Reversibility of mitral regurgitation following rheumatic fever: clinical profile and echocardiographic evaluation

The clinical disappearance of the murmur of rheumatic mitral regurgitation after a period of time has been documented by many researchers. However no studies have related the disappearance of the murmur with the functional or anatomical state of the mitral valve. This study was done to elucidate the mitral valve status using Doppler and color coded echocardiography among those children who have lost their apical pansystolic murmur on auscultation following.a documented attack of rheumatic fever. The study sample consisted of 51 patients including 31 patients in whom the murmur has disappeared [group I], and 20.patients with persistent isolated isolated mitral regurgitation [group II]. Patients of group I had significantly lower grades of murmur intensity, lower incidence of cardiomegaly, and had no heart failure in the initial attack. They were compliant with prophylaxis and had less recurrences than patients of group II. The murmur disappeared in patients of group I from ' to 14 years after the initial attack. Echocardiography revealed that such patients had a normal mitral valve apparatus, and a normal heart size and function. Only5patients of this group had a significant regurgitant jet demonstrated by colour Doppler. We conclude that recovery of the mitral valve and return of cardiac functions to normal is possible in patients inaudible mild regurgitation. Patients who have lost their murmur maybe allowed to exercise freely, yet penicillin prophylaxix should not be discontinued

Infants' feeding pattern and reasons for changing the pattern

Health is a broad concept that includes nutrition as an essential component. Total health cannot be attained without good nutrition, which in turn depends upon adequate food intake. The aim of the research was to study the pattern and the changing pattern of feeding during the first year of life. The sample comprises 1000 infants from the well baby clinic of El-Shatby University Children's Hospital. El Raml Children's Hospital and 24 day-care centers in Alexandria. The study revealed the decline in breast feeding practice. The main reasons reported were to allow for the rapid growth of the infant which was mentioned by almost half the mothers followed by the insufficient amount or dryness of breast milk

relationship between patterns of infants' feeding and the occurrence of diarrhea

Diarrheal diseases pose a grave health threat on infants and children, they are the leading cause of death among them. One reason for this is the close connection between diarrhea and feeding. The aim of this research was to study the relation between the pattern of infant feeding during the first year of life and the occurrence of diarrhea. The sample comprised 1000 infants from the well baby clinic of el-Shatby University Children's Hospital. El-Raml Children's Hospital and 24 day care centers in Alexandria. The study revealed that diarrhea was less among totally breast fed infants as compared to the mixed and bottle fed ones. Also, the duration of attacks was shorter in breast than in mixed and bottle fed ones. Wrong feeding practice among the bottle and mixed fed babies was related to increased diarrheal attacks

Lactose-free formula versus regular animal milk formula in the management of infants with prolonged infantile diarrhea

This study aimed at comparing the effect of feeding infants with prolonged diarrhea a lactose- free milk versus a standard cow's milk formula. It included 50 well nourished infants aged 3-12 months with watery diarrhea for more than 1 week but less than 2 weeks in duration. These were randomly allocated to 2 equal groups receiving either a lactose-free significant differences between the 2 groups as regards the intakes of milk and total calories, the weight gain and increase in skin fold thickness after one month in hospital. Safely used in the treatment of patients with prolonged diarrhea, yet, it did not prove any significant superiority in that respect over regular adapted milk formula. These results are discussed

Efficacy of oral rehydration solution in treatment of different types of dehydration in acute infantile diarrhea

