Toddlers screening for autism in Babil province/ Iraq

Autism is a brain developmental disorder characterized by impaired social interaction and communication, and restricted and repetitive behavior. The aim of present study was to screen for autism among toddlers attending primary health care centers using Modified Checklist for Autism in Toddlers, [1999 Diana Robins, Deborah Fein, and Marianne Barton M-CHAT Questionnaire] and telephone interview. One thousand three hundreds seventy toddlers attending primary health care centers in Babil province/Iraq were screened for autism using Modified Checklist for Autism in Toddlers, 110 of them failed and reviewed within 1-3 months using follow up telephone interview, 74 of them were failed again, who considered at high risk for autistic spectrum disorders. The toddlers who don't need follow up [group 1] include those who passed initial Modified Checklist for Autism in Toddlers [1260] and those who passed follow up interview [36]. Toddlers who need follow up [group 2] include those failed at the 2 times [74]. All the data studied were scored and analyzed by statistical package for the social sciences SPSS [version 15], descriptive t-tests and Chi- square [X2] test. Of the 1370 toddlers, who were screened by Modified Checklist for Autism in Toddlers and follow up telephone interview, only 74 [5.4%] toddlers had risk for autism and positive predictive value was 67.2%. All variables studied in our research show significant difference between group 1 and 2 except mother education and residence. For group 2, all variables shows significant values except mother education. Autism is not rare [5.4%]. Males affected more commonly than females. Risk of autism increased with increased maternal age. Family History of autism, parent separation and preterm delivery play a role in autism.

Ventricular septal defect and it-s effects on growth pattern in children below five years

To study the morphological classification of ventricular septal defect [VSD] and its effects on weight, height and occipitofrontal circumference of children below five years. A case control study of fifty patients with isolated ventricular septal defect [VSD] from Babylon maternity and children teaching hospital [outpatient and inpatient], was done in regard to morphological classification of ventricular septal defect and its effect on growth parameters, for the period from January to July, 2008. Another 50 healthy children of the same ages attending primary health center were chosen as a control group. The patients were ranging between 1 day to 5 years; most of them [60%] were below 1 year of age with male to female ratio of 1.6:1. About [76%] were presented in the first 6 months of life. The most common type of VSD was perimembranous type [72%], about half [52%] of VSD was small size. Weight and occipitofrontal circumference [OFC] were sensitive parameters for studying the effect of VSD on growth and it was greatly affected by the size of VSD with no significant effect of the gender on growth of the patients with VSD. Weight and OFC were affected significantly by the presence of VSD, with no effect for gender. Growth is affected by moderate and large sized VSD, so it should be managed early and carefully

normal anthropometric measurements for healthy full term newborns in Hilla City/Iraq

To establish the normal anthropometric measurements [weight, length, occipto frontal circumference, chest circumference, mid arm circumference and mid thigh circumference] for appropriately grown full term newborns in Hilla city-Babil-Iraq. A descriptive, observational study was carried out enrolling 2051 singleton neonates who were delivered in Babylon gynecology and children teaching hospital during the period from 1st April to 25th of October 2009. The data and measurements were done on the first day of life with exclusion of newborns of mothers with high risk, complicated pregnancies, complicated labor and prematurity. The included measurements were weight, length, occipto frontal circumference, chest circumference, mid-arm circumference and mid-thigh circumference. The studied variables were gender, residence, parity, mode of delivery, ante natal care and socioeconomic state. The data analyzed by SPSS [version 15] program for mean, standard deviation, range, p-value and correlation coefficient. Males had a significantly higher occipto frontal circumference and chest circumference than females while females had a significantly higher mid-arm circumference than males with no significant difference in weight, length and mid-thigh circumference. A significantly higher weight, chest circumference and mid-thigh circumference in urban than rural neonates with no significant difference in length, occipto frontal circumference and mid-arm circumference. A higher occipto frontal circumference, chest circumference and mid-thigh circumference in neonates of primipara mothers but higher length and mid-arm circumference in neonates of multipara mothers with no significant difference in weight. A significantly higher weight and occipto frontal circumference in neonates of mothers with regular ante natal care than neonates of mothers with irregular antenatal care. A higher length, mid-thigh circumference and chest circumference in neonates of mothers from high socioeconomic status group than neonates of those from other socioeconomic state groups. This study establishes local normal values for anthropometric measurements [weight, length, occipto frontal circumference, chest circumference, mid-arm circumference and mid-thigh circumference] for healthy, full term newborn in Hilla city. A significant degree of correlation between all the studied measurements [except occipto frontal circumference which correlated with weight and mid-arm circumference only] and the best correlation between weight-mid-thigh circumference followed by mid-arm circumference and chest circumference

