Publications by authors named "Mohamed Abdullah"

94 Publications

Elucidating the Effects of Reaction Time on the Physicochemical Characterization of Valorized Synthesized Alumina.

Materials (Basel) 2022 Apr 22;15(9). Epub 2022 Apr 22.

Department of Chemical Engineering, Universiti Teknologi PETRONAS, Seri Iskandar 32610, Perak, Malaysia.

Aluminum waste-can management in Malaysia has recently become a serious environmental and public health issue, particularly in metropolitan areas. This has prompted the need to valorize these waste-cans into value-added products using the most economical and environmentally friendly techniques. In this study, the sol-gel technique was used to synthesize high-quality alumina from the aluminum waste-cans collected. From this method, the observed peaks of the synthesized alumina were identified as diaspore (α-AlO(OH)), boehmite (γ-AlO(OH)), aluminum oxide, or gamma-alumina (γ-AlO) crystalline structure and corundum. The morphological configuration, microstructure, and functional group properties of the synthesized alumina were evaluated. All the synthesized alumina exhibited a non-spherical shape and appeared to have hexagonal-like shape particles. Moreover, the XRD patterns of the synthesized alumina AL-6-30 and AL-12-30 exhibited a small angle (1-10°) with no XRD peak, which indicated a mesoporous pore structure with no long-range order. The overall results of γ-alumina synthesized from the aluminum waste-cans showed an optimal condition in producing a highly structured γ-alumina with excellent surface-area characteristics. The synthesized alumina exhibited stronger and highly crystalline functional characteristics almost comparable with the commercially available brands on the market.
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http://dx.doi.org/10.3390/ma15093046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9102604PMC
April 2022

Advanced Machine Learning Modeling Approach for Prediction of Compressive Strength of FRP Confined Concrete Using Multiphysics Genetic Expression Programming.

Polymers (Basel) 2022 Apr 27;14(9). Epub 2022 Apr 27.

Peter the Great St. Petersburg Polytechnic University, 195291 St. Petersburg, Russia.

The purpose of this article is to demonstrate the potential of gene expression programming (GEP) in anticipating the compressive strength of circular CFRP confined concrete columns. A new GEP model has been developed based on a credible and extensive database of 828 data points to date. Numerous analyses were carried out to evaluate and validate the presented model by comparing them with those presented previously by different researchers along with external validation comparison. In comparison to other artificial intelligence (AI) techniques, such as Artificial Neural Networks (ANN) and the adaptive neuro-fuzzy interface system (ANFIS), only GEP has the capability and robustness to provide output in the form of a simple mathematical relationship that is easy to use. The developed GEP model is also compared with linear and nonlinear regression models to evaluate the performance. Afterwards, a detailed parametric and sensitivity analysis confirms the generalized nature of the newly established model. Sensitivity analysis results indicate the performance of the model by evaluating the relative contribution of explanatory variables involved in development. Moreover, the Taylor diagram is also established to visualize how the proposed model outperformed other existing models in terms of accuracy, efficiency, and being closer to the target. Lastly, the criteria of external validation were also fulfilled by the GEP model much better than other conventional models. These findings show that the presented model effectively forecasts the confined strength of circular concrete columns significantly better than the previously established conventional regression-based models.
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http://dx.doi.org/10.3390/polym14091789DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9100819PMC
April 2022

Discharge Enhancement in a Triple-Pipe Heat Exchanger Filled with Phase Change Material.

Nanomaterials (Basel) 2022 May 9;12(9). Epub 2022 May 9.

Mechanical Engineering Department, King Fahd University of Petroleum and Minerals, Dhahran 31261, Saudi Arabia.

This study aims to study the discharging process to verify the influence of geometry modifications and heat transfer flow (HTF) patterns on the performance of a vertical triplex-tube latent heat container. The phase change material (PCM) is included in the middle tube, where the geometry is modified using single or multi-internal frustum tubes instead of straight tubes to enhance the discharging rate. The effects of the HTF flow direction, which is considered by the gravity and opposite-gravity directions, are also examined in four different cases. For the optimal geometry, three scenarios are proposed, i.e., employing a frustum tube for the middle tube, for the inner tube, and at last for both the inner and middle tubes. The effects of various gap widths in the modified geometries are investigated. The results show the advantages of using frustum tubes in increasing the discharging rate and reducing the solidification time compared with that of the straight tube unit due to the higher natural convection effect by proper utilization of frustum tubes. The study of the HTF pattern shows that where the HTF direction in both the inner and outer tubes are in the gravity direction, the maximum discharging rate can be achieved. For the best configuration, the discharge time is reduced negligibly compared with that for the system with straight tubes which depends on the dimensions of the PCM domain.
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http://dx.doi.org/10.3390/nano12091605DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9101366PMC
May 2022

Prediction of COVID-19 manipulation by selective ACE inhibitory compounds of root: study and ADMET profile.

Arab J Chem 2022 Jul 27;15(7):103942. Epub 2022 Apr 27.

Research Centre, Future University in Egypt, New Cairo 11845, Egypt.

In the novel SARS-CoV-2 (COVID-19) as a global emergency event, the main reason of the cardiac injury from COVID-19 is angiotensin-converting enzyme 2 (ACE2) targeting in SARS-CoV-2 infection. The inhibition of ACE2 induces an increase in the angiotensin II (Ang II) and the angiotensin II receptor type 1 (AT1R) leading to impaired cardiac function or cardiac inflammatory responses. The ethyl acetate fraction of L. root can rescue heart dysfunction, oxidative stress, cardiac arrhythmias and apoptosis. Therefore, isolated components of evaluated to identify natural anti-SARS-CoV-2 agents via molecular docking. molecular docking study were carried out using the Auto Dock software on the isolated compounds of root. The protein targets of selective ACE and others obtained from Protein Data Bank (PDB). The best binding pose between amino acid residues involved in active site of the targets and compounds was discovered via molecular docking. Furthermore, ADMET properties of the compounds were evaluated. The triterpenoids of showed more ACE inhibitory potential than catechin in both domains. They were selective on the nACE domain, especially compound 5. Also, the compound 5 & 6 had the highest binding affinity toward active site of nACE, cACE, AT1R, ACE2, and TNF-α receptors. Meanwhile, compound 3 showed more activity to inhibit TXA2. Drug likeness and ADMET analysis showed that the compounds passed the criteria of drug likeness and Lipinski rules. The current study depicted that root showed cardioprotective effect in COVID-19 infection and manipulation of angiotensin II-induced side effects
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http://dx.doi.org/10.1016/j.arabjc.2022.103942DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9044627PMC
July 2022

Forecasting the Mechanical Properties of Plastic Concrete Employing Experimental Data Using Machine Learning Algorithms: DT, MLPNN, SVM, and RF.

