ORIGINAL_ARTICLE
Clinical Pattern of Seizures in the Out Patient Pediatric Neurology Clinic of Al- Hussein University Hospital
Background: Seizures are the most common pediatric neurological disorder. Up to10% of children suffer from at least one episode of seizure in the first 16 years of life. The incidence is highest in children less than 3 years of age, with a decreasing frequency in older children (Friedman and Sharieff, 2006). Febrile seizure is the most common form of seizures in childhood, affects 2-5% of all children across the world (Sampaio et al., 2010). Incidence of first non-febrile seizure in children is 25,000 to 40,000 per year in the United States (Martindale et al., 2011).
Objectives: We aimed to clarify the clinical pattern of seizures including their type, frequency, possible etiology, family history, level of controlling seizure, parents awareness about seizure precaution and home management and antiepileptic drug used 'in pediatric neurology clinic of Al- Hussein University Hospital.
Patients and Methods: This descriptive study was carried out on 200 patients with seizures disorder, from outpatient clinic of pediatric neurology at Al-Hussein University Hospital, during the period from April 2019 to October 2019. All patients were aged from 1 month up to 18 years and of both genders, newly and old diagnosed cases. Patients less than 1 month and more than 18, and mentally retarded children were excluded. History-taking, complete clinical examination and laboratory investigations were registered. Electroencephalography was done. Adequate rationale AED was given.
Results: At the time of interview, of the 200 patient with seizure disorder had age ranges from 1 month -18 years, male more than female (124 (62%) vs. 76 (.38%)) with a male/female ratio 2:1, the most common age for onset of seizures was within the first year of life (56.50%) of all patients, Parental consanguinity was reported in 4.5%. Family history of epilepsy was reported in 9.5%, that most seizures in our patients without triggers (59.0%) followed by fever (30.0%), the most common percentage of our Seizure was Controlled in (65.00%). About 46% reported genetic etiology for epilepsy, 29.5% reported structural etiology with the most common cause Hypoxic ischemic encephalopathy (16%). CNS infection (23%), perinatal complications (birth asphyxia) (2%) and head trauma (1.5%) were identified in the symptomatic group. Febrile seizures were reported in 20.5%. Main seizure types were generalized in 70% and focal with or without focal to bilateral in 17.5%. The generalized motor tonic clonic seizures were frequent in generalized epilepsy (67.5%). Rolandic epilepsy was the most frequent type of age specific epileptic syndrome (4.5 %). Most of our patients (90.00%) were not awareness about seizures precaution and home management. MRI brain findings were normal in 17 .00 %, and Abnormal in 37 % with predominant abnormality was brain atrophy in 46 %.
https://azjp.journals.ekb.eg/article_128345_1d7cad1e49eb14203002fa430348f65c.pdf
2020-06-01
999
1021
10.21608/azjp.2020.128345
Ezzat
Samier Saleh
1
AUTHOR
Aida
Kafafy Abd Elghaffar
2
AUTHOR
Abd Elsattar
Abdullah Elsayeh
3
AUTHOR
Amr
Hemeda Moustafa
4
AUTHOR
ORIGINAL_ARTICLE
CLINICO-ETIOLOGICAL PATTERN OF NEONATAL SEIZURES
Background: Incidence of seizures is highest during the neonatal period, and it is considered a medical emergency that necessitate proper clinical and etiological assessment.
Aim: This study aimed to focus on the etiological, clinical classification of neonatal seizures and proper assessment for appropriate diagnosis.
Patients and methods: This prospective study was performed on 50 neonatal patients who developed neonatal seizures either prior or after admission to the NICU of Al-Hussein University Hospital and Sayed Galal University Hospital below the age of 28 days after an informed written consent from parents in the period between December 2018 and September 2019
Results: In this study, neonatal seizures were more common in males 27 (54%) than females 23(46%); their mean birth weight was 2748 grams. 40% of patients of the study were complaining of perinatal asphyxia evidenced by history of prolonged or instrumental labor, 11 babies (22%) with sepsis,6 babies (12%) with hypocalcemia, 6 babies (12%)with intraventricular hemorrhage, 3 babies (6%)with intracranial hemorrhage, 3 babies(6%) with kernicterus, one baby (2%) with metabolic disorder (Non ketotic hyperglycinemia ) .
