First detection and molecular characterisation of a pigeon aviadenovirus A and pigeon circovirus co-infection associated with Young Pigeon Disease Syndrome (YPDS) in Turkish pigeons (Columba livia domestica)

Pigeon aviadenovirus A and Pigeon circovirus are both DNA viruses, infect and cause severe clinical diseases in pigeons. These viruses are associated with an immunosuppression syndrome similar to ‘Young Pigeon Disease Syndrome’ (YPDS). This study reports the identification of a natural co‐infection, with severe clinical signs (crop vomiting, watery diarrhoea, anorexia and sudden death) of Pigeon aviadenovirus A and Pigeon circovirus in a breeding pigeon flock in Central Anatolia, Turkey. Both viruses were isolated from pigeons pooled internal organs using primary chicken embryo kidney cell cultures (CEKC) and specific pathogen‐free (SPF) embryonated chicken eggs. Also, both viruses were identified by PCR amplification followed by Sanger sequencing whereas histopathological examination showed degenerated hepatocytes with basophilic intranuclear viral inclusions. As known, both viruses typically have similar transmission characteristics and common clinical manifestations; however, co‐infection may exacerbate the disease with devastating outcomes. This is the first report of its kind in Turkey for those viruses and is essential for the protection against these kinds of infections in pigeons.

Tracking acute phase protein response during acute and chronic Toxoplasma gondii infection

Toxoplasmosis is a disease caused by the protozoan Toxoplasma gondii, which occurs worldwide in mammals and birds. Brain is the primary target organ because Toxoplasma gondii is a ubiquitous intracellular parasite that causes most frequently life-threatening encephalitis in immunocompromised patients. Relation of tissue cysts number, histopathology score and acute phase proteins were investigated. In this study, 36 mice are infected with Me49 strain of Toxoplasma gondii. The control group has 6 healthy mice. After inoculation of Toxoplasma gondii, at 10., 15., 20., 30., 45., 60. days, 6 each mice euthanized after collection of blood samples. Hemopexin, haptoglobulin, macroglobulin, serum amyloid A and clusterin levels are determined by ELISA. Then, brain tissues were investigated histopathologically and lesions were scored. The average cyst numbers were determined by counting three samples (25 μl each) of each brain homogenate under light microscopy. Inflammatory reaction was observed on day 10 days after inoculation (d.a.i.) The lesions were characterized by perivascular mononuclear cell infiltration, focal mononuclear cell infiltration in the meninges, and glial proliferation. Tissue cysts were observed in all Toxoplasma gondii-infected groups. The highest lesion score was observed at 60 d.a.i. And the most tissue cyst number were on day 30. d.a.i. Serum levels of hemopexin, haptoglobulin, macroglobulin, serum amyloid A and clusterin were significantly higher than the control group on day 10-20., 10., 10-30., 10.,10-45 d.a.i., respectively. High level of acute phase proteins in mice on certain days infected with Toxoplasma gondii was exhibited a relationship between brain lesions and tissue cysts.

The effect of anticipatory discharge orders on length of hospital stay in staff pediatric patients

Effective discharge planning should serve to reduce length of stay (LOS) and lower readmission rates. A combined prospective/retrospective study was undertaken to assess the effectiveness of anticipated discharge order forms in decreasing LOS for staff pediatric patients. Resident physicians provided advance notice of the planned discharge date to nursing staff and patient family members. Patient selection was random, and the data were collected prospectively. These subjects were matched with patients for whom the order form was not used, and the data was collected retrospectively. Matching variables included: diagnosis, age, gender, race, and method of payment. There were 103 matched pairs. LOS was collapsed into low and high categories. There was a significant difference when comparing subject groups (chi 2 = 8.5; P = 0.005). Whereas only 14% of experimental patients were categorized as high LOS, 32% of control patients were classified as such. Physician prediction of discharge date helped decrease patient LOS.

Childhood leukaemia: experience at King Fahd Hospital, Saudi Arabia

One hundred and twenty eight children suffering from leukaemia were admitted to King Fahd Hospital of the University in the Eastern Province of Saudi Arabia during the period of January 1982-December 1992. Acute lymphoblastic leukaemia was the most common whilst chronic granulocytic leukaemia the least common among the studied group.