Polymers (Basel) 2022 Apr 13;14(8). Epub 2022 Apr 13.

Institute of Civil Engineering, Peter the Great St. Petersburg Polytechnic University, 195291 St. Petersburg, Russia.

Increased population necessitates an expansion of infrastructure and urbanization, resulting in growth in the construction industry. A rise in population also results in an increased plastic waste, globally. Recycling plastic waste is a global concern. Utilization of plastic waste in concrete can be an optimal solution from recycling perspective in construction industry. As environmental issues continue to grow, the development of predictive machine learning models is critical. Thus, this study aims to create modelling tools for estimating the compressive and tensile strengths of plastic concrete. For predicting the strength of concrete produced with plastic waste, this research integrates machine learning algorithms (individual and ensemble techniques), including bagging and adaptive boosting by including weak learners. For predicting the mechanical properties, 80 cylinders for compressive strength and 80 cylinders for split tensile strength were casted and tested with varying percentages of irradiated plastic waste, either as of cement or fine aggregate replacement. In addition, a thorough and reliable database, including 320 compressive strength tests and 320 split tensile strength tests, was generated from existing literature. Individual, bagging and adaptive boosting models of decision tree, multilayer perceptron neural network, and support vector machines were developed and compared with modified learner model of random forest. The results implied that individual model response was enriched by utilizing bagging and boosting learners. A random forest with a modified learner algorithm provided the robust performance of the models with coefficient correlation of 0.932 for compressive strength and 0.86 for split tensile strength with the least errors. Sensitivity analyses showed that tensile strength models were least sensitive to water and coarse aggregates, while cement, silica fume, coarse aggregate, and age have a substantial effect on compressive strength models. To minimize overfitting errors and corroborate the generalized modelling result, a cross-validation K-Fold technique was used. Machine learning algorithms are used to predict mechanical properties of plastic concrete to promote sustainability in construction industry.
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http://dx.doi.org/10.3390/polym14081583DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9026837PMC
April 2022

Computational Valuation of Darcy Ternary-Hybrid Nanofluid Flow across an Extending Cylinder with Induction Effects.

Micromachines (Basel) 2022 Apr 9;13(4). Epub 2022 Apr 9.

Chemistry Department, College of Science, King Khalid University, Abha 61413, Saudi Arabia.

The flow of an electroconductive incompressible ternary hybrid nanofluid with heat conduction in a boundary layer including metallic nanoparticles (NPs) over an extended cylindrical with magnetic induction effects is reported in this research. The ternary hybrid nanofluid has been synthesized with the dispersion of titanium dioxide, cobalt ferrite, and magnesium oxide NPs in the base fluid water. For a range of economical and biological applications, a computational model is designed to augment the mass and energy conveyance rate and promote the performance and efficiency of thermal energy propagation. The model has been written as a system of partial differential equations. Which are simplified to the system of ordinary differential equations through similarity replacements. The computing approach parametric continuation method is used to further process the resultant first order differential equations. The results are validated with the bvp4c package for accuracy and validity. The outcomes are displayed and analyzed through Figures and Tables. It has been observed that the inverse Prandtl magnetic number and a larger magnetic constant reduce the fluid flow and elevate the energy profile. The variation of ternary hybrid NPs significantly boosts the thermophysical features of the base fluid.
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http://dx.doi.org/10.3390/mi13040588DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031502PMC
April 2022

A Novel Splice-Site Deletion in the Gene Causes Combined Pituitary Hormone Deficiency in Multiple Sudanese Pedigrees.

Genes (Basel) 2022 04 8;13(4). Epub 2022 Apr 8.

Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.

Pathogenic variants within the gene encoding the pituitary-specific transcription factor, POU class 1 homeobox 1 (), are associated with combined pituitary hormone deficiency (CPHD), including growth hormone, prolactin, and thyrotropin stimulating hormone deficiencies. The aim of the study was to identify genetic aetiology in 10 subjects with CPHD from four consanguineous Sudanese families. Medical history, as well as hormonal and radiological information, was obtained from participants' medical records. Targeted genetic analysis of the gene was performed in two pedigrees with a typical combination of pituitary deficiencies, using Sanger sequencing, and whole-exome sequencing was performed in the other two pedigrees, where hypocortisolism and additional neurologic phenotypes were also initially diagnosed. In gene (NM_001122757.2) a novel homozygous splice-site deletion-namely, c.744-5_749del-was identified in all 10 tested affected family members as a cause of CPHD. Apart from typical pituitary hormonal deficiencies, most patients had delayed but spontaneous puberty; however, one female had precocious puberty. Severe post-meningitis neurologic impairment was observed in three patients, of whom two siblings had Dyke-Davidoff-Masson syndrome, and an additional distantly related patient suffered from cerebral infarction. Our report adds to the previously reported gene variants causing CPHD and emphasises the importance of genetic testing in countries with high rates of consanguineous marriage such as Sudan. Genetic diagnostics elucidated that the aetiologies of hypopituitarism and brain abnormalities, identified in a subset of affected members, were separate. Additionally, as central hypocortisolism is not characteristic of POU1F1 deficiency, hydrocortisone replacement therapy could be discontinued. Elucidation of a genetic cause, therefore, contributed to the more rational clinical management of hypopituitarism in affected family members.
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http://dx.doi.org/10.3390/genes13040657DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032872PMC
April 2022

Intelligent Deep-Learning-Enabled Decision-Making Medical System for Pancreatic Tumor Classification on CT Images.

