Appropriateness of pediatric hospitalization in a general hospital in Kuwait

To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol [PAEP] and to examine variables associated with inappropriateness of admissions. A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period [August 2010 to December 2010]. A total of 1,022 admissions were included. Of the 1,022 admissions, 416 [40.7%] were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child's condition

Arthrogryposis, renal tubular dysfunction and cholestasis [ARC] syndrome: a case report

Arthrogryposis, renal tubular dysfunctions and chloestasis [ARC] syndrome is a rare multisystem, usually fatal, autosomal recessive disorder. Awareness of this syndrome is growing with more reported cases over the last three decades. Many previously reported cases with similar association are now labeled as ARC syndrome. Although the genetic mutation is recently recognized, the diagnosis still depends on the clinical findings. Our patient is the first case of ARC syndrome to be reported from Kuwait. To the best of our knowledge this is also the first report of an Egyptian family with two siblings of ARC syndrome

Fulminating shigella encephalopathy [Ekiri syndrome]: a case report

Neurological manifestation, particularly seizures and encephalopathy, are common in childhood shigellosis. Fulminating shigella encephalopathy [Ekiri syndrome] is a rare form of shigella associated encephalopathy characterized by a rapid, severe and fatal course with few dysenteric symptoms. Brain edema is a common finding in patients presenting with severe shigella encephalopathy. Shiga toxin production is not essential for development of shigella-associated neurological symptoms. Early recognition and proper management of cases of severe shigella encephalopathy may help to improve the outcome. We are reporting the case of a six and half year old male child with severe fulminating shigella-encephalopathy [Ekiri syndrome] who made a partial recovery. Brain magnetic resonance image [MRI] findings of this patient are reported. To the best of our knowledge, brain MRI studies were not reported before in the pediatric population with Ekiri syndrome; moreover, this is probably the first case of Ekiri syndrome to be reported in the Arab population

New flavone glycosides from anisacanthus virgularis

From the ethanolic extract of the whole plant of Anisacanthus virgularis, the two new natural flavonoids 6,8-dihydroxyapigenin-6-O-alpha-L-rhamnopyranoside-8-O-beta-D-galactopyranoside [1] and 8,3'-dimethoxyluteolin-6-O-alpha-L-rhamnopyranoside [2], as well as other ten known flavonoids were characterized. The structures were established by chromatographic methods, chemical degradation and spectroscopic data. The ethanolic extract of the whole plant was investigated for its antioxidant activity

Wolman disease in an Egyptian patient

Lysosomal acid lipase deficiency leads to accumulation of cholesteryl esters and triglycerides in different body tissues. This disorder is manifested in two clinical forms; cholesteryl ester storage disease which is a benign adult form and Wolman disease [WD], a fatal autosomal recessive form. We present an Egyptian infant with WD whose diagnosis was based on clinical, laboratory and imaging features. This is the first reported patient with WD from Egypt

Evaluation of sensitivity and specificity of bovine Gamma-Interferon In-Vitro Assay for Diagnosis of tuberculosis in buffaloes

The sensitivity and specificity of the Bovine Gamma Interferon [IFN-lambda] in-vitro assay [BOVI-GAM] in the diagnosis of bovine tuberculousis in buffaloes as compared to the single intradermal cervical tuberculin test [SICT] and cultural isolation of Mycobacterium bovis were investigated. Thirty buffaloes from a dairy farm, in which tuberculin positive animals had been previously diagnosed, were tested. In the SICT test examined buffaloes 36.7% were positive and 23.3% were doubtful as compared with 53.3% positive and 16.7% doubtful results using the IFN- lambda assay. Two animals were positive to avian tuberculin in the IFN- lambda assay. The prevalence rate reached 60% and 70% using the SICT test and the IFN- lambda assay respectively. The sensitivity of the SICT and the IFN- lambda assay as compared with the cultural isolation of M. bovis were 75% and 95%, respectively, while the specificity were 70% and 80%, respectively. M. bovis was isolated from five buffaloes that were negative to SICT and one buffalo that was negative to the IFN- lambda assay. In conclusion, the present study demonstrated that the IFN- lambda assay is a practical, more sensitive and specific in-vitro diagnostic test than the conventional tuberculin test for detection of bovine tuberculosis in buffaloes

Affection of the genetic make-up of T-Lymphocytes in chronic liver diseases

In this work, 15 cases suffering from chronic liver disease were studied as regards T-lymphocytes chromosomal abnormalities, according to Savage [1975]. They were divided to 3 groups: Group I with 1ry Hepatocellular carcinoma 7 cases, it was found that the percentages of chromosomal aberrations were from 0 - 6%, with no change after addition of B-interferon. Group II with Chronic Active Hepatitis 3 cases, the percentage of chromosomal aberrations were from 4 - 16%. There was marked decrease of the percentage of abberrations after addition of B - Interferon. Group III with both 1ry Hepato cellular carcinoma and chronic active hepatitis 5 cases aberration were from 0 - 8%, but on addition of B - interferon the percentage of abberrations were also markedly decreased