R. Bhowmick, Divyangi Mishra, P. Kommu, Antonieo Jude Balraj
In children, acute viral hepatitis-A infection is usually a self-limiting illness. In most children, it resolves uneventfully within weeks from the onset of disease. However, rare presentations like acute acalculous cholecystitis and persistent cholestatic jaundice have been reported. We report on a 7-year-old boy with prolonged cholestatic jaundice, which resolved without steroid treatment.
{"title":"Spontaneous resolution of prolonged cholestatic jaundice following hepatitis: an infection in a child","authors":"R. Bhowmick, Divyangi Mishra, P. Kommu, Antonieo Jude Balraj","doi":"10.4103/ajop.ajop_23_21","DOIUrl":"https://doi.org/10.4103/ajop.ajop_23_21","url":null,"abstract":"In children, acute viral hepatitis-A infection is usually a self-limiting illness. In most children, it resolves uneventfully within weeks from the onset of disease. However, rare presentations like acute acalculous cholecystitis and persistent cholestatic jaundice have been reported. We report on a 7-year-old boy with prolonged cholestatic jaundice, which resolved without steroid treatment.","PeriodicalId":7866,"journal":{"name":"Alexandria Journal of Pediatrics","volume":"11 1","pages":"190 - 192"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74118782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Iloh, O. Chidiebere, O. Iloh, O. Igbokwe, E. Nwaneli, Uzoamaka C. Akubuilo
Background The intelligence quotient of a child is determined to a large extent by genetic factors. However, the social context in which a child is brought up also plays a significant role in the overall cognitive capabilities of the child. Patients and methods This cross-sectional descriptive study enrolled 1122 school-aged children between the ages 6 and 12 years in the Enugu-East local government area of Enugu State over a 3-month period using the multistage sampling method. Raven’s Standardized Progressive Matrices and the Draw-A-Person Test (DAPT) were used to assess the intelligence quotient of the study participants. It aimed to assess the relatability of the two intelligent quotient (IQ) assessment system and sociodemographic determinants of IQ in school pupils. Results With the Raven system of IQ assessment, 73 pupils (7.6%) were noted to be above average intelligence, 150 (15.7%) had above average intelligence, 293 (30.6%) were considered to have average intelligence, while 340 (35.5%) and 101 (10.6%) were below average and intellectually defective, while the DAPT system categorized 258 of the pupils surveyed (27%) as having above average intelligence, 593 (62%) were considered to have average intelligence, while 82 (8.6%) and 24 (2.4%) were considered mentally deficient, respectively. Both scoring systems showed slight agreement with an interagreement reliability coefficient (қ) of 0.093 [95% confidence interval (CI) 0.001–0.003]. Pupils’ socioeconomic class [odds ratio (OR) 1.82 (95% CI 1.21–2.73), P=0.004], maternal educational [OR 0.38 (95% CI 0.23–0.63) P=0.001], and school type [OR 2.23 (95% CI 1.45–3.43) P=0.001] significantly predicted suboptimal IQ in study participants under the Raven assessment system. Conclusion Our study identified poor interrater agreement between the Raven and DAPT IQ assessment systems and factors that correlate with suboptimal IQ under the Raven system of IQ assessment.
