Search

ObjectiveWe describe the prevalence of COVID-19 vaccine uptake, substance use, and other factors associated with vaccine hesitancy among participants from nine North American cohort studies following a diverse group of individuals at risk for or living with HIV.MethodsBetween May 2021 and January 2022, participants completed a survey related to COVID-19 vaccination. Participants included those with and without substance use. Those responding as 'no' or 'undecided' to the question "Do you plan on getting the COVID-19 vaccine?" were categorized as vaccine hesitant. Differences between groups were evaluated using chi-square methods and multivariable log-binomial models were used to calculate prevalence ratios (PR) of COVID-19 vaccine hesitancy with separate models for each substance.ResultsAmong 1,696 participants, COVID-19 vaccination was deferred or declined by 16%. Vaccine hesitant participants were younger, with a greater proportion unstably housed (14.8% vs. 10.0%; p = 0.02), and not living with HIV (48.% vs. 36.6%; p

Abstract Dengue or breakbone fever is one of the most important causes of febrile illness in children residing in tropical and subtropical regions. This mosquito-borne viral disease is mediated by the bite of the infected Aedes mosquito. Dengue infection has been expanding rapidly throughout the globe in the past few decades. The virus has hepatotoxic effects. However, the pathophysiology of liver involvement in dengue is still not entirely clear. The reported clinical spectrum of dengue hepatitis ranges from mild asymptomatic elevation in transaminaselevels to acute liver failure in children. This review focuses on hepatic manifestation, the pathogenesis of liver injury, and treatment option of the effects of dengue on the liver in the pediatric population.

Abstract Hepatitis C virus infection is an emerging problem for children and adolescents. Chronic HCV infection affects approximately 3.5–5 million children worldwide. Unaddressed HCV infection in children progresses to decompensated liver disease and hepatocellular carcinoma during adulthood. Early detection of HCV and the administration of appropriate antiviral therapy are required for the prevention of long-term morbidity associated with chronic HCV infection. The perinatal route is the most common source of childhood HCV infection. Anti-HCV positivity at or after 18 months of age necessitates an HCV-RNA assay after age 3 to recognize chronic HCV infection. Both anti-HCV and HCV-RNA positivity are the indications for antiviral therapy. At present, various combinations of oral, direct-acting antivirals (DAAs) have been approved for children above 3 years of age. Their efficacy is high. Apart from the effectiveness of DAA therapy, steps should be taken to screen pregnant women to prevent the transmission of viral infection from mother to child. To increase awareness about the mode of HCV spread, NAT-based tests in blood banks for better screening and making the DAAs available at a subsidized rate in the public sector are necessary to eradicate HCV infection.

Background: Non-alcoholic fatty liver disease (NAFLD) is the most unabating cause of chronic liver disease in children and adolescents. This study aimed to examine the association of single nucleotide polymorphism in patatin-like phospholipase domain containing 3 (PNPLA3) gene with paediatric non-alcoholic fatty liver disease. Methods: This case-control study was conducted from June 2021 to December 2022. Fifty-one overweight children aged 6–17 years were recruited in this study and divided into NAFLD (cases) and non-NAFLD (controls) groups based on hepatic steatosis detected by liver ultrasonography. We analysed the rs738409 polymorphism by TaqMan assay and examined its association with NAFLD. Results: Thirty-one (60.8%) children were in the case group and 20 (39.2%) children were in the control group. Alanine aminotransferase (P

Background: We aimed to examine the persistence of anti-HBs in Bangladeshi children aged 5 and 10 years after primary vaccination, and this response to a booster dose. Methods: A total of 100 children were enrolled who were divided into two groups (A and B). Group A comprised of 50 children vaccinated 5 years ago, and group B had 50 children vaccinated 10 years ago. Hepatitis B surface antibody titer was measured, and a booster dose of the vaccine was administered to those who had anti-HBs less than 10 mlU/ml. Seventeen such children from group A and 27 from group B were vaccinated with a booster dose. After one month, 12 children from group A and 18 children from group B were retested for hepatitis B surface antibody levels. Results: After 5 and 10 years of primary vaccination, 66.0% and 46.0% children had protective antibody levels. After one month of booster dose, 91.6% children responded to the increased level of anti-HBs in group A. Among them, 66.6% showed an adequate response. In group B, 88.8% had an increased level of anti-HBs antibody where 83.3% had an adequate response. Geometric mean titre of anti-HBs antibody boosted by 35 and 75 times from pre-booster time to post-booster vaccination in group A and B, respectively. Conclusion: Children had protective levels of anti-HBs antibodies at 5 and 10 years after completion of the primary vaccinations. Anamnestic response to booster vaccination confirmed the persistence of an effective immunological memory in vaccines. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(2): 101-105