This work aimed at studying the efficacy of Oral Rehydration solution [ORS] recommended by the WHO in the treatment of different types of dehydration in acute infantile diarrhea. It included 200 infants and children aged from 3 months to 3 years and suffering from acute watery diarrhea with mild to moderate degrees of dehydration but without concomitant serious illnesses or malnutrition. They were not receiving ORS at home before admission to the hospital. The results of this study demonstrated that on admission hyponatremic dehydration was reported in 6% [group A], isonatremic dehydration in 84% [group B] and hypernateremic dehydrationin 10% [group C]. All patients among the three groups A, B, and C gained weight properly after rehydration with a% increase of 5.27 +/- 1.46% respectively. There were no statistically significant differences between the percent in weight gain among the three studied groups where F = 0.03. After rehydration, 66.7% of hyponatremic cases were reversed to isonatremia, isonatremic cases were successfully orally rehydrated and the risk of hypernatremia was nil. The percent of increment of serum sodium level in hypernatremic cases was not statistically significant and all cases of hypernatremia were successfully orally rehydrated. Regarding serum potassium levels on admission, hypokalemia i.e. serum potassium levels below 3.5 mEq/L. was reported in 16.7% of cases in group A, 19.05% of cases in group B and 20% of cases in group C. Normal serum potassium levels were reported in 83.3%, 80.95% and 80% in group A, B and C respectively and no hyperkalemic cases were reported in the 3 groups. After rehydration, hypokalemic cases were reported in 7.14% of cases in group B and no hypokalemic cases were reported in both groups A and C. Normal serum potassium levels were reported in 100%, 92.86% and 100% in groups A, B and C respectively and no hyperkalemic cases were reported in the 3 groups. The total serum solids which were increased on admission due to dehydration, decreased after rehydration indicating successful rehydration

Glycine and glycyl glycineenriched oral rehydration solutions in the management of infantile diarrhea

The study was conducted on 150 male formula-fed uncomplicated cases of acute diarrhea with dehydration. They were randomly classified into 3 groups: group A received standard WHO formula [51 cases], group II [49 cases] received ORS containing maltodextrin, glycine and glycyl-glycine while group III [50 cases] received ORS containing maltodextrin in addition to glycine alone. The two new ORS formulations contained the usual thee salts present in the standard ORS with the same concentration. The results showed that there were no significant differences between the thee studied groups as regards the mean number of diarheal motions, the mean daily amounts of diarrheal stools, the mean duration of the diarheal episode, time of first voiding of urine, time needed for initial rehydration, the mean daily amounts of ORS, other plain fluids, milk formula, solid and semisolid foods ingested by the thee groups and mean weight gain. No statistically significant differences were detected between the three studied groups regards the mean serum sodium, potassium and chloride, as well as blood pH and bicarbonate levels recorded levels recorded on admission and after 6, 24 and 48 hours from inclusion in the study and all were within the normal range. It could be concluded that the two study solutions containing maltodextrin together with glycine and glycyl glycine did not prove to have any statistically significant superiority over the standard conventional ORS on the clinical outcome of diarrhea

Oesophageal perforations: an experience with 120 cases [1974-1987]

In this article the experience with the different types of esophageal perforation encountered at the Cardiothoracic Surgery Unit of Alexandria University during the period from June 1974 through August 1987, is presented. Throughout this period 120 cases of esophageal perforation due to various causes were studied with regard to their incidence, etiology, diagnosis and management. The commonest cause of esophageal perforation in the present series was esophageal instrumentation intended for dilatation of caustic esophageal strictures

Campylobacter enteritis in rural community

Sixty stool specimens were collected from diarrheal children living in Sidi-Ghazy, Kafr El-Dawar [El Bahira Governorate]. 33 stool specimens from household contacts of cases positive close contact with them. C. jejuni was isolated from 13 out of 60 diarrheal children examined [21.7%]. The highest isolation rate was found among children below one year, and the lowest isolation rate was found in children above two years. The organism was isolated from two out of 33 household contacts. Eight strains were isolated from 58 stool specimens collected from animals. The isolated strains were sensitive to nalidixic acid, chloramphenicol, erythromycin and garamycin. They were all resistant to cefoxitin and cefotaxim. Seven strains [30.4%] were resistant to ampicillin and five strains [21.7%] were resistant to tetracycline. Using the antibiotic resistance pattern as an epidemiological marker, it was possible to incriminate the possible reservoir in four families

Prevalence of innocent murmurs in preschool children in Alexandria

Among 500 normal preschool children included in this study, innocent cardiac murmurs were detected in 270 cases [54%]. Venous hum was heard in 19.6% of examined children. The age group 5-6 years showed the highest prevalence rate of innocent cardiac murmurs 64% of all examined children of that age. Sex proved to have no influence on the prevalence of innocent murmurs. Murmurs heard on the pulmonary area [30%] and along left sternal border [48.15%] had generally a non musical character in contrast to lower parasternal murmurs [21.85%] which were mostly musical. E.C.G., phonocardiogram and radiograms were done for 50 cases with innocent murmurs and 50 murmur-free children chosen randomly. Their results are discussed