Many types of seizures are represented in our study with different ratios; out of which 18 (36%) had myoclonic seizures, 14(28%) had mixed, 8 (16%) babies had subtle, 4(8%) had clonic and 5(10%) had tonic types), and only 1(2%) baby had multifocal clonic fit.
Conclusion: This study confirms that Hypoxic ischemic encephalopathy was most important etiology of neonatal seizures and most important risk factor for poor neurological outcome followed by sepsis, intraventricular hemorrhage, intracranial hemorrhage, kernicterus and metabolic respectively and most important risk factor for poor neurological outcome and myoclonic seizures being most common clinical type of seizure observed.
https://azjp.journals.ekb.eg/article_127064_8c9abcdee9b698abe3b82d44d666063e.pdf
2020-06-01
1022
1037
10.21608/azjp.2020.127064
Hassan
Ali Hassan
1
AUTHOR
Ahmed
Ismaieel
2
AUTHOR
Eslam
Elsherbeiny Qotb
3
AUTHOR
ORIGINAL_ARTICLE
ASSESMENT OF THYROID PROFILE AND AUTO ANTIBODIES IN CHILDREN WITH ASTHMA AT AL-HUSSEIN UNIVERSITY HOSPITAL
Background: the most important causes of thyroid diseases is autoimmunity in origin, and it seems that people with thyroid diseases present more signs of asthma.
Aim: This study aimed to study the frequency of autoimmune thyroid diseases among patients suffering from bronchial asthma.
Patients and Methods: 50 Egyptian children, with an age range of 2-12 years, 25 children of them were suffering from bronchial asthma and 25 healthy children as a control were included in this cross-sectional study. Asthmatic children were selected from the Allergy Clinic at Al-Hussain Hospital, Al-Azhar University. All participants were subjected to the following: full history taking, full clinical examination, and investigations including (Serum FT3, Serum FT4, Serum TSH, Serum anti TPO, Serum anti TG, Serum IgE & CBC for total Eosinophilic count).
Results: There were a high statically significant increase in Serum IgE level and total esinophilic count in cases compared to control with P value <0.01 but no statistical significant difference between different degrees of asthma. There were no statically significant difference in Serum thyroid hormones level and Serum auto-antibodies level in asthmatic patients when compared to controls (P >0.05).
Conclusion: This study show no significant thyroid affection in asthmatic children compared to studies done before.
https://azjp.journals.ekb.eg/article_127066_c0b42c191093fde6c6d58781c955f9a6.pdf
2020-06-01
1038
1047
10.21608/azjp.2020.127066
Nadia Yahia
Ismaeil
1
AUTHOR
Amr
Hemeda Moustafa
2
AUTHOR
Mohamed
Farouk Mosa
3
AUTHOR
Ali l
Ragab El-Wakeel
4
AUTHOR
ORIGINAL_ARTICLE
RELIABILITY OF PEDIATRIC RISK OF MORTALITY III (PRISM III) AND PEDIATRIC INDEX OF MORTALITY 3 (PIM3) SCORES IN THE PEDIATRIC INTENSIVE CARE UNIT OF EL-HUSSEIN UNIVERSITY HOSPITAL
Introduction: Mortality rate in Pediatric Intensive Care Units (PICU) depends on the severity of illness and can be assessed by scoring systems. Pediatric Risk of Mortality III (PRISM III) and Pediatric Index of Mortality 3 (PIM3) are scores used to assess mortality risk among infants and children admitted in the PICU. Setting: tertiary care unit PICU at El-Hussein University Hospital, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. Design: Thesis, prospective descriptive study. Objectives: To compare the accuracy of the PRISM III and the PIM 3 scores among children admitted to PICU. Patients and Methods: All children admitted to the PICU during the period from December 2015 till December 2016, total 100 patients were studied. We excluded patients who stayed less than 12 hour in the PICU and patients who died within 12 hours after discharge. Measurements and Main Results: Of 100 patients, death ratio was 17 %, the discriminatory performance AUR was 0.987 for PRISM III (CI 95%, 0.968-1.000) and 0.973 (CI 95%, 0.877-0.998) for PIM 3. For calibration PRISM III (Chi-square= 27.25, p = 0.0001) and PIM 3 (Chi-square =20.54, p > 0.0001). Sensitivity for PRISM III (95.12%) and for PIM 3 (82.35%). Specificity for PRISM III (95.18%) and for PIM 3 (97.56%). There were significant correlations between the risk of mortality and both PRISM III and PIM3. Conclusion: Both scores showed excellent overall discrimination. PRISM III showed more discrimination and both scores showed poor calibration under Egyptian circumstances. EPIDEMIOLOGICAL & BACTERIOLOGICAL COMPARATIVE STUDY OF NEONATAL SEPSIS IN AL AZHAR UNIVERSITY HOSPITALS AND MAIN SHAREYANOENATAL INTENSIVE CARE UNITS
