Correlation of thyroid antibodies with TSH, T[3] and T[4] hormones in patients diagnosed with autoimmune thyroid disorders

The serum concentrations of anti-thyroid peroxidase [anti-TPO] and anti-thyroglobulin [anti-TG] antibodies are directly correlate in the induction and diagnosis of autoimmune thyroid disorders [AITDs]. Therefore, the evaluation of serum anti-TPO and anti-TG antibodies in relation to thyroid function test parameters including thyroid-stimulating hormone [TSH], triiodothyronine [T[3]], and thyroxine [T[4]]. This evaluation would be helpful in early diagnosis of abnormal thyroid function and associated autoimmune thyroid diseases. In this cross-sectional study, the serum anti- TPO, anti-TG, T[3], T[4] and TSH levels of 311 suspected patients of autoimmune thyroid disorders and 40 control subjects were evaluated. The data were presented as mean, +/- standard deviations of the mean. Pearson correlation and chi-square tests were used to assess the correlation coefficients and significance in the contingency tables. The thyroid function test parameters in normal and AITDs suspected patients were significantly different in correlation to elevated serum levels of anti-TPO antibody. A significant association was detected between female gender and elevated levels of anti-TPO [P value = 0.047]. A higher percentage of women showed elevated levels of anti-TG, but it was not statistically significant [P value= 0.107]. The findings of the study reveal a strong correlation between thyroid function test and thyroid antibodies levels, elaborating the clinical importance of thyroid antibodies in clinical examination and follow-up of patients with autoimmune thyroid disorders

Tumour-like presentation of central nervous system tuberculosis: a retrospective study in Kingdom of Saudi Arabia

To differentiate the tumour-like presentation of central nervous system [CNS] tuberculosis [TB] from CNS tumours. We conducted a retrospective chart review of all cases of CNS TB seen at King Abdulaziz Medical City, Jeddah, between January 2002 and January 2012. No symptoms or signs of pulmonary or systemic TB were found. Of the 125 patients with CNS TB, 9 [7.2%] presented with clinical and radiological features suggestive of a brain tumour. A diagnosis of tuberculoma was established either intraoperatively in frozen sections [three patients] or postoperatively when the masses were resected [six patients]. After surgery, seven patients recovered after receiving anti-TB treatment; one patient died, and another developed a severe neurological deficit. CNS TB is a great mimicker of brain tumours, and the index of suspicion should be high, especially in endemic areas. A diagnosis is based on clinical presentation and the results of investigations. In patients with CNS TB that present with a mass lesion, a biopsy should be taken to avoid morbidity and mortality from an unnecessary surgical intervention. Greater use should be made of magnetic resonance spectroscopy in the evaluation of brain space-occupying lesions, and CNS TB should be included in the differential diagnosis of such lesions in all areas endemic for TB. The absence of constitutional or pulmonary symptoms of TB is deceiving. More nationwide epidemiological studies are needed to establish guidelines for early detection and successful outcomes of this rising health problem

Cervical gouty myelopathy in two cases at King Abdulaziz medical city

Gout is a rheumatological disorder found exclusively in human species. It is caused by deposition of crystals of monosodium urate in joints, cartilages, tendons, and soft tissues. Involvement of the spine, however, is rare. In this report, we describe two patients presented to King Abdulaziz Medical City in Jeddah with clinical features of cervical myelopathy, including neck pain, L'hermitte phenomena, quadriparesis and sensory deficit [shoulder level]. Magnetic resonance imaging confirmed the presence of cervical cord compression with intrinsic cord signal abnormalities. Both patients had laminectomy and intraoperatively; severe canal stenosis was identified. A whitish cheesy material was noticed causing significant root compression. The pathology was diagnostic of gout. In this article, we present two difficult cases with interesting clinical, radiological and pathological findings. We emphasize on the importance of early diagnosis to prevent morbidity

