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Register a new userAnti-D or Methylprednisolone? Pros and Cons in the Treatment of Acute Immune Thrombocytopenic Purpura in Children
أضداد الريزوس أم الميتيل بريدنزولون؟ الايجابيات و السلبيات في علاج فرفرية نقص الصفيحات المناعي الحادة عند الأطفال
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Damascus University ورقة بحثية
Publication date
2012
fields
Medicine
and research's language is
العربية
Created by
Shamra Editor
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استوحينا فكرة مقارنة فعالية أضداد الريزوس الوريدية كجرعة عليا وحيدة بالميتيل بريدنيزولون بثلاث جرعات متتالية من حيث: 1. سرعة رفع تعداد الصفيحات. 2. استمرارية الفعالية الدوائية مدة ستة أشهر. 3. تخفيض التأثيرات الجانبية، مدة الاستشفاء و التكلفة.
the research performed by the ITP study group in 2006[15] studying the efficacy of single dose IV-Rhesus antibodies (Anti-D) "50 ug/kg or 75 ug/kg" compared to the single dose IVIG "800 mg/kg"; that study revealed that both have a similar therapeutic effect. that study suggest to compare the single high dose of Anti-D withthree consecutive doses of Methyl-prednisolone in respect of: 1- Time of platelet recovery 2- The continuity of mediation effect throughout ( 6 months) 3- Side effects, hospitalization and cost.
Artificial intelligence review:
Research summary
تتناول هذه الدراسة مقارنة بين فعالية الجرعة العالية الوحيدة من أضداد الريزوس الوريدية (Anti-D) وثلاث جرعات متتالية من الميتيل بريدنيزولون (MP) في علاج فرفرية نقص الصفيحات المناعي الحادة (ITP) عند الأطفال. شملت الدراسة 44 طفلاً إيجابيي الريزوس تلقوا Anti-D (المجموعة A) و37 طفلاً تلقوا MP (المجموعة B). تم تقييم سرعة رفع تعداد الصفيحات، استمرارية الفعالية الدوائية، التأثيرات الجانبية، مدة الاستشفاء، والتكلفة. أظهرت النتائج أن سرعة رفع تعداد الصفيحات إلى أكثر من 20,000/ملم3 كانت متماثلة بين المجموعتين بعد 24 ساعة من العلاج. تميز العلاج بـ Anti-D بسهولة الإعطاء وقلة الحاجة للاستشفاء، بينما كانت التكلفة الإجمالية للعلاج متقاربة بين الدواءين. ومع ذلك، حمل العلاج بـ Anti-D خطر البيلة الخضابية وانخفاض قيم خضاب الدم. خلصت الدراسة إلى أن الجرعة العالية الوحيدة من Anti-D ترفع تعداد الصفيحات بشكل سريع فوق حد الخطر وتعتبر أفضل من الميتيل بريدنيزولون إجمالاً، مع الإشارة إلى أن الدراسة غير عشوائية وحجم العينة صغير.
Critical review
تعتبر هذه الدراسة خطوة مهمة في مجال علاج فرفرية نقص الصفيحات المناعي الحادة عند الأطفال، إلا أنها تعاني من بعض القيود التي يجب أخذها بعين الاعتبار. أولاً، الدراسة غير عشوائية مما قد يؤثر على مصداقية النتائج ويزيد من احتمالية التحيز. ثانياً، حجم العينة صغير نسبياً مما يجعل من الصعب تعميم النتائج على نطاق أوسع. ثالثاً، لم تتناول الدراسة بشكل كافٍ التأثيرات الجانبية طويلة الأمد لكل من العلاجين، مما يجعل من الضروري إجراء دراسات مستقبلية لتقييم هذه الجوانب. على الرغم من هذه القيود، فإن الدراسة تقدم معلومات قيمة يمكن أن تكون نقطة انطلاق لدراسات أوسع وأكثر شمولاً.
Questions related to the research
-
ما هو الهدف الرئيسي من هذه الدراسة؟
الهدف الرئيسي هو مقارنة فعالية الجرعة العالية الوحيدة من أضداد الريزوس الوريدية (Anti-D) بثلاث جرعات متتالية من الميتيل بريدنيزولون (MP) في علاج فرفرية نقص الصفيحات المناعي الحادة عند الأطفال.
-
ما هي النتائج الرئيسية التي توصلت إليها الدراسة؟
النتائج الرئيسية أظهرت أن سرعة رفع تعداد الصفيحات إلى أكثر من 20,000/ملم3 كانت متماثلة بين المجموعتين بعد 24 ساعة من العلاج، مع تميز العلاج بـ Anti-D بسهولة الإعطاء وقلة الحاجة للاستشفاء.
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ما هي القيود الرئيسية لهذه الدراسة؟
القيود الرئيسية تشمل أن الدراسة غير عشوائية، حجم العينة صغير، وعدم تناول التأثيرات الجانبية طويلة الأمد بشكل كافٍ.