Healthcare (Basel) 2022 Apr 3;10(4). Epub 2022 Apr 3.

Department of Computer Science, College of Science & Art at Mahayil, King Khalid University, Abha 61421, Saudi Arabia.

Decision-making medical systems (DMS) refer to the design of decision techniques in the healthcare sector. They involve a procedure of employing ideas and decisions related to certain processes such as data acquisition, processing, judgment, and conclusion. Pancreatic cancer is a lethal type of cancer, and its prediction is ineffective with current techniques. Automated detection and classification of pancreatic tumors can be provided by the computer-aided diagnosis (CAD) model using radiological images such as computed tomography (CT) and magnetic resonance imaging (MRI). The recently developed machine learning (ML) and deep learning (DL) models can be utilized for the automated and timely detection of pancreatic cancer. In light of this, this article introduces an intelligent deep-learning-enabled decision-making medical system for pancreatic tumor classification (IDLDMS-PTC) using CT images. The major intention of the IDLDMS-PTC technique is to examine the CT images for the existence of pancreatic tumors. The IDLDMS-PTC model derives an emperor penguin optimizer (EPO) with multilevel thresholding (EPO-MLT) technique for pancreatic tumor segmentation. Additionally, the MobileNet model is applied as a feature extractor with optimal auto encoder (AE) for pancreatic tumor classification. In order to optimally adjust the weight and bias values of the AE technique, the multileader optimization (MLO) technique is utilized. The design of the EPO algorithm for optimal threshold selection and the MLO algorithm for parameter tuning shows the novelty. A wide range of simulations was executed on benchmark datasets, and the outcomes reported the promising performance of the IDLDMS-PTC model on the existing methods.
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http://dx.doi.org/10.3390/healthcare10040677DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9027672PMC
April 2022

State-of-the-Art Review on the Application of Membrane Bioreactors for Molecular Micro-Contaminant Removal from Aquatic Environment.

Membranes (Basel) 2022 Apr 15;12(4). Epub 2022 Apr 15.

Department of Chemical Engineering, Ming Chi University of Technology, New Taipei City 243303, Taiwan.

In recent years, the emergence of disparate micro-contaminants in aquatic environments such as water/wastewater sources has eventuated in serious concerns about humans' health all over the world. Membrane bioreactor (MBR) is considered a noteworthy membrane-based technology, and has been recently of great interest for the removal micro-contaminants. The prominent objective of this review paper is to provide a state-of-the-art review on the potential utilization of MBRs in the field of wastewater treatment and micro-contaminant removal from aquatic/non-aquatic environments. Moreover, the operational advantages of MBRs compared to other traditional technologies in removing disparate sorts of micro-contaminants are discussed to study the ways to increase the sustainability of a clean water supplement. Additionally, common types of micro-contaminants in water/wastewater sources are introduced and their potential detriments on humans' well-being are presented to inform expert readers about the necessity of micro-contaminant removal. Eventually, operational challenges towards the industrial application of MBRs are presented and the authors discuss feasible future perspectives and suitable solutions to overcome these challenges.
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http://dx.doi.org/10.3390/membranes12040429DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032214PMC
April 2022

Predicting the Lateral Load Carrying Capacity of Reinforced Concrete Rectangular Columns: Gene Expression Programming.

Materials (Basel) 2022 Apr 5;15(7). Epub 2022 Apr 5.

Peter the Great St. Petersburg Polytechnic University, 195291 St. Petersburg, Russia.

This research presents a novel approach of artificial intelligence (AI) based gene expression programming (GEP) for predicting the lateral load carrying capacity of RC rectangular columns when subjected to earthquake loading. To achieve the desired research objective, an experimental database assembled by the Pacific Earthquake Engineering Research (PEER) center consisting of 250 cyclic tested samples of RC rectangular columns was employed. Seven input variables of these column samples were utilized to develop the coveted analytical models against the established capacity outputs. The selection of these input variables was based on the linear regression and cosine amplitude method. Based on the GEP modelling results, two analytical models were proposed for computing the flexural and shear capacity of RC rectangular columns. The performance of both these models was evaluated based on the four key fitness indicators, i.e., coefficient of determination (), root mean squared error (), mean absolute error (), and root relative squared error (). From the performance evaluation results of these models, , , , and were found to be 0.96, 53.41, 38.12, and 0.20, respectively, for the flexural capacity model, and 0.95, 39.47, 28.77, and 0.22, respectively, for the shear capacity model. In addition to these fitness criteria, the performance of the proposed models was also assessed by making a comparison with the American design code of concrete structures ACI 318-19. The ACI model reported , , , and to be 0.88, 101.86, 51.74, and 0.39, respectively, for flexural capacity, and 0.87, 238.74, 183.66, and 1.35, respectively, for shear capacity outputs. The comparison depicted a better performance and higher accuracy of the proposed models as compared to that of ACI 318-19.
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http://dx.doi.org/10.3390/ma15072673DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9000259PMC
April 2022

TAVR - From inoperable to younger, lower-risk patients: A slippery slope?

Prog Cardiovasc Dis 2022 Apr 6. Epub 2022 Apr 6.

Department of Cardiovascular Surgery, Mount Sinai Health System, New York, NY, USA. Electronic address:

Despite current valve guidelines recommending both transcatheter and surgical aortic valve replacement (TAVR and SAVR, respectively) in patients with symptomatic severe aortic stenosis (AS), TAVR has recently become the preferred treatment over SAVR, driven by its minimal invasiveness, faster recovery and earlier improvement in quality of life. However, several limitations and unresolved issues remain with TAVR, including stroke, conduction system disorder, durability, bicuspid anatomy, coronary reaccess and lifetime management with aortic valve reintervention. Our review aims to highlight the above issues and discuss them in depth, to demonstrate the complementary role of TAVR and SAVR in the treatment of AS.
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http://dx.doi.org/10.1016/j.pcad.2022.04.001DOI Listing
April 2022

Autologous Cardiac Stem Cell Injection in Patients with Hypoplastic Left Heart Syndrome (CHILD Study).