https://azjp.journals.ekb.eg/article_127067_b1f9f02a7873e52765d98e345f367672.pdf
2020-06-01
1048
1071
10.21608/azjp.2020.127067
Mosallam
M Nasser
1
AUTHOR
Ahmed
Y Al-Sawah
2
AUTHOR
Wael
R Hablas
3
AUTHOR
Ahmed
M Mansour
4
AUTHOR
ORIGINAL_ARTICLE
EPIDEMIOLOGICAL & BACTERIOLOGICAL COMPARATIVE STUDY OF NEONATAL SEPSIS IN AL AZHAR UNIVERSITY HOSPITALS AND MAIN SHAREYANOENATAL INTENSIVE CARE UNITS
Background: Neonatal sepsis is defined as a clinical syndrome in an infant 28 days of life or younger, manifested by systemic signs of infection and isolation of a bacterial pathogen from the blood stream. Diagnosis and management of sepsis are a great challenge facing neonatologists in NICUs. Aim and objectives: The aim of this study is to evaluate and Compare the Epidemiological and Bacteriological Aspects of neonatal sepsis during a period of six months in neonatal Intensive Care units of Al Azhar University Hospitals and Main Shareya NICUs. Subjects and methods: This was A prospective study conducted over a period of six months from 1/7/2018 to 31/12/2018 at NICUs of Al Azhar University Hospitals (Al Hussain &Sayed Galal Hospitals) and Some of Main Shareya NICUs in Grand Cairo, Egypt (Almaza, El-Shohadaa, Istiqamaand 6th October). During the study period, all admitted neonates were recorded, then cases with clinical signs and symptoms of sepsis at the time of admission or who developed sepsis during their hospital stay were assessed (Clinically , Laboratory and Bacteriologically) and included in the study. Results: Out of 1874 of total admitted cases during study period, the incidence of clinically suspected neonatal sepsis among the admitted neonates at the neonatal intensive care units of the included hospitals and Units was 50.3% (942/1874). The sepsis was proved in 410 (43.5%) cases by positive blood culture: 361(44.5%) from Main Shareya and 49 (37.1%) from Azhar hospitals.Regarding demographic characteristics of studied cases, presence of neonatal sepsis is more in (full term, CS, urban residence, male neonates and single) cases, with significant difference between both groups in Post-natal age, Sex and Birth number. Klebsiella is the most organisms in blood cultures in both EOS and LOS of Main Shareya and Azhar cases followed by Staph. Aureus, Proteus, Candida Albicans then E. Coli and finally Strept. Pneumonia .There is no statistically significant difference between types of sepsis regarding to the causative organisms in blood cultures. Death occurs more frequent in EOS than in LOS while improvement is more frequent in LOS. There is no statistically significant difference in Main Shareya and Azhar cases.
https://azjp.journals.ekb.eg/article_127069_0fff715a24ec8fa6218d8f007725f4d8.pdf
2020-06-01
1072
1087
10.21608/azjp.2020.127069
Mohamed
Salah Arabi Taha
1
AUTHOR
Atef
El-Sayed Donia
2
AUTHOR
Ahmed
Yousef Al Sawah
3
AUTHOR
ORIGINAL_ARTICLE
HEALTH, GROWTH AND THROAT MICROFLORA IN RELATION TO TYPE OF FEEDING AMONG INFANTS
Introduction: WHO can now say with full confidence that breastfeeding reduces child mortality and has health benefits that extend into adulthood. On a population basis, exclusive breastfeeding for the first six months of life is the recommended way of feeding infants.
Aim of the study: to evaluate if full breast-feeding confer the greatest protection, and are declining proportions of breast milk in the infant's diet correlated with increasing illness prevalence.
Patients and Methods: Prospective study that was performed on 94 infants (6 months old) presented to Al Hussein and Sayed Galal University hospitals. Patients were divided in three groups Group I: 28 exclusively breast-fed infants, Group II: 49 infants on mixed - breast and formula-feeding and Group III: 17 exclusively formula-fed infants. Every infant was followed-up every 2 months along the second half of first year of his life and all changes that take place in all aspects of his health regarding (feeding, growth, fever, cough, diarrhea, vomiting, otitis media, pneumonia, hospital admission) were recorded. And Laboratory investigations CBC, Throat cultures at age 6 mo. were done.
