Nitric oxide (NO), a neurotransmitter and a free radical, has been purported to be involved in numerous neurological diseases. We investigated the serum nitric oxide concentration in 30 patients with multiple sclerosis (MS), in 30 patients with epilepsy and in 30 control subjects. The aim was also to determine whether a statistically significant difference in serum NO concentrations exists between the groups of interest. The total serum nitric oxide concentration was measured using the Griess reaction after reducing nitrates to nitrites with elemental zinc. In the group multiple sclerosis, the mean NO concentrations were X ± SEM = 31.02 ± 1.79 μmol/l, in the control group X ± SEM = 25.31 ± 1.44 μmol/l and in the group epilepsy X ± SEM = 22.51 ± 1.28 μmol/l. Student's t test showed a statistically significant difference between subjects with multiple sclerosis and the control group (p = 0.013), as well as between the groups multiple sclerosis and epilepsy (p = 0.0002). This data confirms that NO may play an important role in the pathogenesis of multiple sclerosis, whereas its role in epilepsy still remains unclear.
Aims: Upper gastrointestinal (UGI) bleeding is not rare among pediatric patients. However, there are limited reports describing this clinical condition in young infants. This study was aimed to assess and analyze the characteristics of UGI bleeding in infants, and try to define the differences between prematurely and maturely born patients.
Abstract:The aim of our study was to determine the criteria and key factors for the effectiveness of digoxin therapy. A prospective opened-type study was carried out in conditions of everyday clinical practice. The concentrations of digoxin were quantified from blood samples taken following the achievement of drug steady-state (using AxSYM microparticle enzyme immunoassay-MEIA). The risk/benefit ratio was evaluated based upon the correlation between measured blood concentrations of the drug and clinical response. Study results (100 decompensated patients) revealed that therapy indication field was correctly covered, showing a higher prevalence in elderly. On average, each examinee had 2 or 3 comorbidities. Applied daily dose of digoxin ranged from 0.053 mg to 0.25 mg. Renal function was assessed by creatinine clearance which is one of the key factors for the accomplishment of optimal digoxin serum concentrations (p < 0.05). Co-administration of seven drugs was complicating factor for the management of rational therapy. 76/100 patients were within referent range (0.8-2.0 ng/mL), while 13/100 were above the upper limit. Four side effects in total were recorded (nausea, vomiting, confusion), whereas in only two patients digoxin was excluded from the therapy. Digoxin confirmed the justifiability of its use in contemporary clinical practice.
Background: Globally, rotavirus (RV) infection is the primary cause of severe gastroenteritis (GE) in children aged <5 years, leading to >500,000 deaths annually. In the Kingdom of Bahrain, recent data describing the epidemiology of rotavirus-associated gastroenteritis (RVGE) is not available. To address this gap, the present single-center, referral hospital-based surveillance study aimed to estimate the burden of RVGE in children aged <5 years in the Kingdom of Bahrain.Methods: Children aged <5 years hospitalized for GE were enrolled at Salmaniya Medical Complex, a reference pediatric hospital, between April 2006 and April 2007. Stool samples were tested for RV using ELISA and RV-positive samples were genotyped by RT-PCR. The severity of RVGE (Severe = Vesikari score ≥11) was assessed using the 20-point Vesikari scale. Chi-square test was used to analyze the association between the severity of GE and RV-positivity status (post-hoc analysis).Results: 314 children were enrolled after elimination of 75 children who did not meet the eligibility criteria. The according-toprotocol (ATP) analysis included 239 children; 107 (44.8%) children were RV-positive; 128 (53.5%) were RV-negative and 4 (1.7%) had an unknown RV status. The highest proportion of RVGE cases was observed in the 6-23 months age group (76.6%; 82/107). RVGE hospitalizations occurred year-round with peaks in March-06 (75%) and April-06 (61.9%).The association between severe GE episodes and RV-positive status was statistically significant (p = 0.0097). Intravenous rehydration was used for treatment in 28.0% RVpositive and 17.2% RV-negative children before hospitalization. Among the 17 (15.9%) RV-positive samples serotyped and genotyped, G1 (58.8%) and P[8] (82.4%) were the most common RV types detected. Conclusion:The data from this burden of disease study in the Kingdom of Bahrain shows that the disease burden of RVGE is substantial among children aged between 6 months and 23 months. This baseline data will facilitate the documentation of the potential reduction in the RVGE disease burden in children aged <5 years in the Kingdom of Bahrain, since the introduction of RV vaccination into the national immunization program in 2009.
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