Pediatr Cardiol 2022 Apr 8. Epub 2022 Apr 8.

Division of Cardiology, Department of Pediatrics, Emory University, Children's Healthcare of Atlanta, Atlanta, 201 Uppergate Drive, Atlanta, GA, 30322, USA.

Mortality in infants with hypoplastic left heart syndrome (HLHS) is strongly correlated with right ventricle (RV) dysfunction. Cell therapy has demonstrated potential improvements of RV dysfunction in animal models related to HLHS, and neonatal human derived c-kit cardiac-derived progenitor cells (CPCs) show superior efficacy when compared to adult human cardiac-derived CPCs (aCPCs). Neonatal CPCs (nCPCs) have yet to be investigated in humans. The CHILD trial (Autologous Cardiac Stem Cell Injection in Patients with Hypoplastic Left Heart Syndrome) is a Phase I/II trial aimed at investigating intramyocardial administration of autologous nCPCs in HLHS infants by assessing the feasibility, safety, and potential efficacy of CPC therapy. Using an open-label, multicenter design, CHILD investigates nCPC safety and feasibility in the first enrollment group (Group A/Phase I). In the second enrollment group, CHILD uses a randomized, double-blinded, multicenter design (Group B/Phase II), to assess nCPC efficacy based on RV functional and structural characteristics. The study plans to enroll 32 patients across 4 institutions: Group A will enroll 10 patients, and Group B will enroll 22 patients. CHILD will provide important insights into the therapeutic potential of nCPCs in patients with HLHS.Clinical Trial Registration https://clinicaltrials.gov/ct2/home NCT03406884, First posted January 23, 2018.
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http://dx.doi.org/10.1007/s00246-022-02872-6DOI Listing
April 2022

Application of Soft Computing Techniques to Predict the Strength of Geopolymer Composites.

Polymers (Basel) 2022 Mar 8;14(6). Epub 2022 Mar 8.

Peter the Great St. Petersburg Polytechnic University, 195291 St. Petersburg, Russia.

Geopolymers may be the best alternative to ordinary Portland cement because they are manufactured using waste materials enriched in aluminosilicate. Research on geopolymer composites is accelerating. However, considerable work, expense, and time are needed to cast, cure, and test specimens. The application of computational methods to the stated objective is critical for speedy and cost-effective research. In this study, supervised machine learning approaches were employed to predict the compressive strength of geopolymer composites. One individual machine learning approach, decision tree, and two ensembled machine learning approaches, AdaBoost and random forest, were used. The coefficient correlation (R), statistical tests, and k-fold analysis were used to determine the validity and comparison of all models. It was discovered that ensembled machine learning techniques outperformed individual machine learning techniques in forecasting the compressive strength of geopolymer composites. However, the outcomes of the individual machine learning model were also within the acceptable limit. R values of 0.90, 0.90, and 0.83 were obtained for AdaBoost, random forest, and decision models, respectively. The models' decreased error values, such as mean absolute error, mean absolute percentage error, and root-mean-square errors, further confirmed the ensembled machine learning techniques' increased precision. Machine learning approaches will aid the building industry by providing quick and cost-effective methods for evaluating material properties.
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http://dx.doi.org/10.3390/polym14061074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8956037PMC
March 2022

Effectiveness of Ternary Blend Incorporating Rice Husk Ash, Silica Fume, and Cement in Preparing ASR Resilient Concrete.

Materials (Basel) 2022 Mar 14;15(6). Epub 2022 Mar 14.

Research Centre, Future University in Egypt, New Cairo 11745, Egypt.

Although the disposal of waste ashes causes environmental hazards, recycling them helps in reducing their harmful impacts and improves the characteristics of building materials. The present study explores the possible use of locally available waste ashes including Rice husk ash (RHA)and Silica Fumes (SF) as a partial replacement for cement in concrete to counter the negative impact of alkali-silica reactions (ASRs). In the present study, ternary blends including RHA (0-30%), SF (5% and 10%) and Portland cement were investigated. The amorphous behavior of RHA and SF was confirmed by conducting an X-ray diffraction analysis. A petrography analysis was carried out to ensure the reactive nature of aggregates used to prepare the concrete specimen. Accelerated mortar bar tests were performed in accordance with ASTM C 1260 for up to 90 days. It was revealed that specimens incorporating a ternary blend of SF, RHA, and Portland cement exhibited less expansion compared to the control specimens without SF and RHA. The incorporation of 5% SF along with 20% RHA exhibited a 0.13% expansion at 28 days and 10% SF, along with 5% RHA which exhibited 0.18% expansion at 28 days which is within the range specified by ASTM C 1260, with the lowest compromise of the mechanical properties of concrete. Thus, the utilization of SF and RHA in the partial replacement of cement in concrete may be considered a practical approach to mitigate ASR effects as well as to reduce the environmental burden.
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http://dx.doi.org/10.3390/ma15062125DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8953824PMC
March 2022

Feminizing adrenocortical adenoma in a girl from a resource-limited setting: a case report.

J Med Case Rep 2021 Dec 21;15(1):605. Epub 2021 Dec 21.

The Endocrine Division, Department of Pediatrics and Child Health, Faculty of Medicine, University of Khartoum, P.O. Box 102, Khartoum, Sudan.

Background: An adrenocortical tumor is a rare tumor in pediatrics, which can be functional or nonfunctional. Functional tumors present with virilization, feminization, or hypercortisolism. Feminizing adrenal tumors, though rare in pediatrics, need to be excluded in any child presenting with features of feminization.

Case Presentation: We report a case of a 4-year-old Sudanese girl who presented with gradually progressive bilateral breast enlargement and accelerated growth since the age of 6 months. The family had sought medical advice several times in numerous health facilities without much gain. Investigations showed pubertal luteinizing hormone levels, high estradiol E2, and dehydroepiandrosterone sulfate, with normal early morning cortisol level. Abdominal ultrasound revealed a right-sided hypoechoic suprarenal mass. Abdominal computed tomography scan showed a right adrenal mass. The diagnosis of feminizing adrenal neoplasm was confirmed and right adrenalectomy was done. Histopathological examination of the resected adrenal gland showed adrenocortical adenoma. The patient was started on gonadotrophin-releasing hormone agonist for secondary central precocious puberty.

