik;Alagaratnam, Joseph
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7863-7867
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    • 2014
  • Background: Retinoblastoma is a rare type of cancer that usually develops in early childhood. If left untreated it can cause blindness and even death. The aim of this study is to determine sociodemographic and clinical features of retinoblastoma patients and also to determine the treatment pattern and outcome in Malaysia. Materials and Methods: Data for this study were retrieved from the Retinoblastoma Registry of the National Eye Database (NED) in Malaysia. Hospital Kuala Lumpur, Hospital Umum Kuching, Sarawak and Hospital Queen Elizabeth, Kota Kinabalu were the major source data providers for this study. Data collected in the registry cover demography, clinical presentation, modes of treatment, outcomes and complications. Results: The study group consisted of 119 patients (162 eyes) diagnosed with retinoblastoma between 2004 and 2012. There were 68 male (57.1%) and 51 (42.9%) female. The median age at presentation was 22 months. A majority of patients were Malays (54.6%), followed by Chinese (18, 5%), Indians (8.4%), and indigenous races (15.9%). Seventy six (63.8%) patients had unilateral involvement whereas 43 patients had bilateral disease (36.1%). It was found that most children presented with leukocoria (110 patients), followed by strabismus (19), and protopsis (12). Among the 76 with unilateral involvement (76 eyes), enucleation was performed for a majority (79%). More than half of these patients had extraocular extension. Of the 40 who received chemotherapy, 95% were given drugs systemically. Furthermore, in 43 patients with bilateral involvement (86 eyes), 35 (41%) eyes were enucleated and 17 (49%) showed extraocular extension. Seventy-two percent of these patients received systemic chemotherapy. The patients were followed up 1 year after diagnosis, whereby 66 were found to be alive and 4 dead. Sixteen patients defaulted treatment and were lost to follow-up, whereas follow-up data were not available in 33 patients. Conclusions: Patients with retinoblastoma in this middle-income Asian setting are presenting at late stages. As a result, a high proportion of patients warrant aggressive management such as enucleation. We also showed that a high number of patients default follow-up. Therefore, reduction in refusal or delay to initial treatment, and follow-up should be emphasized in order to improve the survival rates of retinoblastoma in this part of the world.

Oncologist Perspectives on Breast Cancer Screening in India-Results from a Qualitative Study in Andhra Pradesh

  • Bodapati, Srikanthi Lakshmi;Babu, Giridhara Rathnaiah
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.5817-5823
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    • 2013
  • Background: It is important to understand the perceptions of oncologists to understand the comprehensive picture of clinical presentation of breast cancer. In the absence of clear evidence, clinical practice involving patients of breast cancer in India should provide insights into stages of breast cancer with which women present to their clinics and mode of screening of breast cancer prevalent in Andhra Pradesh. Materials and Methods: A qualitative study was conducted to understand the perceptions of oncologists regarding clinical presentation of breast cancer, stages at which women present to clinics, and mode of screening of breast cancer prevalent in Andhra Pradesh. In-depth interviews (IDI) were conducted with ten practising oncologists from various public and private cancer hospitals in Hyderabad city to understand their perspectives on breast cancer and screening. The data were triangulated to draw inferences suitable for the current public Health scenario. Results: Late presentation was indicated as the most important cause of decreased survival among women. Most women present at Stage 3 and 4 when there is no opportunity for surgical intervention. The results indicate that there is a huge gap in awareness about breast cancer, especially in rural areas and among poor socioeconomic groups. Even despite knowledge, most women delay in reporting due to reasons like fear, embarrassment, cost, ignorance, negligence, and easy going attitude. Conclusions: It is important to improve awareness about breast cancer and screening methods for promoting early screening. The study inferred that it would be beneficial to establish cancer registries in rural areas. Also, the policymakers need to make key decisions which among three methods (breast self examination (BSE), clinical breast examination and mammography) can best be used as a screening tool and how to successfully implement population wide screening program to prevent mortality and morbidity from breast cancer in India.