儿童的智商在很大程度上取决于遗传因素。然而，孩子成长的社会环境对孩子的整体认知能力也起着重要的作用。患者和方法本横断面描述性研究采用多阶段抽样方法，在埃努古州埃努古-东地方政府地区招募了1122名6至12岁的学龄儿童，为期3个月。采用瑞文标准递进矩阵和画人测验(DAPT)来评估研究参与者的智商。本研究旨在评估两种智商评估系统与小学生智商的社会人口学决定因素的相关性。结果采用Raven智商评价体系，智力超常者73人(7.6%)，智力超常者150人(15.7%)，智力超常者293人(30.6%)，智力超常者340人(35.5%)，智力超常者101人(10.6%);采用DAPT智商评价体系，智力超常者258人(27%)，智力超常者593人(62%);而有82人(8.6%)和24人(2.4%)被认为有智力缺陷。两个评分系统显示出轻微的一致性，一致性间信度系数()为0.093[95%置信区间(CI) 0.001-0.003]。在Raven评估系统下，学生的社会经济阶层[比值比(OR) 1.82 (95% CI 1.21-2.73)， P=0.004]、母亲受教育程度[OR 0.38 (95% CI 0.23-0.63) P=0.001]和学校类型[OR 2.23 (95% CI 1.45-3.43) P=0.001]显著预测了研究参与者的次优智商。结论本研究发现了Raven和DAPT智商评估体系之间较差的解释一致性，以及在Raven智商评估体系下与次优智商相关的因素。
{"title":"Intelligence quotient and its determinants using Draw-A-Person Test and Ravens progressive matrices among primary school children in Enugu, Southeast Nigeria","authors":"K. Iloh, O. Chidiebere, O. Iloh, O. Igbokwe, E. Nwaneli, Uzoamaka C. Akubuilo","doi":"10.4103/ajop.ajop_24_21","DOIUrl":"https://doi.org/10.4103/ajop.ajop_24_21","url":null,"abstract":"Background The intelligence quotient of a child is determined to a large extent by genetic factors. However, the social context in which a child is brought up also plays a significant role in the overall cognitive capabilities of the child. Patients and methods This cross-sectional descriptive study enrolled 1122 school-aged children between the ages 6 and 12 years in the Enugu-East local government area of Enugu State over a 3-month period using the multistage sampling method. Raven’s Standardized Progressive Matrices and the Draw-A-Person Test (DAPT) were used to assess the intelligence quotient of the study participants. It aimed to assess the relatability of the two intelligent quotient (IQ) assessment system and sociodemographic determinants of IQ in school pupils. Results With the Raven system of IQ assessment, 73 pupils (7.6%) were noted to be above average intelligence, 150 (15.7%) had above average intelligence, 293 (30.6%) were considered to have average intelligence, while 340 (35.5%) and 101 (10.6%) were below average and intellectually defective, while the DAPT system categorized 258 of the pupils surveyed (27%) as having above average intelligence, 593 (62%) were considered to have average intelligence, while 82 (8.6%) and 24 (2.4%) were considered mentally deficient, respectively. Both scoring systems showed slight agreement with an interagreement reliability coefficient (қ) of 0.093 [95% confidence interval (CI) 0.001–0.003]. Pupils’ socioeconomic class [odds ratio (OR) 1.82 (95% CI 1.21–2.73), P=0.004], maternal educational [OR 0.38 (95% CI 0.23–0.63) P=0.001], and school type [OR 2.23 (95% CI 1.45–3.43) P=0.001] significantly predicted suboptimal IQ in study participants under the Raven assessment system. Conclusion Our study identified poor interrater agreement between the Raven and DAPT IQ assessment systems and factors that correlate with suboptimal IQ under the Raven system of IQ assessment.","PeriodicalId":7866,"journal":{"name":"Alexandria Journal of Pediatrics","volume":"67 1","pages":"149 - 156"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82240762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Adebiyi, B. Kuti, A. Adegbola, C. Onuchukwu, Oyeku Oyelami
Background Exclusive breastfeeding is highly recommended in early infancy; however, there are concerns about breast milk meeting the vitamin D requirements of infants during this period. Objective This study aimed to determine the serum 25-hydroxyvitamin D (25-OHD) level of lactating mothers and their healthy exclusively breastfeeding young infants, and to ascertain the predictors of deficient 25-OHD (<20 ng/ml) in these infants in a tropical setting. Participants and methods Mother–infant pairs at the Federal Medical Centre, Keffi North Central Nigeria, were consecutively recruited over a 7-month period. The study participants were characterized and their serum 25-OHD was assayed using the chromatography method. Results A total of 111 mother–infant pairs were recruited. The mean (SD) infant age was 3.0 (1.4) months, while the mean (SD) maternal age was 27.5 (5.1) years, with 3.6% being teenagers. The mean (SD) 25-OHD of infants and mothers were 39.7 (25.7) and 33.9 (20.4) ng/ml, respectively. Twenty-six (23.4%) infants and 33 (30.6%) mothers had deficient 25-OHD. Low birth weight and underweight infants, as well as inadequate maternal diet and maternal 25-OHD deficiency were associated with deficient 25-OHD status in infants. Only inadequate maternal diet (odd ratio=3.529; 95% confidence interval=1.100–11.168; P=0.033) and maternal vitamin D deficiency (odd ratio=10.168; 95% confidence interval=3.455–29.920; P=0.001) independently predicted deficient 25-OHD levels in the infants. Conclusion About one of every five exclusively breastfeeding recruited infants had deficient 25-OHD levels and this is associated with modifiable factors. Maternal intake of vitamin D-rich food and vitamin D supplementation may be necessary to meet the vitamin D requirements of these mother–infant pairs.