Maternal responsiveness to infant crying

Colic is a disorder in which an infant has episodes of uncontrollable crying, which often occurs at a predictable times of day or night. The aim of this work is to determine the frequency rate of various calming technique, and how mothers soothed their crying infants. Four hundred twenty one mothers with infants of six months old or below were recruited in this study in Hilla city. A questionnaire comprise on the gender of the baby, mother age and her education level [measured on a scale of 0-6 from illiterate, to postgraduate training], and asking about 21 calming methods of how the mothers soothed her crying baby. It was completed though direct interview of the mothers. Data were analyzed using the statistical package SPSS [version 15.0]. The most common quieting technique used by mothers was holding and carrying the infant [93.1%]. The other common techniques were infant rocking [91.7%], abdominal massage [87.9%], taking to bed [87.2%], administer breast feeding [68.4%], swaddling infant [64.6%], prone sleeping position [64.1%], music [62.5%], night bottle [53.7%], bathing [51.1%], and around one third [36.1%] of mothers preferred to use pacifier. Herbs were used as a remedy for soothing crying infants in [16.4%]. Pain killer was used by 33% of mothers to quiet their babies. Forty six mothers and another 11 mothers had used smothering and slapping of their infants as calming techniques respectively. There was a clear effect of cultural differences in the selection of calming technique. A potentially injurious method for calming infants such as slapping, and smothering was reported in this study

Ventricular septal defect and it's effects on the growth pattern in children below five year

To study the morphological classification of VSD and its effects on weight, height and occipitofrontal circumference of children below five years. A control study of fifty patients with isolated Ventricular septal defect [VSD] from Babylon maternity and children teaching hospital [outpatient and inpatient], was done in regard to morphological classification of VSD and its effect on growth parameters, for the period from January to July, 2008. Another 50 healthy children of the same ages attending primary health center were chosen as a control group. The patients were ranging between 1 day to 5 years; most of them [60%] were below 1 year of age with male to female ratio of 1.6:1. About [76%] were presented in the first 6 months of life. The most common type of VSD was perimembranous type [72%], about half [52%] of VSD was small size. Weight and occipitofrontal circumference [OFC] were sensitive parameters for studying the effect of VSD on growth and it was greatly affected by the size of VSD with no significant effect of the gender on growth of the patients with VSD. Weight and OFC were affected significantly by the presence of VSD, with no effect for gender. Growth is affected by moderate and large sized VSD, so it should be managed early and carefully

Impaired glucose tolerance test in beta thalassemia major

beta thalassemia major is a hereditary disorder of hemoglobin synthesis associated with ineffective erythropoiesis and rapid red cell destruction resulting in sever anemia. Treatment consists of multiple blood transfusions, which is complicated by hemochromatosis in multiple organs including endocrine system. Impaired glucose metabolism is one of the above consequences in the pancreatic beta cells. To report the relationship and risk factors of impaired glucose tolerance test in patients with beta thalassemia major in Hilla, Iraq. Ninety-seven patients with p thalassemia major were enrolled in this study, which was done in Babylon Thalassemic center, Hilla, Iraq, between January and June 2009. There were 56 males [57.73%] and 41 females [42.26%]. The mean age at the time of enrollment was 9.36 +/- 3.75 year. The demographic characteristics of patients with beta-thalassemic major included the age, gender, and height, body weight, age at the first blood transfusion, age at the start of iron-chelation therapy, compliance with iron-chelation therapy, previous splenectomy and family history of diabetes. Estimation of serum ferritin concentration, existence of hepatitis B surface antigen, and hepatitis C antibody were done. All 97 patients underwent oral glucose tolerance test [OGTT]. Blood samples for glucose were drawn at 0 and 120 minutes. Impaired glucose tolerance test [IGT] was found in 5 patients [5.15%], and 92 patients [94.84%] had normal glucose tolerance test. Comparing the patients with normal glucose tolerance test to those with impaired glucose tolerance test, significant differences were found in the serum ferritin concentration. Physicians caring for patients with thalassemia major should be particularly alert to the possibility of diabetes. Serum ferritin concentration, a marker for hepatic iron concentration, was found to be a risk factor in this study

