Study of depression in children with chronic renal failure undergoing renal dialysis in Alexandria

Objectives: The aim of this study was to estimate the prevalence of depression among chronic renal failure children on dialysis and to study some of the multifactorial risk factors, which may affect the prevalence of depression among those patients. Study design: this study was conducted on 55 children. All children were aged [7-18] years and had no other chronic medical or surgical conditions; to exclude the impact of other illness. Depression symptoms among the studied children will be assessed using self reporting scale including; Children Depression Inventory Scale [CDI]. Results: In this study, of the 55 children, there were 17 cases [30, 9%] with mild depression, 18 cases [32, 7%] with moderate depression, 5 cases [9, 1%] with severe depression. We found a significant relationship between the prevalence of depression and age [p value=0.04], hemoglobin level [p value=0.02], however we didn't find a statistically significant relationship between depression and other risk factors including: gender, school attendance, complete family structure, family history of renal disease, presence of a close friend to confide to, number of dialysis sessions/week and socioeconomic status. Conclusion: It is concluded that there is significant increase in the prevalence of depression among chronic renal failure [CRF] children on [HD] in comparison to other studies in foreign counties and here appear the rule of socioeconomic st and ard in Egypt and it's great impact on the psychological well-being of those children. There is a significant relationship between age, hemoglobin level and depression, while no statistically significant relationship was found between depression and other risk factors like; gender, residency, school attendance, complete family structure, family history of renal disease, presence of a close friend to confide to, number of dialysis sessions/week and socioeconomic status.

Pure motor guillain barre among Egyptian infants and children

Guillain Barre syndrome [GBS] is an acute polyneuropathy with a relatively symmetrical weakness and a wide range of severity. It is a heterogeneous disorder which encompasses clinical and electrophysiological subtypes. Variability in the spectrum may be the result of different pathogenic mechanisms. Pure motor GB is one of these variants. If is an acute motor neuropathy with motor weakness without paranesthesia or sensory loss. We studied 9 patients with pure motor GB out of 40 patients with GB to assess the distinctive clinical, electrophysiological, and laboratory findings in this variant in Egyptian children. The results showed that pure motor GB was detected in 22.5% of GB patients during the period from April 2001 till the end of October 2002. The clinical course was preceded by illness during the 4 weeks prior to onset of GB in all patients with pure motor GB [100%] compared with 83.8% in the other GB patients. The cranial nerves were less frequently involved in pure motor GB [11.1%] than in other group [45.2%]. The descending pattern was observed in 33.3% patients with pure motor GB, compared with only 3.2% in other GB patients. However, the mean duration of clinical course until nadir of weakness was not statistically different between the two groups as well as the mean duration of improvement [P: 0.786, P: 0.113 respectively]. As regards the electrophysiological examination, 66.7% of acute motor axonal neuropathy [4 out of 6] had pure motor GB which was statistically significant [X[2]7.897, P: 0.005]. Campylobacter infection was detected in 4 patients of pure motor GB [44.4%] compared with only [12.9%] in other patients [P: 0.05] and Odd's ratio for risk estimate was 5.4 which was statistically significant

Conclusion: pure motor GB in Egyptian children has distinctive clinical, electrophysiological pattern. Ifs association with Campylobacter jejuni infection may explain the increased incidence of this variant in Egyptian children

Study of profile of guillain-barre syndrome among Egyptian children admitted to the Alexandria university children's hospital

Guillain-Barre syndrome [GBS] has become the most common cause of acute flaccid paralysis with virtual elimination of poliomyelitis. It has become apparent that the clinical spectrum of GBS comprises a group of pathological entities, each with distinctive features. The present study was conducted on 40 GBS children who were admitted to Alexandria University Children's Hospital from the start of April 2001 till the end of October 2002. The study finally concluded that: 1. Abnormalities of nerve conduction were the most sensitive and specific finding in GBS. 2. The electrophysiological type which was recorded in majority of the studied cases was acute inflammatory demy elina ting polyradiculo-neuropathy [AIDP], 30 cases [75%]. 3. The most reliable indicators for poor prognosis were respiratory muscle paralysis with the need for ventilation and/or electro diagnostic evidence of markedly reduced amplitude of motor action potentials of less than 20% of the lower limit of normal. 4. General supportive measures still remain important in the management. 5. Specific immunotherapy like I. V. immunoglobulin was found to be effective, particularly if started early within 2 weeks of onset of symptoms. 6. GBS has a good prognosis and mortality rate was about 11% which is similar to that in other studies

Vitiligo: genetic linkage analysis

Since the familial aggregation of vitiligo has suggested a genetic role in the disease susceptibility and the conflicting results of the association studies with the ABO blood groups, we performed this study to clarify the possibility of an ABO blood group-linked control of the susceptibility to vitiligo. Twenty four multi-case families were chosen for the study. The linkage analysis was performed by the computer program LIPED. The highest Lod score [-0.08] achieved with a hypothetical dominant disease susceptibility gene with two alleles at a recombination fraction [] 0.4 and penetrance rate 20%

Epidural versus intercostal block for the relief of postoperative hypoxaemia

This study included 35 patients submitted to a variety of thoracic or upper abdominal operations. The patients were divided into two groups for the relief of their post-operative pain to see the effect of relief of this pain on the post-operative hypoxaemia. 15 patients received extradural analgesia and 20 patients received intercostal block, by Bupivocaine 0.5%. Pulmonary function including tidal volume, frequency, vital capacity and blood gases were assessed for all the patients beside the pulse and blood pressure. Both techniques ameliorated post-operative hypoxaemia but extradural analgesia proved to be superior than intercostal block