Factors Affecting Nursing Students' Adjustment to College Life (간호대학생의 대학생활 적응에 대한 영향요인)

  • Han, Jong-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.7
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    • pp.4459-4466
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    • 2015
  • This study was conducted to identify the factors that influence nursing students' adjustment to college life. Self-report questionnaire surveys were conducted toward 333 South Korean nursing students to measure emotional intelligence, perfectionistic self-presentation, and clinical stress. Data were collected from October 20th to December 8th, 2014. The collected data were analyzed by using t-test, one way ANOVA, Pearson correlation coefficient, and multiple linear regression analysis. The results indicated that emotional intelligence, religion, perfectionistic self-presentation significantly influenced on the adjustment to college life and the explanatory power of the model was 27.2%. Based on the study results, we suggest that it is necessary to develop and apply the educational strategy to improve the emotional intelligence for the adjustment to college life.

Recent progress in the understanding of clinical characteristics, epidemiology, and pathogenesis of new bronchopulmonary dysplasia (새로운 유형의 기관지폐이형성증의 임상적 특성, 역학, 병리기전에 대한 국내외 최근 연구동향)

  • Kim, Beyong Il
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.6-13
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    • 2009
  • Recent advances in perinatal care have resulted in improved survival of extremely low birth weight infants (ELBWI). However, bronchopulmonary dysplasia (BPD) remains one of the major complications in ELBWI. BPD was originally described over 40 years ago; the clinical characteristics, epidemiology, and pathogenesis of BPD have changed markedly through this period. In this article, I have reviewed recent progress in research concerning the clinical presentation and characteristics, epidemiology, and pathogenesis of BPD.

Clinicopathological Profile of Breast Cancer Patients at a Tertiary Care Hospital in Marathwada Region of Westen India

  • Takalkar, Unmesh Vidyadhar;Asegaonkar, Shilpa Balaji;Kulkarni, Umesh;Kodlikeri, Pushpa R;Kulkarni, Ujwala;Saraf, Mamta;Advani, Suresh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2195-2198
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    • 2016
  • Background: Breast cancer is the most prevalent malignancy among women with wide differences in clinical profile from region to region. The present study aimed to describe the profile of breast cancer patients attending a tertiary care hospital in Marathwada region of Western India. Materials and Methods: In this descriptive retrospective study, we reviewed records of pathologically diagnosed patients of breast cancer managed at our center from years 2009 to 2015. Data with respect to demographic status, detailed past, medical, familial and personal history, findings of clinical examination and histological features were obtained. Patients were staged according to the Tumor Node Metastasis (TNM) system. Results: Among 260 cases, mean age of presentation was 52.6, with average age of menarche of 11.3 and menopause of 52.6 years. The majority of patients were from urban regions and were postmenopausal (64.3%). Main clinical features presentation were breast lumps. Most patients were in stage II and had infiltrating duct carcinomas. Conclusions: Most common risk factors for breast cancer observed are increasing age, low parity and obesity. Breast cancer was more prevalent among postmenopausal women presenting in stage II with infiltating duct carcinoma in our region of India.

A Study of Exploration for the Educational-Industrial Joint Research Projects on Oriental Medicine (산학공동연구를 위한 기초조사 연구)

  • Kang, Hyo-Shin;Kwon, Young-Kyu;Park, Jae-Hyun;Seo, Bu-Il;Lee, Jeong-Ho
    • The Journal of Korean Medicine
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    • v.17 no.2 s.32
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    • pp.58-72
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    • 1996
  • I. PURPOSE AND SIGNIFICANCE OF RESEARCH The presentation of research direction for compositive study and application of oriental medicine is urgently demanded. Since there is few investigation for the interest in basic and clinical field of oriental medicine, and we hope that compositive study and concentrative research between instruction in college and local clinics is established by this research. II. RESEARCH CONTENT ${\cdot}$ Analysis of survey in basic field of oriental medicine as instruction curriculum. ${\cdot}$ Analysis of survey in clinical field of oriental medicine as the classification of disease. III. RESULT The result of investigation shows that the most interested field is acupuncture and moxibustion in clinical field and diagnostics in basic field of oriental medicine. And oriental medicinal clinic doctors are concerned about prescription and a newly-developed techniques such as new acupuncture therapy, new machines. They hope that a study of oriental medicine in clinical field be accomplished with the special clinics as leader. According to the previous results, we can work out the foundation of compositive study and concentrative research between instruction in college and local clinics, and on this ground it is considered that we can grope for the presentation of research direction of local clinics.

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