HIV Nursing

To Explore Serum Vitamin D Levels in Children with Autism Spectrum Disorder

2024-04-11T12:04:58+00:00

Background: A complicated neurological ailment that can cause problems for a person's entire life is autism spectrum disorder (ASD). Its social and economic consequences are considerable. ASD is distinguished by difficulty in social communication and a proclivity for repeated behaviors and interests. Autism's prevalence has increased significantly during the last three decades, now impacting 7.6 persons per 1000 people, or around one in every 132 people. Vitamin D deficiency has emerged as a global health concern, driven by factors such as geographic location, season, skin color, indoor lifestyle, air pollution, and obesity. Researchers from many nations found that children with autism spectrum disorder have considerably lower levels of serum vitamin D than healthy youngsters. Objective: To explore serum vitamin D levels in children with ASD and compare them to those of healthy children Study design: A case control study Place and Duration: This study was conducted in Bilawal Medical College for Boys LUMHS Hyderabad from November 2022 to November 2023. Methodology: To perform this study, children diagnosed with autism spectrum disorder aged 3 to 10 years, as validated by a pediatric neurologist, were purposefully enrolled after receiving informed written consent from their parents. The study group consisted of 80 children with Autism Spectrum Disorder. In addition, 80 children who appeared to be healthy were chosen for comparison, with age, BMI, and gender matching. All participants came from middle-class socioeconomic backgrounds. Results: There were a total of 80 children who were enrolled in this research. The mean age for the children who were having ASD was 6.16 years while the ones in the healthy group was 6.04 years. The serum 25(OH) D was low in the ASD group. Overall, 80% of the children were vitamin D deficient in the ASD group while 66.25% were deficient in the control group. Conclusion: Vitamin D insufficiency affects both children with ASD and those without the disease.

Exploring the Relationship Between Alopecia Areata, Vitamin D and Calcium Levels: Ameta-Analysis and Analytical Review

2024-04-17T09:32:55+00:00

Background: The purpose of this study is to investigate any possible relationships between serum calcium and vitamin D levels and alopecia Areata (AA). Study design: A Meta-analysis and analytical review. Place and Duration This study was conducted in Sudan-Khartoum (Khartoum Teaching Hospital) Sudan from January 2019 to January 2020. Methodology: Key focal points of this study included evaluating serum vitamin D levels and the prevalence of vitamin D deficiency, alongside the secondary assessment of serum calcium levels. The chosen studies were subjected to statistical analysis that included odds ratio (OR) and standardized mean difference (SMD) with 95% confidence intervals (CI). Results: Data from eight case-control studies and two cross-sectional studies are included in this meta-analysis. A meta-analysis using a random-effects model revealed that those with AA were more likely to have vitamin D deficiency (p < 0.001) and had considerably lower serum vitamin D levels (p < 0.001). Serum calcium levels, however, showed no discernible variation (p = 0.143). Subgroup analysis revealed that while research design, matched control, and study country may have an impact on vitamin D insufficiency heterogeneity, characteristics including mean age, country, and matched control may have an impact on serum vitamin D levels. Conclusion: Rather than low calcium levels, patients with AA have deficiencies in their serum vitamin D levels. Vitamin D deficiency screening and therapy may be beneficial in the treatment of people with AA.

Results of Patella Surfacing Versus Non-Surfacing in Total Knee Replacement

2024-04-26T12:04:51+00:00

Objective: To compare the functional outcomes of patients after the procedures by resurfacing and not resurfacing the patella during the surgery, Background: The-total-knee arthroplasty (TKA) - is the-prosthetic-replacement of patellofemoral and the femorotibial compartments with an inert mechanical structure, to enable it to restore functional mobility and indolence, restoring its prior autonomy. TKA has advanced, and with it, the implants and friction torques have improved, ensuring the prosthesis' life and durability. Study Design: retrospective cohort study, Place And Duration: This study was conducted in Liaquat National Hospital and Medical College Karachi from October 2022 to October 2023, Methodology: This study includes 57 patients and 60 knees who underwent TKA. The patients of primary osteoarthritis either primary or traumatic origin were included in the study. The information regarding the TKA like -inflammatory-joint-diseases-and-trauma-history-, -medical and surgical history, primary/secondary gonarthrosis ,the affected side, , -the-surgical-technique, -radiological-assessment (knee-radiograph-the -anterior/posterior -view- and lateral view), -and clinical Knee Society Score (KSS) were recorded. The data was entered and analyzed using SPSS version 26.0, Results: The-BMI-of the patients ranged from 19 kg/m2 to 38 kg/m2(mean and SD= 29.6±1). There were 44 (73.33%) female and 16 (26.67%) male in the study. There were 32 (53.33%) left, 24 (40%) right and 4 (6.67%) bilateral knees in the study. We observed that in resurfaced group, 2 (9.52%) cases observed anterior pain, 3 (14.29%) 1(4.76%) and 1(4.76%) observed infection, limping and stiffness respectively. Average postoperative mobility amplified from 86 to °106.7° with an average increase of 106° and -108° in-resurfaced-cases-and-non-resurfaced-cases respectively. Conclusion: We conclude that the replacement patella is expensive procedure with delayed recovery time. However, there were no any functional differences of functional outcomes across the procedures used in the study. Therefore it is the discretion of the surgeon according to his expertise to opt for the procedure aligned with the condition of the patient.