Results: exclusively breast-fed infants had less number of episodes of fever, cough, diarrhea, vomiting, and otitis media than mixed and formula feeding infants. Hemoglobin level at 6 month of artificial fed infants was more than mixed and breast feeding. Pathogenic organisms identified in throat cultures of artificial fed infants were more than that of mixed fed infants.
Conclusion: Exclusive breast-feeding has protective effect against infant illness e.g fever, diarrhea, cough/wheeze, vomiting, otitis media and pneumonia episodes, overweight and underweight.
https://azjp.journals.ekb.eg/article_128348_d794f4ebde01b109b07e7e38ef25e76b.pdf
2020-06-01
1088
1103
10.21608/azjp.2020.128348
Health
throat microflora
feeding
infant
Ahmed Tarek
Abd Elmonem Eltanany
1
AUTHOR
Mahmoud Mohammed
Rashad Elshandidi
2
AUTHOR
Sabry
Mohammed Ghanem
3
AUTHOR
Sawsan Hanem
Mohammed Eltayeb
4
AUTHOR
ORIGINAL_ARTICLE
METABOLIC STATE IN OBESE ASTHMATIC CHILDREN
Background: Childhood asthma and obesity are both major public health concerns worldwide, and the prevalence of both diseases has risen markedly in the last several decades. There is growing evidence of an association between obesity and asthma, both in children and in adults. Abdominal obesity is also strongly associated with a metabolic syndrome (MS) and its components including; obesity, hypertension, dyslipidemia, and hyperglycemic tendencies that is represented at the molecular level by insulin resistance and hyperinsulinism. In some studies using multivariate analysis, insulin resistance accounts for most of the obesity-associated asthma risk. Even maternal overweight seems to increase the risk of childhood asthma in predisposed children, suggesting systemic factors.
Objectives: The aim of the current study is to detect pre-clinical metabolic syndrome among obese asthmatic children & its propable reflection on their asthma protocol of management.
Patients and Methods: The current study is a cross sectional study including 60 asthmatic patients compared to 30 healthy subjects served as control group. The study lasted from December 2018 to September 2019 and took place at Allergy and Pulmonology Unit, Al-Hussein & Sayed Galal Hospitals, Faculty of Medicine, Al-Azhar University.
Results: The mean age of study group was 7.8+2.04 years, 40% males and 60% females and that was compatible in age and gender with control group their mean age was 5.7+1.79, 43.3% males and 56.7% females. Regardless of BMI percentile, children diagnosed with asthma were more likely than children without asthma to have higher SBP, DBP, MAP, HbA1c, and TG (P-value of < 0.001, 0.023, < 0.001, <0.001, <0.001 respectively) & lower HDL (P value of .05).
Overweight/obese children in the Childhood Asthma Management Program showed a decreased response to inhaled budesonide
Conclusion: The emerging interface between asthma and metabolic syndrome (MS) has strong foundations at the research level that gained attention in the last few years.
Keywords: Metabolic State, Obese Asthmatic Children.
https://azjp.journals.ekb.eg/article_128349_d41d8cd98f00b204e9800998ecf8427e.pdf
2020-06-01
1104
1120
10.21608/azjp.2020.128349
Reyadh
Atef El-Gendy
1
AUTHOR
Sameh
Abd El-Aziz Ahmed
2
AUTHOR
Mohammed El-Sayed
Abo Ghabsha
3
AUTHOR
ORIGINAL_ARTICLE
NASAL INTERMITTENT POSITIVE PRESSURE VENTILATION VERSUS NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE FOR PRETERM INFANTS WITH RESPIRATORY DISTRESS SYNDROME
Introduction: Respiratory distress syndrome (RDS) is the most common respiratory morbidity in preterm infants, despite surfactant therapy has become the standard of care in preterm infants with RDS, up to 40% of neonates with RDS may need intubation and mechanical ventilation.
The aim of the work: was to evaluate whether nasal intermittent positive pressure ventilation (NIPPV) is more successful than nasal continuous positive airway pressure (NCPAP) for management of preterm infants with respiratory distress syndrome (RDS) decreasing the requirement for endotracheal ventilation or not, and to compare the related complications and outcomes.