{"title":"Sociodemographic and perinatal factors associated with vitamin D deficiency in exclusively breastfeeding infants in North Central Nigeria","authors":"L. Adebiyi, B. Kuti, A. Adegbola, C. Onuchukwu, Oyeku Oyelami","doi":"10.4103/ajop.ajop_18_21","DOIUrl":"https://doi.org/10.4103/ajop.ajop_18_21","url":null,"abstract":"Background Exclusive breastfeeding is highly recommended in early infancy; however, there are concerns about breast milk meeting the vitamin D requirements of infants during this period. Objective This study aimed to determine the serum 25-hydroxyvitamin D (25-OHD) level of lactating mothers and their healthy exclusively breastfeeding young infants, and to ascertain the predictors of deficient 25-OHD (<20 ng/ml) in these infants in a tropical setting. Participants and methods Mother–infant pairs at the Federal Medical Centre, Keffi North Central Nigeria, were consecutively recruited over a 7-month period. The study participants were characterized and their serum 25-OHD was assayed using the chromatography method. Results A total of 111 mother–infant pairs were recruited. The mean (SD) infant age was 3.0 (1.4) months, while the mean (SD) maternal age was 27.5 (5.1) years, with 3.6% being teenagers. The mean (SD) 25-OHD of infants and mothers were 39.7 (25.7) and 33.9 (20.4) ng/ml, respectively. Twenty-six (23.4%) infants and 33 (30.6%) mothers had deficient 25-OHD. Low birth weight and underweight infants, as well as inadequate maternal diet and maternal 25-OHD deficiency were associated with deficient 25-OHD status in infants. Only inadequate maternal diet (odd ratio=3.529; 95% confidence interval=1.100–11.168; P=0.033) and maternal vitamin D deficiency (odd ratio=10.168; 95% confidence interval=3.455–29.920; P=0.001) independently predicted deficient 25-OHD levels in the infants. Conclusion About one of every five exclusively breastfeeding recruited infants had deficient 25-OHD levels and this is associated with modifiable factors. Maternal intake of vitamin D-rich food and vitamin D supplementation may be necessary to meet the vitamin D requirements of these mother–infant pairs.","PeriodicalId":7866,"journal":{"name":"Alexandria Journal of Pediatrics","volume":"63 Suppl 1 1","pages":"101 - 109"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88061163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Monem, Moftah Hamid, Hala Abdel-Aal, S. Soliman
Background Renal function − as many other organ functions − is immature in the early neonatal period. Aim A prospective study was carried out that aimed at determining serum creatinine and glomerular filtration rate (GFR) in apparently healthy full-term newborns (NBs) on the first and seventh days of postnatal life. Participants and methods This study included 50 apparently healthy full-term neonates born to healthy mothers at Damanhour Medical Institute in AL-Behera governorate. Half of the neonates were males; 27 babies were delivered vaginally and the remaining by cesarian section. All NBs were subjected to a full assessment of history and clinical examination. Complete blood count, C-reactive protein, alanine transaminase, aspartate transaminase, and abdominal ultrasound were performed for all NBs. Serum creatinine and GFR were estimated on the first and seventh days of life. Maternal serum creatinine was determined for all mothers on day 1. Results Serum creatinine showed a significant decrease on the seventh day. GFR was significantly increased by the seventh day of life. NBs’ serum creatinine showed a negative correlation with the postnatal age, while GFR showed a positive correlation.