Chronic liver disease is a uncommon manifestation in the children and many of them presents with oesophageal varices. The aim of this study was to observe the association between severity of chronic liver diseases determined by Child- Pugh score with grading of oesophageal varices. 62 cases (male, 34) were included in the present study. Mean age of the study population was 9.5±3.3 years. Male to female ratio was 1.2:1. Wilson’s disease was the most common etiology of chronic liver disease (64.5%). Of the 62 children, 30.7% had Child class A, 16.1% had Child class B and the remaining 53.2% had Child class C cirrhosis. Oesophageal varices were found in 43 (69.3%) children. On univariate ananlysis low platelet count and splenomegaly were found to be associated with the presence of esophageal varices. Splenomegaly was found as independent predictor for presence of varices on multivariate analysis (OR; 15.51, 95% CI, 3.7-63.5). Furthermore, splenomegaly was also independent risk factor for large esophageal varices. No association was found between Child-Pugh classification (child A, B, C) with grading of oesophageal varices (Grade - I, II, III, IV). Our study showed no positive association between Child-Pugh classifications with grading of esophageal varices. Splenomegaly predicts the presence of oesophageal varices as well as the presence of large esophageal varices. BSMMU J 2022; 15(1): 29-34

Simple Summary: This study focused on the trends of Head and Neck Cancers (HNC) in the First Nations people of Australia. There is an underwhelming amount of literature holistically analysing the trend of HNC among the First Nations people. This study comprehensively analysed incidence, mortality, and survival rates in the First Nations people, and compared these trends with the non-Indigenous Australian population. This emphasized the need to investigate the underlying causes and barriers for differences in the HNC burden between First Nations people and non-Indigenous Australians. Collaborative efforts, spanning from local to national levels, are required to address the HNC burden in Australia, particularly, in First Nations communities. Background: We aim to assess and compare the HNC trends between the First Nations and non-Indigenous population. Methods: HNC incidence (1998–2013) and mortality (1998–2015) data in First Nations people and non-Indigenous Australians were utilised from the Australian Cancer Database. The age-standardised incidence and mortality trends along with annual percentage changes were analysed using Joinpoint models. Age-standardised incidence and mortality rates according to remoteness, states, and five-year survival rates among First Nations people and non-Indigenous Australians were presented as graphs. Results: First Nations people had over twice the age-standardised incidence (2013; 29.8/100,000 vs. 14.7/100,000) and over 3.5 times the age-standardised mortality rates (2015; 14.2/100,000 vs. 4.1/100,000) than their non-Indigenous counterparts. Both populations saw a decline in mortality, but the decline was only statistically significant in non-Indigenous Australians (17.1% decline, 1998: 4.8/100,000, 2015: 4.1/100,000; p < 0.05). Across all remoteness levels and states, First Nations people consistently had higher age-standardised incidence and mortality rates. Furthermore, the five-year survival rate was lower by 25% in First Nations people. Conclusion: First Nations people continue to shoulder a disproportionate HNC burden compared to non-Indigenous Australians. [ABSTRACT FROM AUTHOR]

Abstract Background Histoplasmosis is a rare infectious condition with mainly pulmonary involvement. Disseminated histoplasmosis may occur in immunocompromised condition. It can present in different ways but jaundice and ascites is very uncommon. Case presentation A 8- year old girl visited to department of pediatric gastroenterology & nutrition, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Child presented with fever, jaundice and abdominal distension for 2 ½ months. There was no history of contact with tuberculosis patient and travelling to kala-azar, malaria endemic zone and no history of previous jaundice, blood or blood product transfusion, history of sib death, family history of jaundice or neuropsychiatric disorder, significant weight loss. On general examination she was fretful, febrile, moderately icteric, mildly pale, vitally stable, severely wasted and moderately stunted, skin survey revealed infected scabies, BCG vaccine mark was absent, generalized lymphadenopathy, hepato-splenomegaly and ascites present. After evaluating the physical findings, several investigations was done including lymphnode biopsy, then the case was finally diagnosed as Disseminated histoplasmosis with portal hypertension. Child was treated with injectable Deoxycholate Amphotericin B for 28 days and improved on follow up. Conclusion We suggest that children presenting with fever, jaundice, lymphadenopathy and hepatosplenomegaly and portal hypertension, disseminated histoplasmosis can be one differential.