Patients and methods: The present comparative study included Seventy one preterm neonates with RDS delivered and admitted to neonatal intensive care units of Al Hussein University Hospital and Ahmed Maher Teaching Hospital from October 2014 till November 2015. They were selected by simple random method, sixty patients were enrolled in the study & classified into 2 groups, NCPAP group (n=31) and NIPPV group (n=29). Detailed history-taking, thorough examination and laboratory data were obtained.
The results showed: Those 24 (82.8 %) patients showed NIPPV success with 5 (17.2 %) patients needed endotracheal ventilation versus 22 (71 %) patients showed NCPAP success with 9 (29 %) patients needed endotracheal ventilation. Also, 25 (86.2 %) patients survived and 4 (13.7 %) patients expired among the NIPPV group versus 24 (77.4 %) patients survived, and 7 (22.6 %) patients expired among the NCPAP group. NIPPV group showed less duration of O2 need and hospital stay, and lower initial PEEP and FiO2, but no significant differences as regard complications between the 2 groups.
In conclusion: NIPPV is more effective and safer than NCPAP in the initial treatment of RDS.
https://azjp.journals.ekb.eg/article_128350_f856ade5e97aa9d537f915f9f34ce771.pdf
2020-06-01
1121
1138
10.21608/azjp.2020.128350
ORIGINAL_ARTICLE
L-CARNITINE LEVEL IN CHILDREN WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDER
Background: Throughout the past era, numerous studies reported the association between attention deficit hyperactivity disorder (ADHD) and deficiency of magnesium, zinc, selenium, and vitamins A, D, E, B complex, and essential free amino acids. However, the role of carnitine deficiency in the development on ADHD has not been investigated extensively.
Methods: This is a cross-sectional study which involved 2 groups, a case group of 30 patients and a matching control group of 30 subjects. We employed a spectrophotometric enzymatic assay to quantify total-carnitine using Human L-Carnitine ELISA Kit (96 T Unit).
Results: An overall 60 patients who fulfillment the inclusion criteria were included in the study. Patients were furtherly assorted into ADHD (case) group (30 patients) and healthy control group (30 participants). The mean age of the included patients was 7.1296±1.76 and 7.0417±2.05 among the case and control groups, respectively (p=0.19). As for serum carnitine level, there was no statistically significant difference between control and patients as regards serum carnitine (p=0.792). Comparison between serum carnitine and the different clinical subtypes of ADHD indicated non-significant difference between them as regards serum carnitine level (Predominantly Hyperactive: 75.9+19.0; Predominantly inattentive: 62.5+35.96, and Combined ADHD 54.5+25.4, F-ratio=0.827, p>0.05).
Conclusions: It does not seem that carnitine deficiency is an essential cause for development of ADHD symptoms, but its supplementation in ADHD children has clinically proven beneficial effect that may be attributed to one or more of its various functions in the brain.
https://azjp.journals.ekb.eg/article_128351_27a66968337f07ae297c98d09bd1540a.pdf
2020-06-01
1139
1151
10.21608/azjp.2020.128351
ORIGINAL_ARTICLE
INSULIN LIKE GROWTH FACTOR 1 IN CONGENITAL HEART DISEASES
Background: Congenital heart disease (CHD) is the most common cause of major congenital anomalies. Malnutrition is a constant phenomenon among children with congenital heart disease, irrespective of the nature of the cardiac defect and the presence or not of cyanosis. Many factors may influence growth failure in C.H.D. like feeding disorders, inadequate caloric intake and endocrine factors.
Objectives: The aim of this work was to evaluate insulin like growth factor 1 in children with congenital heart diseases as possible cause of growth affection.
Patients and Methods: After obtaining the approval of the Al-Azhar University Ethical Committee, A cross-sectional study was conducted on sixty children (32 males and 28 females). The study was carried out in Al-Azhar University Hospitals (AL- Hussein &Sayed Galal Hospitals), during the period from January 2017 to May 2019. All patients gave their written informed consents prior to their inclusion in the study. Sixty children divided into 3 groups (control, cyanotic & acyanotic). A blood sample was taken from each participant with the aim of assessment of IGF1. Also Echocardiography, Chest x ray, Electrocardiography had done, Anthropometric measures & Oxygen saturation were measured.