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ما هي التوصيات المستقبلية بناءً على هذه الدراسة؟
التوصيات تشمل إجراء دراسات عشوائية أوسع تشمل عينات أكبر وتقييم التأثيرات الجانبية طويلة الأمد لكل من العلاجين.
References used
Kurtzberg J, Stockman JA 3rd. ITP. AdvPediatr 1994; 41:111
Carcao MD, et al. Fcgamma receptor IIa andIIIa polymorphisms inITP. Br J Haematol 2003; 120:135
Kühne T, et al. A prospective comparative study of 2540 infants and children with newly diagnosed ITP from the Intercontinental Childhood ITP Study Group. J Pediatr 2003; 143:605
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Asthma exacerbations can be frequent and range in severity from relatively mild to
status asthmaticus. While the efficacy of intravenous MgSO4 hasbeen demonstrated, the
informations available on its inhaled role still low and conflicting, so the st
udy aim to
investigate the effect of thecombinationof MgSO4and salbutamol in the management of
acute asthma attack.
A randomized clinical trial was conducted on 76 patients, divided into two groups:
experimental (40) and control (36) patients. The trial received nebulised salbutamol with
magnesium sulphate and control nebulised salbutamol with saline serum 0.9% on three
sessions in 20 minutes. Signs of respiratory distress, wheezing, respiratory rate, pulse,
Sao2 and PEF were assessed.
Magnesium sulphate showed a significant effect in improving respiratory rate, Sao2
and PEF starting from the 20th minute( P <0.05), but did not observe the effect of MgSO4
in improving signs of respiratory distress, pulse and wheezing(P> 0,05), no side effects
attributed to magnesium sulphate were observed.Inhaled MgSO4, incombination with
salbutamol, appears to have benefits in the treatment of acute asthma attack.
Asthma is the most common chronic disease in childhood, the
incidence progresses and constitutes a public health problem which needs
the research of factors that increase the incidence and severity of crisis, and
among these factors IgG4 deficiency. Therefore the objective of the study is
to know the effect of IgG4 deficiency on severity and evolution of asthma in
children.
This study was done to determine whether use of nebulized salbutamol therapy for
treatment of an acute attack of asthma in children is associated with hypokalaemia and if
so what is its frequency, severity and what is accompanying clinical symptoms
103 child,
aged 3 years to 14 years with asthma attack, treated with three doses of nebulized
salbutamol 0.15mg/kg, every 20 min participated in the study. Blood for serum potassium
was obtained at the beginning and after three doses of nebulized salbutamol therapy.The
mean serum potassium level decreased from 3.94 mEq/L to 3.28 mEq/L (P < 0.05). A
decrease in serum potassium concentration was noted in 93 child (90.3%).). Mild
hypokalemia formed the highest proportion in 43child (41.7%) followed by moderate
hypokalemia in 28 child( 27.2%). Severe hypokalemia did not happen.This decrease was
accompanied with clinical symptoms (palpitations 23,muscle weakness 21,nausea 15,
headache 12,myalgia 11,vomiting 9).These symptoms were moreclosely to moderate
hypokalemia.
The objective of this research is to insist on the most important symptoms and signs
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aim of the study was to establish diagnostic criteria for acute appendiciti
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light of the data obtained from the study of a large number of patients with appendicitis
and to determine the surgical indication to reduce complications and negative abdominal
opening and to include the studied criteria in a spec
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Introduction: Urinary tract infections are very common in childhood (especially under the age of 5 years) and because of the large number of complications resulting from it (renal failure – hypertension- kidney scarring) had to be diagnosed and early
treatment, although that urine culture is the standard Golden diagnosis, but its results are late to appear, Many studies have indicated an accompanying increase in platelet counts in urinary tract infections, so that platelet counts may be a vital indicator directed to it without asylum to the costly analyzes in its diagnosis. Objective: the objective of the following study is to assess the sensitivity and specificity of the plate count (PLT) in UTI. Methods: The study included 65 Patients (14 males, 51females) They were between (3-6) year with upper urine tract infections were diagnosed through symptoms, urological test, Serum tests, and radiology, who were admitted to the pediatric department at Tishreen University Hospital in Lattakia City. PLT was obtained through a complete CBC blood count (sensitivity and sensitization), and comparison of the ratio Percentage of Thrombocytosis between urine culture with Gram-positive germs and Gram-negative germs. Results: The study showed a good sensitivity=80.39% [75–84] to platelet counts compared to urine culture. it also showed statistically significant paper p-value=0.003 between platelet count and type of pathogen (positive or negative Gram) and the increase was more favorable to positive urine culture. Also showed that the average value of platelets is higher in culture a positive gram 521.9±90.9 x103 platelet/mcl than in gram negative 432.3±73.5 x103 platelet/mcl. Conclusion: higher Platelet numbers are a good analysis or sensitivity for the diagnosis of upper urinary tract infection in children with reliable urinary symptoms to start treatment. So that we get the results of culture urine .and the higher platelet count must be taken gram positive bacteria into account.
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