{"title":"Glomerular filtration rate changes in the first week of healthy full-term newborns","authors":"A. Monem, Moftah Hamid, Hala Abdel-Aal, S. Soliman","doi":"10.4103/ajop.ajop_28_21","DOIUrl":"https://doi.org/10.4103/ajop.ajop_28_21","url":null,"abstract":"Background Renal function − as many other organ functions − is immature in the early neonatal period. Aim A prospective study was carried out that aimed at determining serum creatinine and glomerular filtration rate (GFR) in apparently healthy full-term newborns (NBs) on the first and seventh days of postnatal life. Participants and methods This study included 50 apparently healthy full-term neonates born to healthy mothers at Damanhour Medical Institute in AL-Behera governorate. Half of the neonates were males; 27 babies were delivered vaginally and the remaining by cesarian section. All NBs were subjected to a full assessment of history and clinical examination. Complete blood count, C-reactive protein, alanine transaminase, aspartate transaminase, and abdominal ultrasound were performed for all NBs. Serum creatinine and GFR were estimated on the first and seventh days of life. Maternal serum creatinine was determined for all mothers on day 1. Results Serum creatinine showed a significant decrease on the seventh day. GFR was significantly increased by the seventh day of life. NBs’ serum creatinine showed a negative correlation with the postnatal age, while GFR showed a positive correlation.","PeriodicalId":7866,"journal":{"name":"Alexandria Journal of Pediatrics","volume":"61 1","pages":"125 - 129"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81437940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Childhood myasthenia gravis (CMG) is MG occurring in childhood or adolescence (i.e. Aim The aim of the work was to identify different clinical presentations and classifications of CMG, current diagnostic modalities, treatment strategies, and outcome to provide a profile of CMG among a cohort of Egyptian children attending Alexandria University Children’s Hospital as a tertiary pediatric center. Patients and methods All children diagnosed as having CMG who attended Pediatric Neurology Clinic at Alexandria University Children’s Hospital from January 1, 2010 to December 31, 2019 were included. A questionnaire for parents or caregivers including demographic data was administered. Clinical examination, clinical scoring system for MG, MG Foundation of America (MGFA) clinical classification system, electrophysiological studies, laboratory investigations, and clinic records review were done. Results Male : female ratio was 1 : 2.75. Mean age at start of symptoms was 4.97±3.78 years. Ptosis was presented in all (100%) patients, swallowing difficulty and choking in 40% of the patients, generalized weakness in 40% of the patients, and slurred speech and nasal tone in 33.3% of the patients. Overall, 46.7% of the patients were classified as pure ocular myasthenia gravis (MGFA class I), 20.0% as MGFA class II (mild generalized), 26.7% as MGFA class III (moderate generalized), and 6.7% as MGFA class IV (severe generalized). Pyridostigmine was used by 100% of the patients, prednisolone by 60% of the patients, and azathioprine by four (26.7%) patients. Pyridostigmine was the commonest single drug used by 40% of the patients. The common combinations were pyridostigmine with prednisolone alone or with added azathioprine. The comparison between the MG-Activities of Daily Living scale profile scores in first and last visits for patients was statistically significant. There was a significant improvement in the class of diseases, with remission in 70% of the patients. Failure rate of management was found in 20% of the patients. Conclusion Ocular myasthenia gravis was the most common subclass of CMG; ptosis was the most common presenting symptom. All patients received pyridostigmine as the first-line treatment. Remission occurred in 70% of the patients.