Efficacy of Ponseti Casting in Syndromic Clubfoot Cases in Children: A Quasi-Experimental Study

2024-05-08T17:10:33+00:00

Objective: This study aimed to assess the efficacy of Ponseti casting in the management of syndromic clubfoot deformities. Study design: A quasi-experimental study. Place and Duration: This study was conducted in Liaquat College of Medicine and Dentistry, Darul Sehat Hospital Karachi from December 2022 to December 2023. Methodology: Children under one year of age, regardless of gender, with syndromic clubfoot and without prior casting or surgical interventions, were included. Exclusion criteria comprised prior treatment, parental reluctance, or specified conditions. Initial assessments included photographic documentation and Pirani scoring before casting initiation. Weekly casting sessions were documented, with selective TA tenotomies performed when necessary prior to the final cast. Post-treatment documentation and Pirani scoring were conducted, with follow-up assessments at 3 and 6 months to monitor recurrence and surgical requirements. Data analysis was conducted using SPSS version 26. Results: The study enrolled 100 children (70 males, 30 females) with 80 bilateral and 20 unilateral clubfeet. Initial Pirani scores indicated significant deformity, necessitating varying numbers of casts and occasional tenotomies. Despite challenges, notable improvement was observed, although syndromic cases required a greater number of casts compared to idiopathic clubfeet. The mean pre-Ponseti Pirani score was 4.1±0.83, demonstrating a significant reduction to 2.1±0.6 post-treatment (p < 0.001). Recurrence occurred in 40 (40%) children, with 20 (20%) requiring surgical intervention. Conclusion: Ponseti casting demonstrates utility in correcting syndromic clubfoot deformities, albeit with increased casting requirements. Despite the challenges, the method effectively corrects deformity to a considerable extent. Therefore, it is recommended for use in children.

The Brain Natriuretic Peptide (BNP) Precursor is the Major Immunoreactive form of BNP in Patients with Heart Failure

2024-06-01T18:15:53+00:00

Background: Heart failure (HF) diagnosis often relies on peptides originating from the BNP precursor, including BNP, proBNP, and the NT-proBNP, serving as key markers. However, there remains ambiguity regarding the specific forms of these peptides present in the bloodstream and their detectability through existing assays. Objective: To increase our understanding and knowledge of the circulating forms of BNP peptides in HF and their implications for diagnostic and prognostic assessment. Study design: An analytical cross-sectional study. Place and Duration: This study was conducted in The Indus Hospital and Health Network Karachi from March 2023 to March 2024. Methodology: In this research, we developed innovative assays for detecting NT-proBNP, proBNP, and BNP using specific monoclonal antibodies designed for their recognition. These antibodies were thoroughly tested in dual-site-combinations by using time-resolved immunoassays. We employed synthetic antigens and recombinant antigens, as well as plasma samples from HF patients. Furthermore, we utilized gel filtration fast protein liquid chromatography (FPLC) to analyse proBNP and related molecules in both pre- and post-protein fractionated HF plasma extracts and samples, using Sep-Pak C18 cartridges. Results: Our investigations demonstrated specific detection limits for proBNP, BNP, and NT-proBNP assays, measured at 0.4, 3, and 10 ng/L, respectively. Following analyses using gel filtration-FPLC, distinct peaks emerged, with one each for NT-proBNP (25 kDa) and proBNP (37 kDa), and two for BNP immunoreactivity. Particularly noteworthy was the finding that in patient plasma, the molar concentration of NT-proBNP exceeded that of proBNP by almost tenfold. The mean proBNP:BNP ratio in patient plasma was calculated at 6.3, with variations ranging from 1.8 to 10.8. Conclusions: Our findings highlight proBNP as the principal BNP-immunoreactive form circulating in human blood. Moreover, we underscore the influence of sample handling techniques and assay methodologies on determining the proBNP:BNP ratio in plasma samples, emphasizing the importance of standardized protocols in peptide measurement.