Conclusion: Adrenocortical tumors, though rare in pediatrics, are a documented cause of precocious puberty; biochemical and imaging screening protocol should be adopted for patients with precocious puberty, even in a resource-limited setting, for early detection and treatment.
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http://dx.doi.org/10.1186/s13256-021-03203-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8690961PMC
December 2021

TAVR in Prior Valve-Sparing Aortic Root Replacement: Critical Factors to Consider to Achieve Successful Outcomes.

JACC Case Rep 2021 Dec 1;3(17):1803-1805. Epub 2021 Dec 1.

Department of Cardiovascular Surgery, Mount Sinai Health System, New York, New York, USA.

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http://dx.doi.org/10.1016/j.jaccas.2021.09.020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8642720PMC
December 2021

Challenges in diagnosis and management of neonatal hyperparathyroidism in a resource-limited country: a case series from a Sudanese family.

Pan Afr Med J 2021 15;40:105. Epub 2021 Oct 15.

Faculty of Medicine, University of Khartoum, Khartoum, Sudan.

Neonatal hyperparathyroidism is a rare disease caused by a homozygous inactivating mutation in the calcium sensing receptor gene. It presents early in life with life threatening manifestations of hypercalcemia, if left untreated the condition may be lethal. This is the first case series reported from Sudan. Three Sudanese siblings presented with severe symptoms of hypercalcemia in the form of polyuria, failure to thrive and multiple bone fractures. Serum calcium and parathyroid hormone levels were very high with low phosphate and normal alkaline phosphatase levels. Ultrasonography and sestamibi scan were normal and did not assist in diagnosing their condition. Medical management was a great challenge due to unavailability of medications such as parentral bisphosphonates and calcimimetics. Parathyroidectomy was inevitable. Tissue biopsies revealed parathyroid hyperplasia and no adenoma. Gene sequencing revealed a homozygous missense mutation: c 2038 C T p (Arg680Cys) in two siblings, both parents were heterozygous for the same missense mutation. Our report reflects the challenges in diagnosis and management of neonatal hyperparathyroidism in resource limited countries. We also highlight the importance of genetic testing in the diagnosis and management of such cases in countries with high rates of consanguineous marriage.
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http://dx.doi.org/10.11604/pamj.2021.40.105.29527DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627147PMC
December 2021

Clinical profile, etiology, and diagnostic challenges of primary adrenal insufficiency in Sudanese children: 14-years' experience from a resource limited setting.

J Pediatr Endocrinol Metab 2022 Feb 15;35(2):231-237. Epub 2021 Oct 15.

Pediatric Endocrinology Unit, Gaafar Ibn Auf Children Hospital (GIA), Khartoum, Sudan.

Objectives: Primary adrenal insufficiency (PAI) in children is an uncommon condition. Congenital adrenal hyperplasia (CAH) is the commonest cause followed by autoimmune disorders. Diagnosis and management are challenging especially in resource-limited settings. Studies from Africa are scanty and here we describe for the first time the clinical presentation, possible etiologies, and challenges in diagnosis and management of PAI in a large cohort of Sudanese children.

Methods: This was a descriptive hospital-based study where all patients diagnosed with PAI between 2006 and 2020 were reviewed. The diagnosis was based on clinical presentation, low morning cortisol ± high adrenocorticotropic hormone (ACTH), or inadequate response of cortisol to synacthen stimulation. Challenges faced in diagnosis and management were identified.

Results: From 422 PAI suspected patients, 309 (73.2%) had CAH, and 33 (7.8%) had PAI-like symptoms and were not furtherly discussed. Eighty patients (19%) had fulfilled the study criteria: 29 had Allgrove syndrome, nine auto-immune polyendocrinopathy syndrome, seven adrenoleukodystrophy, and one had an adrenal hemorrhage. Hyperpigmentation was the cardinal feature in 75 (93.8%) while the adrenal crisis was not uncommon. Lack of diagnostic facilities has obscured the etiology in 34 (42.5%) patients.

Conclusions: PAI is not uncommon in Sudanese children where genetic causes outweigh the autoimmune ones. Many cases were missed due to nonspecific presentation, lack of awareness, and difficult access to tertiary health care facilities. In addition to the clinical findings, early morning cortisol ± ACTH levels can be used in diagnosis where facilities are limited particularly synacthen stimulation test.
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http://dx.doi.org/10.1515/jpem-2021-0545DOI Listing
February 2022

Sound frequency spectra of snore in relation to the site of obstruction among snorers.

Acta Otorhinolaryngol Ital 2021 Aug;41(4):348-355

Department of Otorhinolaryngology, Head and Neck Surgery, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Objective: This study aimed to describe the sound frequency of snoring in relation to the site of upper airway vibration among snorers.

Methods: 383 snores from 40 participants who complained of snoring were digitally recorded during natural and induced sleep using a level III polysomnography monitor with a built-in microphone. During drug-induced sleep endoscopy (DISE), the real-time site of upper airway obstruction was assessed, and the sound frequency of snoring was recorded synchronously.

Results: The mean peak of snoring frequency for unilevel palatal, oropharynx and epiglottis obstruction were 522.5, 482.4 and 300.0 Hz, respectively. Most participants showed multilevel obstruction at the palate and oropharynx, in which the mean for bi-peak snoring frequency were 402.90 Hz and 1086.96 Hz, respectively. Severity of OSA was significantly associated with multilevel obstruction.

Conclusions: There was a significant association between the snoring sound frequency and site of unilevel obstruction. Palatal or oropharyngeal obstruction produced sound at mid-frequency range, while the epiglottis produced a low frequency range. Multilevel obstruction documented a bi-peak snoring frequency.
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http://dx.doi.org/10.14639/0392-100X-N1202DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8448177PMC
August 2021

Efficacy and cost effectiveness of intravenous ferric carboxymaltose versus iron sucrose in adult patients with iron deficiency anaemia.