背景:儿童期重症肌无力(CMG)是发生在儿童期或青少年期的重症肌无力。本研究的目的是确定CMG的不同临床表现和分类、目前的诊断方式、治疗策略和结果，以提供一组在亚历山大大学儿童医院作为三级儿科中心就诊的埃及儿童的CMG概况。患者和方法纳入2010年1月1日至2019年12月31日在亚历山大大学儿童医院儿科神经病学诊所就诊的所有诊断为CMG的儿童。对父母或照顾者进行问卷调查，包括人口统计数据。临床检查、MG临床评分系统、美国MG基金会(MGFA)临床分类系统、电生理检查、实验室检查和临床记录复习。结果男女比例为1:2 .75。出现症状的平均年龄为4.97±3.78岁。所有患者(100%)均出现上睑下垂，40%的患者出现吞咽困难和窒息，40%的患者出现全身无力，33.3%的患者出现言语不清和鼻音。总体而言，46.7%的患者被归类为纯眼重症肌无力(MGFA I级)，20.0%的患者被归类为MGFA II级(轻度全身性)，26.7%的患者被归类为MGFA III级(中度全身性)，6.7%的患者被归类为MGFA IV级(重度全身性)。100%的患者使用吡哆斯的明，60%的患者使用强的松龙，4例(26.7%)患者使用硫唑嘌呤。40%的患者使用吡哆斯的明是最常见的单一药物。常见的联合用药是吡哆斯的明单独与强的松龙或加用硫唑嘌呤。患者初访和末访MG-Activities of Daily Living scale profile得分比较有统计学意义。这类疾病有了显著的改善，70%的患者得到了缓解。治疗失败率为20%。结论眼部重症肌无力是CMG最常见的亚型;上睑下垂是最常见的症状。所有患者均以吡哆斯的明作为一线治疗。70%的患者出现缓解。
{"title":"Childhood myasthenia gravis − clinical characteristics, diagnostic modalities, treatment strategies, and outcome: a single tertiary hospital study","authors":"Elham E. Elsakka, Mohamed H Elmekky, T. Omar","doi":"10.4103/ajop.ajop_15_21","DOIUrl":"https://doi.org/10.4103/ajop.ajop_15_21","url":null,"abstract":"Background Childhood myasthenia gravis (CMG) is MG occurring in childhood or adolescence (i.e. Aim The aim of the work was to identify different clinical presentations and classifications of CMG, current diagnostic modalities, treatment strategies, and outcome to provide a profile of CMG among a cohort of Egyptian children attending Alexandria University Children’s Hospital as a tertiary pediatric center. Patients and methods All children diagnosed as having CMG who attended Pediatric Neurology Clinic at Alexandria University Children’s Hospital from January 1, 2010 to December 31, 2019 were included. A questionnaire for parents or caregivers including demographic data was administered. Clinical examination, clinical scoring system for MG, MG Foundation of America (MGFA) clinical classification system, electrophysiological studies, laboratory investigations, and clinic records review were done. Results Male : female ratio was 1 : 2.75. Mean age at start of symptoms was 4.97±3.78 years. Ptosis was presented in all (100%) patients, swallowing difficulty and choking in 40% of the patients, generalized weakness in 40% of the patients, and slurred speech and nasal tone in 33.3% of the patients. Overall, 46.7% of the patients were classified as pure ocular myasthenia gravis (MGFA class I), 20.0% as MGFA class II (mild generalized), 26.7% as MGFA class III (moderate generalized), and 6.7% as MGFA class IV (severe generalized). Pyridostigmine was used by 100% of the patients, prednisolone by 60% of the patients, and azathioprine by four (26.7%) patients. Pyridostigmine was the commonest single drug used by 40% of the patients. The common combinations were pyridostigmine with prednisolone alone or with added azathioprine. The comparison between the MG-Activities of Daily Living scale profile scores in first and last visits for patients was statistically significant. There was a significant improvement in the class of diseases, with remission in 70% of the patients. Failure rate of management was found in 20% of the patients. Conclusion Ocular myasthenia gravis was the most common subclass of CMG; ptosis was the most common presenting symptom. All patients received pyridostigmine as the first-line treatment. Remission occurred in 70% of the patients.","PeriodicalId":7866,"journal":{"name":"Alexandria Journal of Pediatrics","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91032012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. A. Mohamed, A. Mansour, N. Abousamra, Gehan A Elswaah, E. Ahmed
Background Pulmonary affection in patients with thalassemia major (TM) is well established; however, a special pattern of disease has not yet been observed. Suggestions in preference of the role for transforming growth factor-β1 (TGF-β) superfamily members in the pathogenesis of airway obstructive diseases has arisen from previous genetic studies. Objectives We aimed to assess TGF-β1 serum level in the blood and its relation to pulmonary affection in children with TM. Patients and methods A total of 40 patients with β-TM were included, who were compared with 40 age-matched and sex-matched normal children as a control group. Cases were subjected