Prevalence of wheat allergy in Al-Kharj, Saudi Arabia

Wheat allergy has been suggested to represent an important allergic disease. This study collates clinical and laboratory aspects in patients with wheat allergy in Al-Kharj city, Saudi Arabia. Total and specific IgE were measured in 15 suspected cases of wheat allergy. Protein allergenicity was assessed with Western blotting. Significant elevation of total and specific IgE was found in 4 cases. Basophlia was also demonstrated on blood film. Western blotting results showed 2 bands [83 and 40 kDa]. Wheat allergy must also be considered when planning treatment of asthma and eczema of adult patients

Animal allergy among husbandry personnel in Riyadh

The importance of specific animal allergy in immuno-pathology of asthma and atopic diseases remained to be defined. We measured total and specific IgE. Western blotting of some allergens was also characterised. There was a significant elevation of IgE in 3 persons among 15 samples collected. Western blotting showed common husbandry allergens from 3 sources that have common allergenicity. Exposure to animal products exacerbates allergic asthma in adults, suggesting that preventive measures should be taken to reduce their sensitivity

comparison between a new 2-dimensional digital on-screen tooth measurement method with direct measurements

To compare the accuracy and reproducibility of tooth measurements using newly developed software that gives 2-dimensional scanned images of dental setups with direct measurements using digital calipers. This experimental study was performed at the Dental Laboratories of the Faculty of Dentistry, University of Jordan, Amman, Jordan from September 2010 to December 2010. Ten sets of acrylic teeth [10 upper and 10 lower arches] were used. The mesiodistal width of each individual tooth was measured using a digital caliper [method I], which was considered the gold standard. The teeth were set to create 20 dental setups. The mesiodistal widths of teeth on the created setups were then measured by using a digital caliper [method II]. The dental setups were then scanned using a flatbed computer scanner and tooth width measurements were performed using a special computer program [method III]. Tooth measurements were divided into 6 groups, and the 3 methods were compared. There was a statistical significant difference between the 3 measurement methods in most of the measured tooth groups. Methods I and II exhibited significant differences for most of tooth groups [ranged from 0.02 to 0.22 mm] while no significant difference was found between methods I and III [ranged from 0.03 to 0.11 mm]. Tooth width measurement with onscreen 2-dimensional scanned images of dental casts is comparable to measurements obtained using direct digital caliper

Linkage and haplotype analysis for chemokine receptors clustered on chromosome 3p21.3 and transmitted in family pedigrees with asthma and atopy

Genomic scan analyses have suggested that the chemokine receptor cluster [CCR2, CCR3, CCR5 <300 kb span] on the short arm of chromosome 3 may contribute to susceptibility to HIV-1 infection and to the expression of a number of inflammatory diseases. Two single nucleotide polymorphisms [SNP] and a deletion in these chemokine receptors have also been found in case-control studies to be associated with susceptibility for asthma and related phenotypes. We extended these case-control studies by establishing whether these polymorphisms were in linkage and linkage disequilibrium with asthma and related phenotypes using linkage and haplotype analyses. We genotyped 154 nuclear families identified through two child probands with physician-diagnosed asthma [453 unrelated individuals] including 303 unrelated parents and 150 unrelated children. Atopy was defined as a positive skin prick test [SPT 3 mm] to a panel of common inhaled allergens. From a panel often known SNPs, only three polymorphisms: -G190A in CCR2, -T51C in CCR3, and a 32 bp deletion in CCR5 were found to occur at clinically relevant frequencies. All 154 families were used for haplotype analysis but only 12 nuclear families were eligible for linkage analysis. Both analyses confirmed that the mutations were in linkage with asthma, but not with atopy. The chemokine receptor genes on 3p21.3 are significantly plausible candidate genes that can influence the expression of asthma. The previous association of the CCR5delta32 deletion with protection from childhood asthma appears to be explained by linkage disequilibrium with the -G190A mutation in the CCR2 receptor gene

Interstitial cells of Cajal and intestinal function in Trinidadian children / Células intersticiales de Cajal y función intestinal en niños trinitenses

OBJECTIVE: This study was carried out to compare the density of the interstitial cells of Cajal (ICCs) in the bowel wall of children with Hirschsprung's disease (HD), anorectal malformations (ARM) and normal controls in Trinidad and Tobago. SUBJECTS AND METHOD: Segments of bowel wall excised from eight children with HD, three controls and two children with ARM were immunostained with c-Kit primary antibody. Cells with features of ICCs were counted. RESULTS: All three controls and the two children with ARM had dense distribution of ICCs. Most children (6/8;75%) with HD had markedly reduced counts in aganglionic bowel. Two (25%) also had a decrease in ganglionic bowel. Possible influences were patient age and gender and the level of bowel sectioned. CONCLUSION: Analysis of this sample suggests that immunostaining for c-Kit positive cells might be a useful screening test in the assessment of bowel motility disorders. The possible effects of age, gender and the level of bowel sampled await determination.