PLoS One 2021 10;16(8):e0255104. Epub 2021 Aug 10.

National Center for Cancer Care and Research, Hematology Department, HMC, Doha, Qatar.

Background: Iron deficiency anaemia (IDA) is a major health issues and common type of nutritional deficiency worldwide. For IDA treatment, intravenous (IV) iron is a useful therapy.

Objective: To determine the efficacy and cost-effectiveness (CE) of intravenous (IV) Ferric Carboxymaltose (FCM) versus IV Iron Sucrose (IS) in treating IDA.

Data Sources: Electronic medical record i.e. Cerner® system.

Target Population: Adults patients with iron deficiency anaemia.

Time Horizon: A 12-month period (01/01/2018-31/12/2018).

Perspective: Hamad Medical Corporation (HMC, a public hospital).

Intervention: IV Ferric Carboxymaltose versus IV Iron Sucrose.

Outcome Measures: With regard to responses to treatment i.e., efficacy of treatment with FCM & IS in IDA patients, hemoglobin (Hgb), ferritin, and transferrin saturation (TSAT) levels were the primary outcomes. Additionally, the researchers also collected levels of iron, platelet, white blood cell (WBC), red blood cell (RBC), mean corpuscular hemoglobin (MCH), and mean corpuscular volume (MCV). The costs i.e. resources consumed (obtained from NCCCR-HMC) and the CE of FCM versus IS were the secondary outcomes.

Results Of Base-case Analysis: There was a significant improvement in Hgb, RBC and MCH levels in the IS group than the FCM group. The overall cost of IS therapy was significantly higher than FCM. The medication cost for FCM was approximately 6.5 times higher than IS, nonetheless, it is cheaper in terms of bed cost and nursing cost. The cost effectiveness (CE) ratio illustrated that FCM and IS were significantly different in terms of Hgb, ferritin and MCH levels. Further, Incremental Cost Effectiveness Ratio (ICER) indicated that further justifications and decisions need to be made for FCM when using Hgb, iron, TSAT, MCH and MCV levels as surrogate outcomes.

Results Of Sensitivity Analysis: Not applicable.

Limitations: The study did not consider the clinical or humanistic outcome.

Conclusions: The higher cost of FCM versus IS can be offset by savings in healthcare personnel time and bed space. ICER indicated that further justifications and decisions need to be made for FCM when using Hgb, iron, TSAT, MCH and MCV levels as surrogate outcomes.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0255104PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354439PMC
November 2021

Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation.

Front Immunol 2021 9;12:667093. Epub 2021 Jun 9.

Department of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United States.

Background: Perioperative cardiac xenograft dysfunction (PCXD) describes a rapidly developing loss of cardiac function after xenotransplantation. PCXD occurs despite genetic modifications to increase compatibility of the heart. We report on the incidence of PCXD using static preservation in ice slush following crystalloid or blood-based cardioplegia versus continuous cold perfusion with XVIVO heart solution (XHS) based cardioplegia.

Methods: Baboons were weight matched to genetically engineered swine heart donors. Cardioplegia volume was 30 cc/kg by donor weight, with del Nido cardioplegia and the addition of 25% by volume of donor whole blood. Continuous perfusion was performed using an XVIVO Perfusion system with XHS to which baboon RBCs were added.

Results: PCXD was observed in 5/8 that were preserved with crystalloid cardioplegia followed by traditional cold, static storage on ice. By comparison, when blood cardioplegia was used followed by cold, static storage, PCXD occurred in 1/3 hearts and only in 1/5 hearts that were induced with XHS blood cardioplegia followed by continuous perfusion. Survival averaged 17 hours in those with traditional preservation and storage, followed by 11.47 days and 15.03 days using blood cardioplegia and XHS+continuous preservation, respectively. Traditional preservation resulted in more inotropic support and higher average peak serum lactate 14.3±1.7 mmol/L compared to blood cardioplegia 3.6±3.0 mmol/L and continuous perfusion 3.5±1.5 mmol/L.

Conclusion: Blood cardioplegia induction, alone or followed by XHS perfusion storage, reduced the incidence of PCXD and improved graft function and survival, relative to traditional crystalloid cardioplegia-slush storage alone.
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http://dx.doi.org/10.3389/fimmu.2021.667093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8220198PMC
October 2021

Adaptation and Validation of the Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) Questionnaire into Bahasa Malaysia.

J Voice 2021 Jun 24. Epub 2021 Jun 24.

Department of Otorhinolaryngology and Head and Neck Surgery, UKM Medical Centre, National University of Malaysia Kuala Lumpur Campus, Bandar Tun Razak, Kuala Lumpur, Malaysia. Electronic address:

Background: Communication adjustment from patients' perspective is paramount to ensure optimization of voice rehabilitation post laryngectomy. Very few specific self-rating tools exist with the Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) having the most evidence regarding validity, reliability and clinical utility.

Objectives: This study aimed to translate and validate a Bahasa Malaysia version of SECEL (mSECEL) using a validated framework of transcultural adaptation.

Methods: This cross-sectional study was conducted in the Otorhinolaryngology, Department of Universiti Kebangsaan Malaysia Medical Centre from February 2019 to May 2020. The mSECEL was produced following a rigorous forward and backward translation. Eighty-three laryngectomees (78 male, five female) using various methods of alaryngeal communication (47 voice prosthesis, 29 electrolarynx, three esophageal speech and four pen and paper), completed the mSECEL and mVHI-10 before head and neck and flexible laryngoscopic examinations. The mSECEL was repeated in 2 weeks via telephone interview or clinic visit. Its reliability was assessed using intraclass correlation. The Pearson product-moment correlation test was used to analyze correlation between the mSECEL and mVHI-10.

Results: The mSECEL questionnaire showed strong internal consistency with the Cronbach alpha of >0.90 for total score, Environmental and Attitude subscale. The test-retest reliability for total mSECEL score was high with the intraclass correlation of 0.97. There was a highly significant positive correlation between the mSECEL total score and mVHI-10 (P < 0.001). Items in the General subscale showed poorer internal consistency with Cronbach alpha ranging 0.55-0.46 and poor correlation with mVHI-10.