to clinical assessment for anthropometric measurements and respiratory examination, spirometry, and chest radiograph, whereas serum TGF-β1 was assessed in cases and control using a TGF-β1 capture enzyme-linked immunosorbent assay. Results Different patterns of pulmonary dysfunction in spirometry were found: 12 (30%) patients had obstructive pattern, seven (17.5%) patients had restrictive pattern, nine (22.5%) patients had mixed pattern, whereas 12 (30%) patients had normal pulmonary function. Moreover, a significant negative correlation between serum TGF-β1 and both forced expiratory volume in 1 s (r: −0.317, P Conclusion Inflammatory markers such as serum TGF-β1 may play a role in pulmonary affection in patients with thalassemia, either obstructive or restrictive pattern. There is a potential role of excess ferritin deposited in the airways, resulting in obstructive pulmonary pattern in pulmonary function tests.
{"title":"Pulmonary affection and serum transforming growth factor-β1 among Egyptian children with thalassemia major","authors":"H. A. Mohamed, A. Mansour, N. Abousamra, Gehan A Elswaah, E. Ahmed","doi":"10.4103/ajop.ajop_4_21","DOIUrl":"https://doi.org/10.4103/ajop.ajop_4_21","url":null,"abstract":"Background Pulmonary affection in patients with thalassemia major (TM) is well established; however, a special pattern of disease has not yet been observed. Suggestions in preference of the role for transforming growth factor-β1 (TGF-β) superfamily members in the pathogenesis of airway obstructive diseases has arisen from previous genetic studies. Objectives We aimed to assess TGF-β1 serum level in the blood and its relation to pulmonary affection in children with TM. Patients and methods A total of 40 patients with β-TM were included, who were compared with 40 age-matched and sex-matched normal children as a control group. Cases were subjected to clinical assessment for anthropometric measurements and respiratory examination, spirometry, and chest radiograph, whereas serum TGF-β1 was assessed in cases and control using a TGF-β1 capture enzyme-linked immunosorbent assay. Results Different patterns of pulmonary dysfunction in spirometry were found: 12 (30%) patients had obstructive pattern, seven (17.5%) patients had restrictive pattern, nine (22.5%) patients had mixed pattern, whereas 12 (30%) patients had normal pulmonary function. Moreover, a significant negative correlation between serum TGF-β1 and both forced expiratory volume in 1 s (r: −0.317, P Conclusion Inflammatory markers such as serum TGF-β1 may play a role in pulmonary affection in patients with thalassemia, either obstructive or restrictive pattern. There is a potential role of excess ferritin deposited in the airways, resulting in obstructive pulmonary pattern in pulmonary function tests.","PeriodicalId":7866,"journal":{"name":"Alexandria Journal of Pediatrics","volume":"154 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78790449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Thalassemia is a genetic disorder of hemoglobin synthesis. Beta-thalassemia is particularly prevalent among Mediterranean people. Long-term transfusion therapy and iron chelating agents are the mainstay treatments of thalassemia patients. Aim The aim of this study was to identify the demographic, clinical, laboratory profile, and therapeutic features of B-thalassemia patients attending the Pediatric Hematology Clinic at Damanhour Medical Institute. Patients and methods This study included 74 thalassemia patients in the age range of 2–16 years, mostly from rural areas (el Behera Governorate). The total number of thalassemia patients followed up in the Pediatric Hematology Unit at Damanhour Medical Institute is up to 400 cases; the patients of this study were selected randomly from among them. Results Dysmorphic features were demonstrated in 44% of cases; 74% of cases were receiving packed red blood cells every month and 26% were receiving packed red blood cells more than once a month. Oral iron chelator (Deferasirox) was the main chelator used. Most of the patients had serum ferritin greater than 1000 µg/ml; thyroid dysfunction was evident in 21% of cases, with no definite clinical manifestations.