Results: we found highly statistical significant (p-value < 0.001) decrease in the level of IGF1 between studied groups. There was no statistical significant difference (p1-value = 0.15) between cyanotic group and acyanotic group. Highly statistical significant difference (p2-value < 0.001) between cyanotic group and control group. Highly statistical significant (p3-value < 0.001) decrease between acyanotic group and control group. Also we found Highly statistical significant difference (p-value < 0.001) between studied groups as regard weight, B.M.I, SD weight for length and height (p-value=0.001).
Conclusion: We determined that IGF1 was low in children with congenital heart diseases. It was lower in malnourished more than well nourished, and was also lower in cyanotic more than acyanotic. As when caloric restriction is present, mammals synthesize less IGF-1 and its synthesis in the liver is refractory to GH stimulation
https://azjp.journals.ekb.eg/article_128352_6e494459e8bae4e43d6e39983de6e407.pdf
2020-06-01
1152
1170
10.21608/azjp.2020.128352
ORIGINAL_ARTICLE
PREVALENCE OF IRON DEFICIENCY ANEMIA AMONG CHILDREN WITH SCHOOL FAILURE AND ITS RELATION TO INTELLIGENCE QUOTIENT
Introduction: An estimated 25% of school-aged children a worldwide is anemic. Iron deficiency is thought to account for about half of the global cases of anemia and is associated with inadequate dietary Recent years have shown a growing interest and concern in many countries about the problem of school failure and the determination of its main contributing factors. This problem is known as the “one hundred factors problem” and a great deal of research has been done on identifying the factors that affect the low performance of students (school failure and dropout) at different educational levels (primary, secondary and higher).
Aim of the study: This study will be designed to evaluate the prevalence of iron deficiency anemia among children with school failure, the relationship between the degree of iron deficiency anemia (IDA) and changes in the level of intelligence quotient (IQ).
Patients and Methods: This study is a prospective study on 100 children aged from 5 to 12 years old during the period from August 2018 – October 2019 and are divided in to two groups group A with IDA and group B without IDA. The patients who will be included in our study as anemic group who have: CBC: Hgb less than 11.5gm% Low MCV, Serum Ferritin: Less than 12ng/ml, and Free Erythrocyte Protoporphyrin: Increase than 23.8mg/dl. Then after confirmation that our patients are iron deficiency anemia the following was done for anemic and non-anemic group. Intelligence quotient: IQ was assessed by Stanford _Binet Intelligence scales.
Before and after treatment, after correction of clinical and lab manifestations.
Statistical analysis: Data were analyzed using Statistical Program for Social Science (SPSS) version 15.0. Quantitative data were expressed as mean ± standard deviation (SD). Qualitative data were expressed as frequency and percentage.
Results: Prevalence of IDA was significantly higher among children with school failure. 68% of the studied group had IDA while the other 32% had no IDA (Mean hematological values of Hb, MCV and serum ferritn; respectively were low and FEP was elevated in anemic children, our results confirmed Free erythrocyte protoporphyrin (FEP) to be the most significant factor for the diagnosis of iron deficiency anemia in children, Our result revealed that there was a significant difference in the level of IQ between anemic and non-anemic group and in our study there was improvement of IQ after treatment with iron).
Conclusion: The study found a positive correlation between IDA and poor school performance, although iron deficiency anemia (IDA) is a high risk factor for school failure but not the only cause in primary school children, free erythrocyte protoporphyrin (FEP) is the most sensitive and specific predictor for diagnosis of iron deficiency anemia in comparison to the other predictors although it is expensive.
Recommendations: Pediatricians and mass media should raise awareness about iron deficiency and its sequelae, also the importance of the presence of the pediatric clinics for those apparently normal children. Screening of iron deficiency anemia in pale children and in poor school performance children to decrease its prevalence and impact on children.
Proper complementary early feeding with iron rich foods to decrease iron deficiency anemia between infants and children.
Treatment of IDA should occur early as possible by dietary improvement or by oral iron supplementation by giving 6mg elemental iron/kg/day divided into 2-3 doses continued for 2-3 month after correction of anemia to replenish body stores.