Abstract not available BSMMU J 2021; 14(3): 92-98

Aim: The study was aimed to find out the efficacy of a stool color card (SCC) in differentiating biliary atresia (BA) from non-BA in resource-limited countries. Background: stool color screening system was introduced in 2004 which lead to marked improvement in sensitivity of detecting BA. Methods: This cross-sectional observational study was conducted from January, 2019 through July, 2022 on purposively sampled infants who developed jaundice before three months of age, had direct bilirubin of > 20 % of total with pale stool and dark urine. Results: 144 cases (male, 96) were included in the study and their mean age at admission was 87.3±37.2 days and mean age at onset of jaundice was 6.1±7.7 days. BA was confirmed in 106 (73.6%) cases and 38 (26.4%) children were in non-BA group. Frequency of persistent pale stool between BA and non- BA were 88 vs 8 (83.0 % Vs 21.0 %) which was highly significant (p=0.000). Mean difference of total and direct serum bilirubin, median alanine transferase and alkaline phosphatase were not statistically significant between two groups. Median of serum gamma glutamyl transpeptidase (GGT) in BA was 570 U/L and in non-BA it was 138.0 U/L which was statistically significant (p=0.000). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of SCC were 83%, 78.9%, 91.7%, 62.5% and 81.9% respectively. Conclusion: SCC has good sensitivity to diagnose BA but failed to prove better specificity to rely simply on it. SCC may be used as early screening tool for prompt referral to appropriate medical care centers for final evaluation of BA. [ABSTRACT FROM AUTHOR]

A 12-year-old immunized girl with only issue of non-consanguineous parents presented with the complaints of severe, agonizing, and continued upper abdominal pain which radiated to the back, aggravated after taking food and partially relieved on leaning forward for the last 4 days. The pain was associated with several episodes of vomiting. She had a history of similar types of 3 attacks within the last 1 year and in between attacks, she was comparatively well. On query, the mother gave a history of gradual weight loss.

A 10-year-old immunized girl, 6th issue of consanguineous parents, presented with the complaints of jaundice for the last 2 years and deterioration of school performance for the same duration. She also had generalized itching for the last 6 months. She had no history of altered sleep pattern, any gastrointestinal bleeding, surgical or dental procedures, history of blood and blood products transfusion, taking any offending drugs, sib death or family history of such type of illness.

In brief: DGCR8 microprocessor complex, which is important for miRNA biogenesis, is regulated by peptidylarginine deiminase 2 and expression fluctuates in gonadotrope cells across the mouse estrous cycle. Canonical miRNA biogenesis requires DGCR8 microprocessor complex subunit, which helps cleave pri-miRNAs into pre-miRNAs. Previous studies found that inhibiting peptidylarginine deiminase (PAD) enzyme activity results in increased DGCR8 expression. PADs are expressed in mouse gonadotrope cells, which play a central role in reproduction by synthesizing and secreting the luteinizing and follicle stimulating hormones. Given this, we tested whether inhibiting PADs alters expression of DGCR8, DROSHA, and DICER in the gonadotrope-derived LßT2 cell line. To test this, LßT2 cells were treated with vehicle or 1 µM pan-PAD inhibitor for 12 h. Our results show that PAD inhibition leads to an increase in DGCR8 mRNA and protein. To corroborate our results, dispersed mouse pituitaries were also treated with 1 µM pan-PAD inhibitor for 12 h which increases DGCR8 expression in gonadotropes. Since PADs epigenetically regulate gene expression, we hypothesized that histone citrullination alters Dgcr8 expression thereby affecting miRNA biogenesis. LßT2 samples were subjected to ChIP using an antibody to citrullinated histone H3, which shows that citrullinated histones are directly associated with Dgcr8. Next, we found that when DGCR8 expression is elevated in LßT2 cells, pri-miR-132 and -212 are reduced, while mature miR-132 and -212 are increased suggesting heightened miRNA biogenesis. In mouse gonadotropes, DGCR8 expression is higher in diestrus as compared to estrus, which is the inverse of PAD2 expression. Supporting this idea, treatment of ovariectomized mice with 17ß-estradiol results in an increase in PAD2 expression in gonadotropes with a corresponding decrease in DGCR8. Collectively, our work suggests that PADs regulate DGCR8 expression leading to changes in miRNA biogenesis in gonadotropes. [ABSTRACT FROM AUTHOR]