Cystic fibrosis in Saudi Arabia-hepatic presentation

Cystic fibrosis [CF] is an autosomal recessive disorder which, until recently, was thought to be extremely rare or non existent in Saudi Arabia. In view of the high rate of consanguinity, and the high number of children dying so young, many Saudi infants and children with CF remain undiagnosed due to lack of clinical suspicion and proper diagnostic facilities. Based on repeated high sweat chloride of 60 mmol/L or more, 36 patients were diagnosed to have CF over the period 1986 - 1992. The aim of this report is to increase awareness for the diagnosis of the CF in the developing world and to focus on the hepatic involvement in CF. Nine patients [25%] were referred as having liver disorders but subsequent investigations confirmed the diagnosis of CF. Liver biopsies, obtained in 6 cases, demonstrated portal fibrosis and steatosis. Consanguinity was present in 8 cases, 2 were siblings. Four patients died. Our report emphasizes the high incidence and early presentation of liver involvement among CF children in Saudi Arabia

Bacteriology of neonatal septicemia at the Jordan University Hospital

Septicemia has been diagnosed clinically in 431 of the 10,492 neonates admitted to the Jordan University Hospital, over a six-year period,1977 to 1982. Blood cultures were positive in 242 [56.1%] of the cases. The major Isolates were Staph. spp., both coagulase positive and negative, followed by KlebsiellaEnterobacter group, E. coil, Pseudomonas spp. and Salmonella spp. In vitro, gentamicin was the most active agent and ampicillin, cephalothin and chloramphenicol were active agents against most clinical isolates. Most patients were treated with a combination of a beta-lactam antibiotic and an aminoglycoside. Mortality rate from septicemia decreased significantly from 24.8% to 13.4% with an overall mortality rate of 24.8%. It is concluded that for successful treatment of neonatal infection consideration of the common local pathogens, nosocomial organisms and their susceptibility patterns would be very helpful

Astrovirus-associated gastroenteritis: clinical manifestations in 45 patients

Astrovirus was detected by electron microscopy of the stools specimens from 45 children hospitalized with diarrhea over the period February 1979 to August 1982. Mean age of patients was 6.4 months [range 1-24 months]. In this series, 40 out of the 45 children [89%] had diarrhea during the period of astrovirus excretion. Vomiting was noted in 31 [69%], respiratory manifestations in 11 [24%] and mild dehydration in seven children [15.5%]. Transient monosaccharide intolerance occurred in 23 children [51%] and milk elimination responsive postenteritis enteropathy in four children [9%]. Rotavirus coexisted in 17 patients [37.7%] The clinical significance of astrovirus excretion is presented with emphasis on the role of astrovirus in nonbacterial gastroenteritis of childhood

Cow's milk protein intolerance

Cow's milk protein intolerance is a disease of early infancy with varied clinical, manifestations, gastrointestinal as well as others such as failure to thrive, respiratory tract infection, eczema, asthma and even shock. Acute gastroenteritis, which is a major health problem in the developed world and even more so in the developing world, is an important predisposing factor. There is nowadays a recognized association between delayed recovery from acute gastroenteritis, postenteritis enteropathy, lactose intolerance, IgA deficiency and cow's milk intolerance. The affected children should be given cow's milk elimination diet for a minimum period of approximately six months before milk challenge is attempted. This ensures a safer return to cow's milk formula