Splenectomy in compound heterozygous hemoglobinopathies in Saudi Arabia

Hemoglobinopathies are a major public health problem in Saudi Arabia. We studied the effect of splenectomy in 16 Saudi Arabian children with compound hemoglobinopathies. Seven patients no longer require regular blood transfusions, and transfusion requirements were decreased by 30 to 60% in the other eight patients. Three patients whose heights and weights were below the 5th percentile before splenectomy reached the 25th percentile 1 year after the surgery. In spite of preoperative pneumococcal vaccination and the penicillin prophylaxis after the surgery, one patient died of Haemophilus influenzae Group B bacteremia, and three others had six episodes of pneumonia.

Treatment of fever and neutropenia with antibiotics versus antibiotics plus intravenous gammaglobulin in childhood leukemia

Thirty-three children with leukemia who had neutropenia and fever were randomized to receive cefataxim and amikacin, versus the same antibiotics plus intravenous gammaglobulin (i.v. IgG). Duration of neutropenia, hospitalization and the interruption of chemotherapy were not different in the two groups; however, duration of fever was significantly shorter in the i.v. IgG group.

Serum immunoglobulin and complement levels in patients with sickle cell anaemia from eastern province of Saudi Arabia

Serum immunoglobulin (IgG, IgA, IgM) and complement (C3, C4) levels were determined in 61 sickle cell anaemia patients of various age groups and both sexes in their steady state by nephelometry. Serum IgG was found to be consistently elevated in 46% cases of all age groups. Increase in the levels of IgA, IgM and in the complement values (C3, C4) was also observed. Although the mechanism responsible for these variations was unclear, however, this study gave an idea about the general pattern of serum immunoglobulin and complement levels in sickle cell anaemia patients from the Eastern Province of Saudi Arabia.

Inherited bleeding disorders in the Eastern Province of Saudi Arabia

Thirty-four cases of inherited bleeding disorders are reported. All are Saudi patients from the Eastern Province of Saudi Arabia. There were 15 haemophiliacs, 1 factor VII deficiency, 1 factor X deficiency, 12 Glanzmann's thrombasthenia, and 5 unidentified platelet function disorders. Consanguinity was common among the families of these patients. Different age groups were affected and the severity of bleeding varied in the different conditions reported.

Pathological fracture of vertebral column in association with sickle cell anemia in Saudi Arabia

We describe two cases of sickle cell anemia who were admitted in the hospital with the complaint of backache. X-ray examination and bone scan revealed pathological fracture of vertebral column. These cases are of interest since sickle cell anemia in the Eastern part of Saudi Arabia is reported to run a relatively 'benign' course.

Severe congenital factor X deficiency with intracranial haemorrhage

A Saudi Arabian infant with severe factor X deficiency who had had two intracranial haemorrhages is described. Attempts to raise his factor X level and improve his prothrombin time (PT) and partial thromboplastin time (PTT) by using vitamin K, oestradiol and danazol have failed. New therapeutic trials are necessary for patients with severe forms of this rare disorder.

Determining prognosis in childhood acute lymphoblastic leukemia by phytohemagglutinin (PHA) stimulated lymphocytes

The cellular immunity of 49 children between the ages of five months and 17 years with acute lymphoblastic leukemia (ALL) in remission was studied in vitro by stimulating the lymphocyte cultures with phytohemagglutinin (PHA). The mitogenic responses of the lymphocytes were followed for seven days in short term tissue culture and the maximum peak days were correlated to the disease-free period. The patients who had the maximum mitogenic response on day five or later had a significantly better prognosis than patients who peaked on day four or earlier.

Stage IV non-Hodgkin's lymphoma in children

Twenty-five children with previously untreated stage IV non-Hodgkin's lymphoma (NHL) were studied. At the time of evaluation 16 patients were disease-free (64%), with a median observation time of 23 months. Intensive chemotherapy for childhood NHL provides a better outlook for these patients, including those who would be considered high-risk acute lymphoblastic leukemia (ALL).

Chemotherapy in recurrent noncystic low-grade astrocytomas of the cerebrum in children

Six children with grade II astrocytomas were treated with combination chemotherapy consisting of 1,3 bis(2-chloroethyl) 1-nitrosourea (BCNU). Vincristine (VCR), intrathecal Methotrexate (i.t. MTX), and Dexamethasone. Of the children, 3 showed a partial remission, and 1 other showed clinical improvement. Our data suggest that chemotherapy is effective in low-grade astrocytomas, and there is now a need for larger trials in low-grade astrocytomas to document the role of chemotherapy accurately in these tumors. It is suggested that trials of chemotherapy as adjuvant to surgery and radiotherapy should be initiated.