Background: The HLA-B*15:02 polymorphism in epileptic patients is known to be associated with carbamazepine-induced Stevens-Johnson syndrome (SJS). The prevalence of HLA-B*15:02 polymorphism seemed to be ethnic-specific with a higher frequency of HLA-B*15:02 in Asian compared to the Europeans. This study was performed to determine the frequency of the HLA-B*15:02 polymorphism in epileptic patients at the Chancellor Tuanku Muhriz Hospital-UKM Medical Centre (HCTM-UKMMC) using high resolution melting-real time PCR (HRM-QPCR) method.
Methods: We performed a fast and effective in-house high resolution melting-real time polymerase chain reaction method and compared it with the conventional multiplex-PCR method. The specificity and sensitivity of each test were also determined using DNA from saliva.
Results: Using the conventional multiplexPCR approach for screening, 25 out of 64 (39.1%) epileptic patients were positive for HLA-B*15:02. However, using the HRM-QPCR technique, 24/64 (37.5%) of the patients were positive. The one patient who tested positive by the multiplex-PCR but negative using the HRM-QPCR turned out to be negative by DNA sequencing. The HRM-QPCR and DNA sequencing showed 100% sensitivity and specificity. The multiplex-PCR showed 100% sensitivity and 98.4% specificity compared to both HRM-QPCR and DNA sequencing. The HRM-QPCR is also more cost-effective (
This review explores the establishment of diagnostic reference levels (DRLs) for pediatric brain computed tomography (CT) examinations in Saudi Arabia and compares them with nine other countries. An extensive search strategy was employed across various databases, resulting in the inclusion of 9 studies. The studies included patient-based and phantom-based investigations into DRLs, highlighting variations across age groups and countries. Findings suggest notable differences in CT dose index (CTDI mGy) and dose length product (DLP mGy.cm) values. There was a difference in the classification of age group between Saudi food and drug administration (SFDA) and literature. For the age groups 0-5 years and 6-15 years, the DRLs for the SFDA were as follows: CTDI (28 and 42 mGy) and DLP (482 and 697 mGy cm). The discussion emphasizes the importance of age-specific DRLs to optimize radiation doses while ensuring patient safety and diagnostic efficacy. Recommendations include adopting globally accepted standards for dose optimization and continued research into factors influencing DRL variations. Limitations include varying age groupings among studies and limited access to some relevant literature. Overall, this study underscores the importance of standardizing DRLs for pediatric CT to improve patient care and safety.