Clinical and laboratory predictors of acute bacterial diarrhea

Diarrhea is one of the most common childhood illnesses worldwide and exerts major financial impact. The presence of gross blood or an inflammatory response in the stool [leukocytes or lactoferrin] significantly increases the chance for isolation of invasive enteric bacteria. Improved knowledge of the microbiologic etiology of childhood diarrhea could help clinicians make appropriate diagnostic and therapeutic decisions and diminish the burden of these illnesses. The aim of this work is to determine the predictive utility of certain clinical and stool parameters in diagnosing bacterial diarrhea. A prospective one year study was conducted on 142 patients, below 5 years of age, with acute diarrhea, in Babylon Maternity and Children Teaching Hospital [Outpatient and Emergency department] during the months of January to December 2007. The positive stool culture was yield in 64 patients [45.07%]. The isolated pathogens were Escherichia coli in 44 patients [68.7%], Shigella spp. in 14 patients [21.6%], and Slamonella spp. in 6 patients [9.3%]. The best predictive variable for a stool culture positive for a bacterial pathogen was the presence of fecal leucocytes, with a sensitivity of 92%, a specificity of 75%, and positive and negative predictive values of 75% and 92%, respectively, with odd ratio of 36.6. The next predictive variable was the presence of both fecal leucocytes and fecal blood with a sensitivity of 88%, a specificity of 82%, and positive and negative predictive values of 76% and 91%, respectively, with odd ratio of 36.1. The best historical factors for predictive accuracies were abrupt onset, fever >/= 38[degree sign]C, abdominal pain, frequent bowel motions and no vomiting before the onset of diarrhea. Examination of stool for fecal leukocytes and fecal blood is a rapid, reliable, and inexpensive way to be the best method of predicting a positive stool culture, while detecting a blood in the stool only had high specificity with low sensitivity

Prevalence of rotavirus causing acute diarrhea in children below two years in Babylon governorate in Iraq

Acute diarrhea is considered as the major cause of morbidity and mortality disease to infants in the world. This research is done to reveal the prevalence of rotavirus that cause diarrhea in children below two years with their spreading according to age, sex, feeding pattern, residence and mother education. 315 children less than two years of age, who were suffering from acute diarrhea, were studied between November 2003 and April 2004 in Babylon governorate including 225 hospitalized patients and 90 outpatients. Rotavirus antigen was detected in their stool by latex agglutination technique.Rotavirus antigen was positive in 22.5% of cases. The frequency of rotavirus infection was significantly higher among patients under one year of age [99%]. Breast-feeding proved to have a protective action against rotavirus infection

Datura stramonium [Jimsonweed] poisoning in Babylon city, Iraq

Datura stramonium poisoning is reported to be a relatively common problem. The aim of this study is to alert doctors and parents about this poisoning and its danger. Twenty one patients who presented to the emergency department at Babylon Maternity and Children's Hospital with features of intoxication with Datura seeds, were studied after treatment. Variables of the patients and their mothers, clinical features, and treatment were studied. The commonest age was 1-2 years [42.8%]. Males were affected more than females [71.4%]. The most frequent clinical features were, tachycardia [100%], agitation [95.2%], dilated pupils [81%], and flushing [76.1%]. Neostigmine was used for treatment and no deaths were reported. Datura stramonium poisoning is a common problem in Babylon city especially in infants. It carries a good prognosis

Hydrocarbon poisoning in children in Hilla, Iraq

Accidental hydrocarbon ingestion is the most common form of acute childhood poisoning in most developing countries. There are few published studies from Iraq on this subject. This study was conducted to document this problem among children in Hilla, Iraq. The study is a prospective hospital-based study of 1672 cases of hydrocarbon poisoning which were admitted to the Emergency Department [ED] of Babylon Maternity and Children's Hospital from October 2002 to October 2005. Of the 1672 patients with hydrocarbon poisoning, 1583 [94.6%] were identified as cases of kerosene poisoning. There was a male preponderance. The age group mostly affected was one to three years [72%]. More patients were seen in autumn and early winter months. Children from the lower socio-economic groups and overcrowded living conditions were affected more. The majority of families had stored the hydrocarbon substance in household containers inside the home. The death rate was low [< 0.5%]. Hydrocarbon poisoning is a common problem in Iraq, and there is a need to provide health education for parents in order to increase their awareness of this danger and to reduce the risk of poisoning among children