Conclusions: The Bahasa Malaysia version of the SECEL measure is a valid and reliable instrument to evaluate communication perception after laryngectomy. Future studies should consider subscale validation and further abbreviation of its items to make this measure clinically relevant.
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http://dx.doi.org/10.1016/j.jvoice.2021.04.020DOI Listing
June 2021

Systemic pseudohypoaldosteronism-1 with episodic dyslipidemia in a Sudanese child.

Endocrinol Diabetes Metab Case Rep 2021 Jun 1;2021. Epub 2021 Jun 1.

Departmentof Pediatric Endocrinology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.

Summary: Systemic pseudohypoaldosteronism type 1 (PHA1) is a rare genetic syndrome of tissue unresponsiveness to aldosterone caused by mutations affecting the epithelial Na channel (ENaC). The classical presentation is life-threatening neonatal/infantile salt-losing crises that mimic congenital adrenal hyperplasia (CAH). Consistently, extra-renal manifestations, including respiratory symptoms that resemble cystic fibrosis, are well reported. Clinical diagnosis is made by the presence of hyponatremia, hyperkalemia, metabolic acidosis, respiratory symptoms, evidence of high renal and extra-renal salt loss in addition to high plasma renin and aldosterone levels. We herein report a novel manifestation of PHA1: episodic dyslipidemia in a 7-month-old Sudanese boy that occurred during the salt-losing crises. Whole exome sequencing of the patient revealed one homozygous missense variant c.1636G>A p.(Asp546Asn) in the SCNN1B gene, confirming our clinical and laboratory findings that were compatible with PHA1. This report aims to highlight the possible explanation of dyslipidemia in PHA1 and its expected consequences in the long term.

Learning Points: A child presenting with features that mimic salt-losing congenital adrenal hyperplasia (CAH) crises that do not respond to glucocorticoid and mineralocorticoid therapy should alert the pediatricians to the possibility of end-organ resistance to aldosterone. Pseudohypoaldosteronism type 1 (PHA1) can be diagnosed even in the absence of advanced laboratory investigations. To our knowledge, this is the first case of systemic PHA1 to have a documented episodic dyslipidemia (primarily as marked hypertriglyceridemia).
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http://dx.doi.org/10.1530/EDM-21-0010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240716PMC
June 2021

Stem Cell Therapy in Single-Ventricle Physiology: Recent Progress and Future Directions.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2021 ;24:67-76

Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Feinburg School of Medicine, Chicago, Illinois. Electronic address:

Current surgical and medical treatment options for single ventricle physiology conditions remain palliative. On the long term, despite treatment, the systemic ventricle has a significant risk of developing failure. There are unmet needs to develop novel treatment modalities to help ameliorate the ventricular dysfunction. Advances in the field of stem cell therapy have been promising for the treatment of heart failure. Numerous stem cell populations have been identified. Preclinical studies in small and large animal models provide evidence for effectiveness of this treatment modality and reveal several mechanisms of action by which stem cells exert their effect. Many clinical trials have been designed to further investigate the therapeutic potential that stem cell therapy may hold for pediatric populations with single ventricle physiology. In this review, we discuss the stem cell types used in these populations, some preclinical studies, and the clinical trials of stem cell therapy in single ventricle patients.
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http://dx.doi.org/10.1053/j.pcsu.2021.03.003DOI Listing
October 2021

Quantitative laryngeal electromyography (LEMG) in unilateral vocal fold paralysis: Developing normative values using the opposite normal mobile vocal fold.

Auris Nasus Larynx 2021 Dec 23;48(6):1140-1149. Epub 2021 Apr 23.

Department of Otorhinolaryngology-Head and Neck Surgery, National University Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, Kuala Lumpur 56000, Malaysia. Electronic address:

Objective: Laryngeal electromyography (LEMG) is used to confirm neuropathy; traditionally, it is evaluated qualitatively. This study aimed to develop normative values for the thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex by determining the mean turns (MT) and mean amplitudes (MA) using the opposite normal mobile vocal fold in unilateral vocal fold paralysis (VFP). This study also compared the MT and MA of the paralyzed vocal fold with that of the normal side and analyzed their correlations.

Methods: This is a cross-sectional study in which 77 patients (18 males, 59 females, mean age of 48) with unilateral VFP with an opposite normal mobile vocal fold underwent LEMG with a standardized protocol. Koufman gradings and MT and MA were used for the qualitative and quantitative evaluations. Mann-Whitney U test was performed to compare the median of the turns and amplitudes between the opposite normal mobile vocal fold and the paralyzed side. A linear-scale graphical "cloud" of the normal TA-LCA muscle complex was generated using logarithmic regression analysis. The qualitative and quantitative parameters were analyzed using multiple analysis of variance and Kruskall-Wallis test. Post-hoc analysis was performed to further determine the differences of the significance between both parameters. The correlation between the qualitative and quantitative parameters was analyzed using Spearman correlation.

Results: The MT and MA were significantly higher for the normal TA-LCA muscle complex than the paralyzed side (582 vs. 336; 412 vs. 296, respectively) and the median of the turns and amplitudes were significantly lower in the paralyzed side with p-values <0.001. A significant difference was observed between the Koufman grading and the combination of MT and MA [F (8,144) = 73.254] and between the Koufman grading and MT and MA individually [H (4, 72) = 18.3 and H (4, 72) =33.4], in which both had p-values <0.001. A moderate negative linear relationship was seen between the Koufman grading and MT and MA. On further analysis, it was revealed that only certain pairs of Koufman grading were statistical significant.

Conclusions: This study was the first to present the quantitative normative values and "cloud" of the TA-LCA muscle complex using the opposite normal mobile vocal fold in patients with unilateral VFP in which it is comparable to healthy controls. We concluded that quantitative LEMG supports the qualitative Koufman grading method however it cannot be used independently to determine the severity of neuropathy.
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http://dx.doi.org/10.1016/j.anl.2021.03.028DOI Listing
December 2021

Adipsic hypernatremia in a young Sudanese child, challenges in a limited-resource setting: a case report.