Adding iron to widespread food as bread may be beneficial for prophylaxis of IDA.
https://azjp.journals.ekb.eg/article_127062_9c9b9ebbf944085904400ddf38a5ea1c.pdf
2020-06-01
1171
1188
10.21608/azjp.2020.127062
Iron Deficiency Anemia (IDA)
School Failure
Intelligence Quotient (IQ)
Hossam Al-Din Mohammed
Hussain El-Shreif
1
AUTHOR
Hatem El-Sayed
Mohamed Abd El-Aziz
2
AUTHOR
Kamel
Soliman Hammad
3
AUTHOR
Al-Hassan
Mostafa Zahran
4
AUTHOR
ORIGINAL_ARTICLE
PROFILE OF PATIENTS VISITING THE PEDIATRIC EMERGENCY SERVICE IN EL-BEHERA HOSPITALS
Background: The emergency department (ED) is an essential component of the medical service offered in any hospital. Yet, the published information about patients profile and utilization of emergency services in both developing and developed countries is scarce. Visits caused by non-serious diseases remain a burden on the emergency department, preventing efficient and effective use of health services and compromising quality.
Aim of work: This study aimed to characterize the profile of patients visiting the emergency service in EL-Behera hospitals, Damanhour Teaching hospital, Central Abo Hommos hospital and General Kafr El-Dawar hospital, describing the epidemiology of patient presentations and outcome in the emergency department.
Patient and methods: This is a cross sectional study reporting the profile of patients visiting the ED for 3 months from January to March, 2019. The emergency departments served children up to the age of 18 years. Patients are first examined by a junior physician on a 24 hours basis. The emergency department offered diagnostic services in the form of basic laboratory tests and imaging as well as brief therapeutic measures. Our data were collected from the emergency department sheet initiated by the first examiner and completed by the emergency department senior. Forms were first checked for adequacy and completeness. The data included the following:
• Demographic characteristics: age / sex and season.
• Clinical history: symptoms / diagnosis and outcome within the first 24hours of presentation.
• Patients with previously diagnosed chronic conditions were noted.
• The outcome including discharge from the emergency department whether discharges on treatment or follow up, referral, hospitals admission, or mortality also is noted.
Our cases were collected by visiting the ED for 2 hours at the morning, 2 hours at the evening and 2 hours at the night. Every visit was once per week for 3 months in the 3 study hospitals. During the time of the visit, the investigator was able to examine the majority of children coming for health service.
Results: The total number of registered ED visits during the study period (3months) at El-Behera hospitals (Damanhour Teaching hospital, Central Abo Hommos hospital and General Kafr El-Dawar hospital) was 130500 patients, the number of registered pediatric ED visits at this period was 29340 patients (22.5%).The sample of our study represented 600 patients by collecting random sample through regular visits to ED. Infants (1month-1year) represented the largest age group (52.5%) and boys represented the majority of cases (51.5%). The main presentation was cough (25%) and respiratory distress (21%), followed by fever (15.5%), diarrhea (11%), wheezy chest (11.5%) and then convulsion (4%). Long term illnesses were predominantly bronchial asthma(9%),hemolytic anemia(1%),congenital heart disease(0.5%),down syndrome(0.5%) and failure to thrive(0.5%). The overall mortality rate was zero.
Conclusion: Infants younger than one year are the largest group attending ED 315(52.5%). The respiratory emergencies are the main cause of attending ED 390(65%). Rural attendees are more than urban 375(62.5%) vs 225(37.5%). Chronic disorder is one of causes attending ED. The rate of hospitalization is low 72(12%). The case fatality rate is zero percent. The most patients attending ED at the evening were 285 (47.5%).
https://azjp.journals.ekb.eg/article_128353_9272c375c76213bd9a57547735d28463.pdf
2020-06-01
1189
1210
10.21608/azjp.2020.128353
ORIGINAL_ARTICLE
EVALUATION OF PULMONARY FUNCTION PARAMETERS USING THE IMPULSE OSCILLOMETRY TECHNIQUE IN WHEEZY CHILDREN
Background: Asthma is the most common chronic disease of childhood and the leading cause of morbidity from chronic illness. The challenge was the difficulty to make diagnosis of asthma in children 5 years and younger.
Objective: To evaluate the results of pulmonary function data by impulse oscillometry in young children with recurrent wheeze, its value to diagnose asthma, and to compare IOS data with result of asthma predictive index in young children.
Methods: A case control study was conducted on 60 children enrolled from the pediatric pulmonology and allergy outpatient clinic of Al-Hussein university hospital. Forty patients (group-1), were subdivided into group A: wheezy with positive Asthma predictive index and group B: wheezy with negative API, and 20 children ( group-2): The patients were presented with recurrent attacks of wheeze suggestive clinically to be asthmatic (GINA,2018). All children were subjected to full history, physical examination, and pulmonary function by Impulse oscillometry (IOS). Absolute eosinophilic count (AEC) for patient group.
