1.Endoscopic Yield, Appropriateness, and Complications of Pediatric Upper Gastrointestinal Endoscopy in an Adult Suite: A Retrospective Study of 822 Children
Manzoor Ahmad WANI ; Showkat Ali ZARGAR ; Ghulam Nabi YATOO ; Inaamul HAQ ; Altaf SHAH ; Jaswinder Singh SODHI ; Ghulam Mohammad GULZAR ; Mushtaq KHAN
Clinical Endoscopy 2020;53(4):436-442
Background/Aims:
This study aimed to study the endoscopic yield, appropriateness, and complications of pediatric endoscopy performed by adult gastroenterologists in an adult endoscopic suite.
Methods:
This a retrospective study in which records of all the patients less than 18 years of age who underwent endoscopy in the last 5 years were studied. The indications of endoscopy in children were categorized as appropriate or inappropriate per the latest guidelines by American Society for Gastrointestinal Endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Positive endoscopic yield was defined as the presence of any abnormality on endoscopy.
Results:
Among the total of 822 children (age <18 years), the most common indications were variceal surveillance/eradication in 157 (19.1%), followed by dyspepsia in 143 (17.4%), upper gastrointestinal (UGI) bleeding in 136 (16.5%), recurrent abdominal pain in 94 (11.4%), unexplained anemia in 74 (9%), recurrent vomiting in 50 (6.08%), chronic refractory gastroesophageal reflux disease in 34 (4.1%) and others; 780 out of 822 endoscopic procedures (94.9%) done in children were appropriate as per the guidelines. The endoscopic yield was 45.8%, highest in patients with UGI bleeding (71.3%), followed by variceal surveillance (54.8%), recurrent vomiting (38%), dyspepsia (37.8%), and recurrent abdominal pain (36%). Minor adverse events occurred in 7.3% of children.
Conclusions
Pediatric endoscopy performed by an experienced adult gastroenterologist may be acceptable if done in cooperation with a pediatrician.
2.Molecular evidence and hematological alterations associated with the occurrence of coronavirus in domestic dogs in Pakistan
Sulehria, M.U. ; Ahmad, S.S. ; Ijaz, M. ; Mushtaq, M.H. ; Khan, A.Y. ; Ghaffar, A.
Tropical Biomedicine 2020;37(No.4):963-972
Canine Enteric Coronavirus (CCoV) is one of the major enteric pathogen affecting
dogs. This study aims to investigate the molecular prevalence, phylogenetic analysis,
associated risk factors, and haemato-biochemical alterations in Canine Coronavirus in dogs
in district Lahore, Pakistan. 450 fecal samples were collected from symptomatic dogs
originating from various pet-clinics and kennels during 2018-2019. Samples were initially
analyzed by sandwich lateral flow immunochromatographic assay and then further processed
by RT-PCR (reverse transcriptase polymerase chain reaction) targeting the M gene followed
by sequencing. RT-PCR based positive (n=20) and negative (n=20) dogs were samples for
their blood for the haemato-biochemical analysis. A questionnaire was used to collect data
from pet owners, in order to analyze the data for risk factors analysis by chi square test on
SPSS. The prevalence of CCoV was 35.1%, and 23.8 % through Sandwich lateral flow
immunochromatographic and RT-PCR respectively. Various risk factors like breed, age, sex,
vomiting, diarrhea, sample source, body size, cohabitation with other animals, living
environment, food, deworming history, contact with other animals or birds feces, and season
were significantly associated with CCoV. The CCoV identified in Pakistan were 98% similar
with the isolates from China (KT 192675, 1), South Korea (HM 130573, 1), Brazil (GU 300134,
1), Colombia (MH 717721, 1), United Kingdom (JX 082356, 1) and Tunisia (KX156806). Haematobiochemical alterations in CCoV affected dogs revealed anaemia, leucopenia, lymphopenia,
neutrophilia, and decreased packed cell volume, and a significant increase in alkaline phosphate
and alanine transaminase. It is concluded that infection with canine coronavirus appears
widespread among dog populations in district Lahore, Pakistan. This study is the first report
regarding the molecular detection and sequence analysis of CCoV in Pakistan.