Adie's syndrome in childhood

An 8-year-old girl with a history of mild amblyopia who had occlusion therapy, but her anisocoria went unnoticed, was studied. Old photographs of the patient were reviewed and a 0.1% pilocarpine test was performed. Review of her old photographs suggested that she had anisocoria at least since she was 3 years old. The 0.1% pilocarpine test confirmed a diagnosis of Adie's syndrome. In light of this case, it must be kept in mind that though rare, Adie's syndrome can be encountered in early childhood.     

Effect of valproate and carbamazepine on visual evoked potentials in epileptic children

The effects of carbamazepine (CBZ) and sodium valproate (SV) monotherapy on visual evoked potentials (VEP) were studied in 18 epileptic children receiving CBZ and nine epileptic children receiving SV. Pattern reversal VEP were determined before the administration of antiepileptic drugs (AED) and 1 year later during which time the patients had received AED. The VEP amplitude showed no consistent changes after 1 year of CBZ and SV therapy, but VEP P-100 latencies were significantly prolonged after 1 year of CBZ therapy. We conclude that CBZ causes a slowing down of central impulse conduction and that VEP is useful to evaluate the effects of AED within the central nervous system.     

ANEMIA AND INFECTION IN SCHOOL-AGED EGYPTIAN CHILDREN

Iron-deficiency anemia and infection are deterrents to optimal child health in many developing countries. We investigated the prevalence of anemia and elevated erythrocyte sedimentation rate (ESR), which reflects chronic background infection, recent illness, and diet for 190 children aged 10 to 13 years in 1995 in a Nile Delta village. The children exhibited a high prevalence of anemia (61.6%) and elevated ESR (54.9%). One-third of the children reported a minor illness within the past week, and more than 75 per cent had one or more parasites evident in stool or urine samples. There was no relationship of socioeconomic or dietary indicators to anemia or elevated ESR. Mothers’ evaluation of the child’s health status had no relationship to anemia or elevated ESR, with 43.6 per cent of mothers reporting their child’s health status as excellent or good. Maternal report of the child’s health as poor was related to recent illness. We speculate that where anemia and chronic infection are hyperendemic, both children and mothers may become habituated to the associated symptoms and consider them normal.     

Main haplotypes and mutational analysis of vitamin K epoxide reductase (VKORC1) in a Swedish population: a retrospective analysis of case records

BACKGROUND: Vitamin K epoxide reductase (VKORC1) is the site of inhibition by coumarins. Several reports have shown that mutations in the gene encoding VKORC1 affect the sensitivity of the enzyme for warfarin. Recently, three main haplotypes of VKORC1; *2, *3 and *4 have been observed, that explain most of the genetic variability in warfarin dose among Caucasians. OBJECTIVES: We have investigated the main haplotypes of the VKORC1 gene in a Swedish population. Additional objective was to screen the studied population for mutations in the coding region of VKORC1 gene. PATIENTS/METHODS: Warfarin doses and plasma S- and R-warfarin of 98 patients [with a target International Normalized Ratio (INR) of 2.0-3.0] have been correlated to VKORC1 haplotypes. Controls of 180 healthy individuals have also been haplotyped. Furthermore, a retrospective analysis of case records was performed to find any evidence indicating influence of VKORC1 haplotypes on warfarin response in the first 4 weeks (initiation phase) and the latest 12 months of warfarin treatment. RESULTS AND CONCLUSIONS: Our result shows that VKORC1*2 is the most important haplotype for warfarin dosage. Patients with VKORC1*2 haplotype had more frequent visits than patients with VKORC1*3 or *4 haplotypes, higher coefficient of variation (CV) of prothrombin time-INR and higher percentage of INR values outside the therapeutic interval (i.e. 2.0-3.0) than patients with VKORC1*3 or *4 haplotypes. Also, there was a statistically significant difference in warfarin dose (P < 0.001) and R-warfarin plasma levels (P < 0.01) between VKORC1*2 and VKORC1*3 or 4 haplotypes. Patients with VKORC1*2 haplotype seem to require much lower warfarin doses than other patients.     

Quadricuspid Aortic Valve Diagnosed by Multiplane Transesophageal Echocardiography

The usefulness of multiplane transesophageal echocardiography in the diagnosis of quadricuspid aortic valve is described.
quadricuspid aortic valve, multiplane transesophageal echocardiography     

喀什市某乡居民健康教育前后内脏利什曼病知晓率的改变

2004-2006年在新疆喀什市伯什克然木乡内脏利什曼病流行的1、4、18和20村,通过发放宣传材料,张贴宣传画,开设健康教育课等方式,开展防治内脏利什曼病基本健康知识教育活动,使居民和中小学生对内脏利什曼病及其防治知识的知晓程度,由健康教育前的0.7%和0提高到健康教育后的54.2%和70.7%。通过健康教育活动,提高了人群自觉防病的知识水平。     

Transesophageal Echocardiographic Findings of a Dehisced Duran Mitral Annuloplasty Ring

We describe multiplane transesophageal echocardiographic findings in a patient with severe mitral regurgitation secondary to dehiscence of a Duran ring.