Objective: To determine the frequency of autoimmune thyroiditis in children with Celiac disease and the effect of gluten free diet on autoimmune thyroiditis. Methods: We enrolled 100 patients, age 1-12 years of either gender diagnosed as Celiac disease (CD) in this prospective observational study in the Department of Pediatric Medicine, from 1st January 2018 to 30th June 2019. Diagnosis of autoimmune thyroiditis was made if anti–thyroperoxidase >35 iu/ml or anti–thyroglobulin >20 iu/ml at diagnosis of CD and then at one year on gluten free diet (GFD) in all cases. Children with repeat anti-tTG levels > 10 times upper limit normal at 6-months after enrollment were labelled as non-compliant to GFD. Descriptive statistics were used to analyze the data. Results: Mean age of the participants was 5.94±3.16 years and 53% were females. Fourteen cases of autoimmune thyroiditis were detected at enrollment and six (7%, n/N = 6/86) were later diagnosed on follow-up who were initially negative. Seven hypothyroid cases among the autoimmune thyroiditis were treated with thyroxine and became euthyroid on follow-up testing. Compliance to GFD was 52%. Autoimmune thyroiditis improved on gluten free diet in four cases (28.6%). Of the six euthyroid cases at diagnosis three cases became hypothyroid and all were non-compliant. Conclusion: Frequency of autoimmune thyroiditis was 20% over a follow-up period of one year. Good compliance with the GFD has some effect on improving autoimmune thyroiditis and maintaining euthyroid status of CD patients. doi: https://doi.org/10.12669/pjms.36.6.2226 How to cite this:Rasheed J, Hassan R, Khalid M, Zafar F. Frequency of autoimmune thyroiditis in children with Celiac disease and effect of gluten free diet . Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2226 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Many perinatal deaths follow birth asphyxia that occurs in babies of women who are referred on developing life-threatening obstetric complications. Objectives: To determine the antenatal and intrapartum risk factors for perinatal asphyxia among babies delivered by women admitted as emergency obstetric referrals. Study Design: Cross-sectional study. Setting: Pediatric Unit 1, Nishtar Hospital Multan, Pakistan. Period: From May 2017 to April 2018. Material & Methods: A total of 150 newborn term babies (and their mothers) with a 1, 5, & 10-minutes Apgar score 4 or less (perinatal asphyxia) were considered for the study. Antepartum and intraparturn risk factors were noted among newborn babies (and their mothers) from socio-demographic characteristics, obstetric complications or labour management. Results: Out of150 neonates, 57(38%) were presented with perinatal asphyxia at the age of 1 minute, 62(41.3%) at the age of 5 minutes and 31(20.1%) neonates were presented at the age of 10 minutes. In these cases, 45(30%) were related to maternal causes, 71(47.3%) to placental causes and 34(22.7%) to fetal cause. Conclusions: Early recognition of antepartum and intraparturn risk factors for perinatal axphyxiaamong emergency obstetric referrals, followed by prompt and appropriate management, may reduce the perinatal deaths from perinatal asphyxia.
Objectives: To know the frequency of hypertension among children having acute kidney injury (AKI) at a tertiary care hospital. Study Design: Descriptive, cross-sectional study. Setting: Department of Pediatric Medicine, Nishtar Hospital, Multan, Period: 1st January to 31 December 2019. Material & Methods: A total of 718 children with AKI were included from department of Pediatric medicine, Nishtar Hospital, Multan. Once registered, study variables were noted along with systolic and diastolic blood pressure. Results: Of these 718 study cases, majority, 439 (61.1%) were male, 435 (61.0%) belonged to rural areas, 443 (61.7%) from poor socioeconomic status and 551 (76.7%) mothers were illiterate. Mean age was 4.33±2.56 years whereas mean body mass index was 23.58±3.17 kg/m2. Overall, family history of AKI was noted in 165 (23.0%) children. Hypertension was noted in 228 (31.8%) cases. Conclusion: Very high frequency of hypertension was seen in children presenting with AKI.
Allergic bronchopulmonary aspergillosis (ABPA) is an illness caused byhypersensitivity to colonized Aspergillus fumigatus, mostly involving susceptible adult patientswith history of asthma and cystic fibrosis. Timely given appropriate treatment can reduceclinical symptoms, decrease lung infiltrates and stop progression to chronic lung disease. Inliterature review, treatment strategies used in ABPA children are limited. Herein we present acase of 10-year old asthmatic girl who, on developing ABPA, was successfully treated by theuse of low dose corticosteroids combined with itraconazole for 3 months duration. We suggestthat in financial constraint circumstances, ABPA in children can be successfully treated withoutanti-IgE therapy.
… Allergic bronchopulmonary aspergillosis (ABPA) is an illness caused by hypersensitivity to colonized Aspergillus fumigatus, mostly involving susceptible adult patients with history of asthma and cystic fibrosis. Timely given appropriate treatment can reduce clinical symptoms, decrease lung infiltrates and stop progression to chronic lung disease. In literature review, treatment strategies used in ABPA children are limited. Herein we present a case of 10-year old asthmatic girl who, on developing ABPA, was successfully treated by the use of low dose corticosteroids combined with itraconazole for 3 months duration. We suggest that in financial constraint circumstances, ABPA in children can be successfully treated without anti-IgE therapy.
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