{"title":"Descriptive clinical study of children with beta-thalassemia at Damanhour Medical National Institute","authors":"A. Monem, S. Shehata, Madiha Elsayed, A. Ayad","doi":"10.4103/ajop.ajop_13_21","DOIUrl":"https://doi.org/10.4103/ajop.ajop_13_21","url":null,"abstract":"Background Thalassemia is a genetic disorder of hemoglobin synthesis. Beta-thalassemia is particularly prevalent among Mediterranean people. Long-term transfusion therapy and iron chelating agents are the mainstay treatments of thalassemia patients. Aim The aim of this study was to identify the demographic, clinical, laboratory profile, and therapeutic features of B-thalassemia patients attending the Pediatric Hematology Clinic at Damanhour Medical Institute. Patients and methods This study included 74 thalassemia patients in the age range of 2–16 years, mostly from rural areas (el Behera Governorate). The total number of thalassemia patients followed up in the Pediatric Hematology Unit at Damanhour Medical Institute is up to 400 cases; the patients of this study were selected randomly from among them. Results Dysmorphic features were demonstrated in 44% of cases; 74% of cases were receiving packed red blood cells every month and 26% were receiving packed red blood cells more than once a month. Oral iron chelator (Deferasirox) was the main chelator used. Most of the patients had serum ferritin greater than 1000 µg/ml; thyroid dysfunction was evident in 21% of cases, with no definite clinical manifestations.","PeriodicalId":7866,"journal":{"name":"Alexandria Journal of Pediatrics","volume":"209 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73224261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Data from published epidemiological and virology studies around the world provide evidence that coronavirus disease 2019 (COVID-19) has a lower incidence rate in children compared with adults. COVID-19 infection typical presentations include respiratory symptoms, such as cough, respiratory distress and hypoxia, fever, and dyspnea, which are considered the main symptoms of this novel disease in adults, but atypical presentations, especially in children, could be a diagnostic challenge. We report a child whose initial presentation was gastrointestinal, and in whom COVID-19 infection was confirmed, concluding that cases of mesenteric adenitis may be confusing and may mask this virus infections, and they should therefore be investigated in this respect. Earlier studies reported 15–16% of COVID-19-infected patients presented with gastrointestinal symptoms such asloss of appetite, nausea, vomiting,abdominal pain, diarrhea, and variable liver injury. Gastrointestinal symptoms may be associated with respiratory symptoms or without it. There are very few studies on COVID-19 infection in children, and there are uncertainties in the published papers. Thisarticle isabout a 5-year-old COVID-19-infected girl who presented with acute abdomen owing to mesenteric adenitis.
