Health-related quality of life and cognitive function in children with Crigler-Najjar syndrome type 1

BACKGROUND

The aim of the study was to assess the health-related quality of life (HRQOL) and cognitive function in patients with Crigler-Najjar syndrome (CNS) type I and its impact on their lives.

METHODS

Twenty-one patients diagnosed with CNS type I aged 1 month to 18 years in the Paediatric Hepatology Unit of Cairo University Children's Hospital were enrolled in this cross-sectional observational study. The patients' health-related quality of life (HRQOL) was assessed using the World Health Organization Quality Of Life BREF questionnaire (WHOQOL-BREF) and the Short Form 36 Health Survey Questionnaire (SF-36). Cognitive function was assessed using the Stanford-Binet Intelligence Scale: Fifth Edition (SB5).

RESULTS

All patients had a history of admission to a neonatal intensive care unit, 17 were managed by phototherapy only and 5 also underwent exchange transfusion. According to the WHOQOL questionnaire, 11 cases (52.4%) had a low QOL score, and 7 of 13 patients had an average score for their total IQ test. Cases with poor compliance to phototherapy had statistically significantly lower QOL scores (p=0.001), while, according to the SF36 survey, cases who received exchange transfusion had statistically significantly higher cognitive function (p=0.03). There was a positive correlation between the neurological effect as a complication of the disease and poor physical QOL.

CONCLUSION

Paediatric patients with CNS have significantly lower HRQOL, especially physically, psychologically and environmentally. It is recommended that assessment of HRQOL should be a routine part of follow-up in CNS patients. Patients whose HRQOL is affected receive regular psychiatric counselling, social support and rehabilitation.Abbreviations: CNS: Crigler-Najjar syndrome; HRQOL: health-related quality of life; IQ: intelligence quotient; NICU: neonatal intensive care unit; QOL: quality of life; SB5: Stanford-Binet intelligence scale: 5th edition; SF-36: Short Form 36 Health Survey Questionnaire; UDGT: uridine diphosphate glucuronosyl transferase; UGT1A1: uridine 5'-diphosphate glucuronosyltransferase; WHOQOL-BREF: World Health Organization Quality of Life Brief Version.

Immunological Role of Toll-Like Receptor Markers (TLR2 and TLR4) in Patients with Helicobacter pylori infection at Basrah, Iraq

Helicobacter pylori is a spiral-shaped, flagellated, microaerophilic bacteria found in the human gastric sub-mucosa. This study aimed to investigate the association between toll-like receptor markers (TLR2 and TLR4) and the infection with Helicobacter pylori. The study involved 224 participants randomly divided into 2 equal groups (n=112). The patient group (n=112) was involved with several gastrointestinal symptoms. They were compared to a control group (n=112) with negative H. pylori tests. Patients and control were subjected to upper digestive endoscopy with gastric biopsy for the rapid urease test, rapid diagnostic test, and ELISA test for TLR2 and TLR4 detection. The recorded data showed that 36 (32.1 %) patients with H. pylori were in the second to the third decades of their life (25-34 years), while 22 (19.6 %) positive H. pylori-infected individuals were in the age range of 15-24 years, which were very close to the participants in the age range of 35-44 years. On the other hand, it is revealed that 15 (13.4%) participants were in the fourth to fifth decades of life. This rate was very similar to the groups of patients within the sixth to seventh decades of their life (13 (11.6 %)), but the lowest number of cases with H. pylori patients found in the age range of 55-64 years were recorded 7.1%. In conclusion, the concentration of TLR2 and TLR4 is higher in H. pylori-positive participants compared to the control group. This might reflect the response of innate immunity of the body to the presence of H. pylori infection, and thus it may be used as an ancillary tool in the detection of the patient's susceptibility to this type of infection.