Results: This study revealed that the IOS parameters were significantly higher in patients compared to controls including pulmonary resistance (R5); respiratory reactance (X5); small airway resistance (R5-R20); Frequency (Fres) and reactance area (Ax). In patients there were a significant higher values pre than post bronchodilator as regard R5, R5-R20, Fres. and Ax. Also X5 parameter showed a significant change, being more negative pre- than post-bronchodilator, There were significant high values of IOS parameters in patients with positive API compared to those with negative API. There was positive correlation between AEC and IOS parameters post-bronchodilator. Also there was a significant association between asthma control score and asthma control using the reactance area (Ax) < 7 kPa/L.
Conclusion: Our study concluded that: IOS is helpful for diagnosis of asthma in children 5 years and younger, as it is sensitive and specific in identifying children with reversible obstruction. There was positive correlation with IOS parameter and AEC. This study showed usefulness of IOS and API to categorize the severity of the disease, and determination of asthma control using the reactance area (Ax) < 7 kPa/L. that reflects the degree of peripheral small airway obstruction.
https://azjp.journals.ekb.eg/article_128354_72606cdea9e03164c1ce515e176eabe4.pdf
2020-06-01
1211
1226
10.21608/azjp.2020.128354
ORIGINAL_ARTICLE
MISCONCEPTIONS TOWARDS BREASTFEEDING AMONG LACTATING MOTHERS
Background: Scientific research studies conducted during the last three decades have clearly proved that breastfeeding provides the most suitable nutrition for an infant. However in Egypt, BF is inadequately practiced due to prevailing misconceptions and cultural taboos.
Aim of the Work: This study was to assess the socio-cultural beliefs influencing breastfeeding practices among postnatal mothers in urban and rural areas of Cairo and Banha governorates respectively.
Subjects and methods: This descriptive comparative study was conducted in Cairo Governorate (represented by Al Hussein University hospital (AHUH)) as urban residents and Qaliubya Governorate represented by Banha University hospital (BUH)) as rural residents (residents of villages of Banha area), comparing the misbelieves regarding breast feeding among lactating mothers. The study population was 200 lactating healthy mothers whose babies are healthy and who were willing to participate and to come back during the study period.100 of them in Cairo at AHUH and the other 100 in Qaliubya Governorate at BUH. They were enrolled by simple random method from outpatient Pediatrics and BF clinics at AHUH (on Sunday& Wednesday weekly) and BUH (on Saturday & Tuesday weekly) during the period between December 2018 and October 2019.The research design selected for the study is descriptive comparative design. The tool used for data collection was an interview questionnaire written in local language consisting of both open and closed ended items. After obtaining the verbal consent from mothers, the validated interview questionnaire was administered to collect their socio-demographic data and to assess their socio-cultural believes on breastfeeding. The questionnaire was answered by all selected mothers individually without any support from the examiner (pre-intervention stage). Supporting correction for each misconception was declared. By the end of each session, the questionnaire was checked by the BF consultant and the professor of psychiatry who did help in counseling the mothers, and a group discussion was conducted to declare the correct answers (intervention stage). Same mothers were asked to come back after two months to assess the effect of correcting their misbelieves towards BF that influenced their knowledge, attitude and practice regarding BF by answering the same questionnaire (post-intervention stage).
Results: Total breast feeding score was improved from 57.5 in pre intervention to 76.1 in post intervention stage in rural areas, and improved from 65.6 to 76.4 in urban areas.
Conclusion: It is evident that counseling on BF is not given its importance as part of antenatal visits; Breastfeeding clinic is not a routine outpatient clinic and no mother support groups to support lactating mothers after discharge.
Recommendations: All ante-natal women should be informed about the benefits and management of BF. Health care providers also need education training on BF support and management, including pediatricians. Obstetricians should be trained well to assure fruitful antenatal education for pregnant women to practice successful BF. All post-natal mothers should be counseled based on their answers and given advice regarding BF. More support to BF outpatient clinic. Both AHUH and BUH should establish and encourage these mother support groups.
https://azjp.journals.ekb.eg/article_128355_1e900c8cf9feeb52fc58ae1d6d16148f.pdf
2020-06-01
1227
1245
10.21608/azjp.2020.128355