OBJETIVO: Este estudio se llevó a cabo con el propósito de comparar la densidad de las células intersticiales de Cajal (CIC) en las paredes intestinales de niños con la enfermedad de Hirschprung (EH), y malformaciones anorectales (MAR), frente a controles normales en Trinidad Tobago. SUJETOS Y MÉTODOS: Segmentos de las paredes intestinales les fueron extirpados a ocho niños con EH; tres controles y dos niños con MAR fueron inmunoteñidos con anticuerpo primario c-kit. Se contaron las células con características de CIC. RESULTADOS: Los tres controles y los dos niños con MAR presentaban una distribución densa de CICs. La mayor parte de los niños (6/8; 75%) con EH tuvieron conteos marcadamente reducidos de intestino agangliónico. Dos niños (25%) también tuvieron una disminución de intestino gangliónico. Entre las influencias posibles se cuentan la edad y el género del paciente así como el nivel de intestino seccionado. CONCLUSIÓN: El análisis de esta muestra sugiere que la inmunotinción para células c-kit positivas podría ser un útil test de pesquisaje a la hora de evaluar desórdenes en la motilidad intestinal. Los efectos posibles de la edad, el género y el nivel de intestino muestreado, están pendientes de determinación.

Association and preferential transmission of the CCR2V64I polymorphism with absence of asthma in high-risk families

To explore a possible association between the major functional CCR2V64I polymorphism and asthma and related phenotypes independent of atopy. We conducted this study in the Royal Aberdeen Children's Hospital, University of Aberdeen Medical School, United Kingdom from September 2004 to December 2006. One hundred and fifty-four unrelated nuclear families [598 individuals including children and parents] were identified from the local Grampian population. The major functional polymorphism CCR2V64I was analyzed for associations with asthma, lung function [forced expiratory volume% [FEV1%] of predicted], bronchial hyperresponsiveness [BHR] to methacholine, total serum-immunoglobulin E [s-IgE] and allergic sensitization [positive skin prick test to common allergens] in 154 asthmatic families. Pedigree disequilibrium test and case control analyses showed that the CCR2V64I polymorphism was significantly associated with the absence of asthma FEV1%, predicted above the population median of 83%, but not with s-IgE levels or specific sensitization. We identified associations between the V-64I CCR2 polymorphism and protection against asthma, higher FEV1, and absence of BHR in families at high risk of asthma and atopy, suggesting an important role for the CCR2 receptor in modulating airway inflammation independent of atopy

A childhood malignant rhabdoid tumour of the kidney

A case report is presented of a malignant rhabdoid tumour occurring in the kidney of a 23-month-old boy. Important differences between this and the conventional Wilms' tumour include the histological demonstration of sheets or cords of large cells resembling myoblasts, a tendency to frequent clinical relapse, and a high mortality rate despite multimodal therapy. In this child, an encouraging initial response to pre-operative chemotherapy, followed by surgical excision and postoperative triple chemotherapy, was not sustained. Recurrence of pulmonary metastases did not respond to further chemotherapy and whole lung irradiation.

Evaluation of oestrogen and progesterone receptors, and c-erbB-2 in carcinoma of the breast in Trinidadian women

One hundred and three consecutive cases of breast cancer in Trinidadian women were evaluated for steroid receptor status and c-erbB-2 receptor along with conventional parameters including age, ethnicity, tumour size, histological type and grade, and lymph node status: The molecular markers were studied by immunohistochemistry (IHC) on paraffin sections. Tumour size > 2 cm was seen in 60 of the cases. Oestrogen receptor (ER), progesterone receptor (PR) and c-erbB-2 showed 54, 46 and 63 positivity, respectively. There was no correlation between c-erbB-2 and steroid receptors. Forty-one per cent of cases showed double negativity for steroid receptors (ER-/PR-). No correlation was found between the markers and conventional parameters except for a negative correlation with the tumour grade. The high percentage of c-erbB-2 positivity and the high proportion of steroid receptor negativity suggest a need for studies on adjuvant therapy. Integration of selected markers with conventional parameters could help define subgroups for treatment and prognosis.