Pan Afr Med J 2021 26;38:86. Epub 2021 Jan 26.

Department of Pediatric Endocrinology, Faculty of Medicine, University of Khartoum, khartoum, Sudan.

Adipsia is a rare condition characterized by a lack of thirst due to a defect in specific osmoreceptors located in the hypothalamus. The disorder is characterized by failure to maintain the body's normal plasma osmolality (POSM), resulting in chronic or recurrent severe hypernatremia and dehydration. Adipsia is usually accompanied by central diabetes insipidus (DI). Isolated adipsia (without DI) is very rare, with causes ranging from congenital central nervous system malformations to acquired anterior hypothalamic lesions. The diagnosis and management of the condition are considerably challenging for both clinicians and patients/parents, especially in a resource-limited setting. We here in present the first case report of adipsia from Sudan; a young child with isolated adipsia, diagnosed after recurrent severe hypernatemic dehydration episodes. The report portrays the unique challenges in suspecting, diagnosing, and managing the condition in a limited-resource setting.
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http://dx.doi.org/10.11604/pamj.2021.38.86.26236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033193PMC
May 2021

Aetiologies and clinical patterns of hypopituitarism in Sudanese children.

Sudan J Paediatr 2021 ;21(1):53-60

Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.

There is paucity of reported information regarding aetiology and clinical profile of hypopituitarism from resource-limited countries particularly in populations with high rates of consanguineous marriages. Here, we are reporting the first data on this aspect from Sudan. This is a descriptive, retrospective, hospital-based study, carried out in the two main paediatric endocrinology centres in Sudan (Gafaar Ibn Auf Paediatric Tertiary Hospital and Soba University Hospital, Khartoum) from January 2006 up to December 2014. Patients' records were reviewed for relevant demographical, clinical, hormonal and radiological data using pretested study forms. The study included 156 patients. One hundred and one patients were males (M: F = 1.8:1). The commonest age groups were adolescents (57.7%). Consanguinity was found in 77.8% of patients overall and 91% of patients with congenital aetiologies. The commonest clinical presentation was short stature (93.5%). Congenital causes (86.5%) were more prevalent than acquired causes (13.5%). There were six family clusters with multiple pituitary hormone deficiencies (MPHD) and three families with isolated growth hormone (GH) deficiency (IGHD). Most of the congenital cases with MPHD were phenotypic for gene mutation (77.5% of sporadic cases and 50% of familial cases). Craniopharyngioma was the commonest of the acquired causes (10.2%). GH was the most frequent hormone deficient (89.7%). Abnormal Magnetic resonance imaging brain findings were significantly seen more in MPHD in comparison to IGHD. The genetic forms of hypopituitarism in populations with high rates of consanguineous marriage like Sudan may be higher than those reported internationally. Molecular genetic studies are, therefore, highly recommended.
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http://dx.doi.org/10.24911/SJP.106-1588448825DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8025993PMC
January 2021

Clinical features, biochemistry, and HLA-DRB1 status in youth-onset type 1 diabetes in Sudan.

Pediatr Diabetes 2021 08 20;22(5):749-757. Epub 2021 Apr 20.

Life for a Child Program, Diabetes NSW, Glebe, New South Wales, Australia.

Objective: To further understand clinical and biochemical features, and HLA-DRB1 genotypes, in new cases of diabetes in Sudanese children and adolescents.

Research Design And Methods: Demographic characteristics, clinical information, and biochemical parameters (blood glucose, HbA1c, C-peptide, autoantibodies against glutamic acid decarboxylase 65 [GADA] and insulinoma-associated protein-2 [IA-2A], and HLA-DRB1) were assessed in 99 individuals <18 years, recently (<18 months) clinically diagnosed with T1D. HLA-DRB1 genotypes for 56 of these Arab individuals with T1D were compared to a mixed control group of 198 healthy Arab (75%) and African (25%) individuals without T1D.

Results: Mean ± SD age at diagnosis was 10.1 ± 4.3 years (range 0.7-17.6 years) with mode at 9-12 years. A female preponderance was observed. Fifty-two individuals (55.3%) presented in diabetic ketoacidosis (DKA). Mean ± SD serum fasting C-peptide values were 0.22 ± 0.25 nmol/L (0.66±0.74 ng/ml). 31.3% were autoantibody negative, 53.4% were GADA positive, 27.2% were IA-2A positive, with 12.1% positive for both autoantibodies. Association analysis compared to 198 controls of similar ethnic origin revealed strong locus association with HLA-DRB1 (p < 2.4 × 10 ). Five HLA-DRB1 alleles exhibited significant T1D association: three alleles (DRB1*03:01, DRB1*04:02, and DRB1*04:05) were positively associated, while three (DRB1*10:01, DRB1*15:02, and DRB1*15:03) were protective. DRB1*03:01 had the strongest association (odds ratio = 5.04, p = 1.7 × 10 ).

Conclusions: Young Sudanese individuals with T1D generally have similar characteristics to reported European-origin T1D populations. However, they have higher rates of DKA and slightly lower autoantibody rates than reported European-origin populations, and a particularly strong association with HLA-DRB1*03:01.
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http://dx.doi.org/10.1111/pedi.13209DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8274711PMC
August 2021

Commentary: Energizing with ATP may be critical in ischemic pediatric hearts.

J Thorac Cardiovasc Surg 2021 09 20;162(3):1005-1006. Epub 2021 Jan 20.

Division of Cardiac Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill. Electronic address:

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http://dx.doi.org/10.1016/j.jtcvs.2021.01.024DOI Listing
September 2021

Commentary: Cell Therapy for HLHS: Does Correlation Imply Causation?

Semin Thorac Cardiovasc Surg 2021 15;33(3):804-805. Epub 2021 Feb 15.

Division of Cardiac Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. Electronic address:

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http://dx.doi.org/10.1053/j.semtcvs.2021.01.030DOI Listing
October 2021
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