{"title":"Coronavirus disease 2019 infection presenting as acute abdomen: a case report","authors":"Parastoo Sharifi, M. Moghtaderi","doi":"10.4103/ajop.ajop_35_20","DOIUrl":"https://doi.org/10.4103/ajop.ajop_35_20","url":null,"abstract":"Data from published epidemiological and virology studies around the world provide evidence that coronavirus disease 2019 (COVID-19) has a lower incidence rate in children compared with adults. COVID-19 infection typical presentations include respiratory symptoms, such as cough, respiratory distress and hypoxia, fever, and dyspnea, which are considered the main symptoms of this novel disease in adults, but atypical presentations, especially in children, could be a diagnostic challenge. We report a child whose initial presentation was gastrointestinal, and in whom COVID-19 infection was confirmed, concluding that cases of mesenteric adenitis may be confusing and may mask this virus infections, and they should therefore be investigated in this respect. Earlier studies reported 15–16% of COVID-19-infected patients presented with gastrointestinal symptoms such asloss of appetite, nausea, vomiting,abdominal pain, diarrhea, and variable liver injury. Gastrointestinal symptoms may be associated with respiratory symptoms or without it. There are very few studies on COVID-19 infection in children, and there are uncertainties in the published papers. Thisarticle isabout a 5-year-old COVID-19-infected girl who presented with acute abdomen owing to mesenteric adenitis.","PeriodicalId":7866,"journal":{"name":"Alexandria Journal of Pediatrics","volume":"216 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77070069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim To evaluate the risk factors that contribute to the development of ventilator-associated pneumonia (VAP) in children. Settings and design A prospective observational study was conducted. The study was done in pediatric intensive care unit (PICU) at Mansoura University Children’s Hospital, Egypt, over 1 year. The study included 154 patients. Patients and methods Many variables were analyzed such as demographic characteristics; previous hospital and PICU admission; drugs used such as inotropes, steroids, sedatives, H2 blockers, or proton pump inhibitors; nutritional therapies; chronic illnesses; invasive procedures such as central line insertion; duration of mechanical ventilation (MV); and PICU stay before development of VAP. Statistical analysis used All patients were assessed by Pediatric Risk of Mortality Score III in the first 24 h and evaluated for VAP by daily clinical examination and by radiological and laboratory evaluation. Results Duration of MV and PICU stay (before development of VAP) markedly increased the incidence of VAP (P value for both was Conclusions Use of steroids and sedatives, prolonged MV, and length of PICU stay are the main risk factors that contribute toward the increased risk of VAP development in Mansoura University Children’s Hospital intensive care.
{"title":"Risk factors of ventilator-associated pneumonia in children in an Egyptian University Children’s Hospital: a prospective study","authors":"A. Noaman","doi":"10.4103/ajop.ajop_3_21","DOIUrl":"https://doi.org/10.4103/ajop.ajop_3_21","url":null,"abstract":"Aim To evaluate the risk factors that contribute to the development of ventilator-associated pneumonia (VAP) in children. Settings and design A prospective observational study was conducted. The study was done in pediatric intensive care unit (PICU) at Mansoura University Children’s Hospital, Egypt, over 1 year. The study included 154 patients. Patients and methods Many variables were analyzed such as demographic characteristics; previous hospital and PICU admission; drugs used such as inotropes, steroids, sedatives, H2 blockers, or proton pump inhibitors; nutritional therapies; chronic illnesses; invasive procedures such as central line insertion; duration of mechanical ventilation (MV); and PICU stay before development of VAP. Statistical analysis used All patients were assessed by Pediatric Risk of Mortality Score III in the first 24 h and evaluated for VAP by daily clinical examination and by radiological and laboratory evaluation. Results Duration of MV and PICU stay (before development of VAP) markedly increased the incidence of VAP (P value for both was Conclusions Use of steroids and sedatives, prolonged MV, and length of PICU stay are the main risk factors that contribute toward the increased risk of VAP development in Mansoura University Children’s Hospital intensive care.","PeriodicalId":7866,"journal":{"name":"Alexandria Journal of Pediatrics","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80024337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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