Medical errors in neonatal intensive care unit at Benha University Hospital, Egypt

This study was conducted in the neonatal intensive care unit of Benha University Hospital, Egypt from 1 August 2012 to the 31 January 2013 to identify medical errors and to determine the risk factors and consequences of these errors. Errors were detected by follow-up of neonates and review of reports including nursing follow-up sheets, resident progression notes and investigation reports. We detected 3819 errors that affected 97% of neonates. Types of errors included 403 medication errors [10.55% of total errors], 652 errors in daily routine procedures [17.07%], 1042 errors in invasive procedures [27.28%], 68 errors in nutrition [1.78%], 63 equipment errors [1.64%], 260 administration errors [6.8%], 656 staffing errors [17.18%], 107 environmental errors [2.8%], 448 infection control errors [11.73%] and 120 nosocomial infection errors [3.14%]. Medical errors were high in low birth weight, low gestational age neonates and increased with duration of admission

Serum sialic acid concentration in children and adolescence with insulin dependent diabetes mellitus [IDDM]

It is well established that total serum sialic acid [TSA], a potent cardiovascular risk factor, is elevated in patients with type 2 diabetes mellitus [NIDDM] compared to non diabetics. However, it is not clear whether TSA is elevated in type I diabetic patients [IDDM]. The study included 32 children and adolescence with insulin dependent diabetes mellitus [IDDM], 19 males and 13 females, their ages were 14.8 +/- 2.7 years [8-19 years] with a diabetes duration of 7.3 +/- 2.9 years [3-12 years]. A group of 15 age and sex matched controls were studied, 9 males and 6 females, their ages were 14.5 +/- 2.5 years [9-18 years]. Fasting blood samples were taken for assessment of fasting blood glucose, glycated haemoglobin [HBAIc], serum cholesterol, serum creatinine and serum sialic acid, as was a first morning urine sample for assessment of microalbuminuria. Fasting blood glucose and serum sialic acid were estimated in the control group. Serum sialic acid was significantly elevated in diabetic patients compared to controls [91.8 +/- 27.6 mg/dl v.s 70.3-7 mg dl, P < 0.001]. 9 out of 32 diabetic patients had microalbuminuria, their serum sialic acid was significantly elevated compared to normoalbumi nuric diabetics [193.1 +/- 37.1 mg/dl v.s 81 +/- 11.9 mg/dl, P = 0.002]. Serum sialic acid correlated significantly with HBA1c [r = 0.49, P = 0.004] and serum cholesterol [r = 0.50, P = 0.003]. A weak correlation existed be tween serum sialic acid and fasting blood glucose [r = 0.36, P = 0.039], serum creatinine [r = 0.42, P = 0.016] and age [r = 0.44, P = 0.010]. In a multiple regression analysis including fasting blood glucose, HBAIc, creatinirte, cholesterol, age, diabetes duration, systolic and diastolic blood pressure and microalbuminuria, it was found that microalbuminuria was the only variable which affected the levels of sialic acid. It is concluded that serum sialic acid is elevated in IDDM patients and is further increased in diabetic patients with microalbuminuria. Whether serum sialic acid is predictive for early nephropathy and cardiovascular disease in IDDM has to be shown in the future

Evaluation of lead level in breast milk and fresh milk and its effect on blood lead level in infants

[III] infants attending Benha Teaching Hospital aged less than 6 months were subjected to this study. They were classified into 51 infants exclusively fed and 60 infants fed on animal fresh milk. All infants were subjected to good history taking, complete clinical examination and blood lead determination. Also we evaluated the blood lead level for the mothers breast fed infants. Infants of the two groups were matched thoroughly for age, sex and residence either rural of urban.Lead levels in maternal blood, breast milk and infants blood in rural areas were 21.13, 2.18, 14.21 ug/dl respectively in comparison to 25.63, 2.73, 18.86 ug/dl respectively in urban population with very highly significant difference. Lead level of fresh cow's milk was 3.03 ug/dl and that of buffalo's milk was 3.02 ug/dl and this difference was not significant and both values were higher than lead level of breast milk of rural [2.18 ug/dl] and urban [2.73 ug/dl] mothers. Blood lead level of urban artificially fed infants [19.13 ug/dl] was higher than that of the rural artificially fed infants [16.95 ug/dl] with significant difference and both were higher than lead level of breast fed babies [14.21 ug/dl rural and 18.86 ug/dl urban]. Blood lead level was significantly increasing with pollution and urbanization