Cardiac fibroma presenting as sudden death in a six-month-old infant

Cardiac fibroma is a rare benign tumour which occurs predominantly in infancy and childhood. We present the case of a six-month-old female infant who died suddenly at home and was found at autopsy to have a large cardiac fibroma in the ventricular septum. The tumor was apparently asymptomatic although there was evidence of mild cardiac failure. Death was thought to be due to a fatal arrhythmia.

Nephrotic syndrome in Trinidadian children

Fifty seven children with idiopathic nephrotic syndrome who were seen at two hospitals in Trinidad between 1989 and 1995 (median follow-up period, 38 months) were classified according to their response to glucocorticoids. 27 (47 percent) were two to six years old at presentation; 37 (65 percent) were of East Indian descent, 7 (12 percent) were of African descent, and 12 (21 percent) were of mixed race. 55 (96 percent) responded to glucocorticoids. Renal biopsies in 15 patients revealed membranoproliferative glomerulonephritis and membranous nephropathy in the two patients who had not responded to glucocorticoids. Ten patients showed mesangial hypercellularity, associated with immunoglobulin deposits in 7 cases. Age, presentation with nephrotic features, mesangial hypercellularity and immunoglobulin deposits did not predict for unresponsiveness to glucocorticoids. These findings may be explained by the predominance of East Indians in the study group.

Epidemiological survey of spinal cord injury: a study of 377 patients

The total number of patients admitted to the Spinal Cord Injury Unit, Riyadh Central Hospital, Riyadh, Saudi Arabia from June 1979 to March 1984 approached 450 patients. Of those, 377 [369 males and 8 females] patients with complete records and sustaining traumatic injury were studied. The patients were divided into four groups: cervical, dorsal, dorsolumbar and lumbar. In each group, the following parameters were studied: age, sex, nationality, length of period prior to admission, and source of admission. The cause of injury was divided into four groups, including road traffic accident, industrial injuries, domiciliary injuries and gunshot wounds. The study included the type of bony injury and associated injuries, complications both on admission and during hospital course and neurological deficit and progress. The results of treatment are displayed in a variety of tables with explanations in the text. It is hoped that this work would be a pointer to the size of the problem in Saudi Arabia, and would highlight the difficulties encountered and tentatively put forth suggestions for correction

Protective effect of doxium in open angle glaucoma in diabetics

Thirty non-insulin-dependent diabetic subjects with early stages of diabetic retinopathy [DR] and open angle glaucoma, contributed in this study, to verify the effect of Doxium on intraocular pressure [IOP], and visual fields. Only Doxium was given to 12 cases, and it was combined with antiglaucoma therapy in another 12 cases, while the remaining 6 cases received antiglaucoma treatment without Doxium. It was found that Doxium has a hypotensive effect and improves, or prevents progression, of glaucomatous field defects, probably through its blood viscosity reducing effect

Recovery of optic neuritis

Certain visual functions, such as colour vision, contrast sensitivity, field changes and visually evoked potentials were tested in 16 subjects recovering from unilateral optic neuritis, and an equal number of control normal subjects. It was found that despite the apparent full recovery from optic neuritis, as indicated by recovering Snellen visual acuity, yet deficits were detected in all of the above mentioned functions. Colour vision testing was the least sensitive one in detecting such deficits. The use of steroid treatment did not seem to affect or improve recovery from optic neuritis

alternative to Amsler's chart

Many of negative scotomas escaped detection by Amsler's chart. In this study various modifications of this chart parameters were tried to enhance its yield. The phenomenon of completion rendered these modifications useless and another chart, displaying widely spaced targets, was found more reliable