ABSTRACT
Background: Congenital Adrenal Hyperplasia [CAH] is the commonest cause of disorders of sex development [DSD] in children. The surgical management of children with CAH has always been difficult, subject to evolving attitudes and techniques, and at times controversial. The timing of surgery is one of the many factors that influence outcomes and is currently controversial
Patients and methods: Our study was conducted on patients of 46, XX DSD referred to pediatric endocrinology clinic in Alexandria University Children's Hospital. We studied the age of these patients at presentation, degree of civilization, presence of adrenal crisis, hormonal assay and radiological findings. We compared the early [done before the age of 2 years] versus late [done after the age of 2 years] surgical intervention done to these patients. We assessed these patients after at least six months of feminizing surgery, the assessment included the genital anatomical assessment, overall cosmetic results and further treatment recommendations
Results: In our study, there were 35 patients with early intervention and 26 patients with late intervention. Good cosmetic results were found more significantly in the early group [94.3%] in comparison to only 19.2% in the late group. Good cosmetic results [97.4%] are found more with the one stage operations
Conclusions: After doing the anatomical assessments, cosmetic results and assessing the need for further treatment recommendations, we can state that early feminizing genitoplasty has better anatomical and cosmetic results than late intervention
ABSTRACT
Background: obesity and iron deficiency are two of the most common nutritional disorders worldwide. Although these two conditions represent opposite ends of over- and under-nutrition, they appear to be linked
Objective: To investigate the association between body mass index and iron status in obese and overweight children
Methods: It was a case control study that included 40 children aged 2-14 years, 20 overweight [BMI 85th -95th percentile] and 20 obese [BMI more than or equal 95th percentile]. Twenty healthy non obese children of comparable age and sex served as a control group. All studied children were subjected to calculation of body mass index and laboratory investigations including complete blood picture and Iron profile [serum iron, serum ferritin, total iron binding capacity, serum transferring, and transferring saturation]
Results Compared to the control group, hemoglobin, MCV, serum iron and transferrin saturation were significantly lower in the obese and overweight group [p<0.05]. There was a negative correlation between BMI and both serum iron and transferring saturation, while there was a positive correlation between BMI and TIBC within the total sample
Conclusions: There was a relation between BMI and iron status in children. Obese and overweight children had higher rates of iron deficiency than normal-weight children
ABSTRACT
Objective: obesity is considered to be a worldwide health proble with a steadily and dramatically increasing prevalence all over the world. Obese individuals area at high risk of developing dyslipidemia, hypertension, impaired glucose tolerance and consequent increase of the risk of metabolic and cardiovascular diseases. several studies have reported abnormal thyroid function tests in obese children in which the commonest abnormality is a slightly too moderately increased thyroid stimulating hormone [TSH] levels
Aim of the work: This study aims to assess the thyroid function among prepubertal obese children. Patients and methods: The study was carried on 40 prepubertal obese children attending the Pediatric Endocrinology and Obesity Clinics in Alexandria University Children's Hospital. They were subjected to complete history taking including age, sex, family history of obesity and thyroid disease, organized sports practicing and thorough clinical examination including vital signs, anthropometric measurements, signs suggestive of thyroid dysfunction, presence of goiter and systemic features suggestive of syndrome obesity. The laboratory investigations done were thyroid function tests [TSH, Free thyroxin hormone FT4, Anti-thyroid peroxidase antibody TPO] and thyroid ultrasound
Results: A cross sectional analysis of 40 prepubertal obese children [BMI >95 th percentile for age and sex]. Their age ranged from 6-12 years with mean value 8.95 +/- 2.00 years, males were 19 [47.5%] and females were 21[52.5%]. There were 9 cases [22.5%] with elevated TSH and 2 cases [5%] with elevated anti-thyroid peroxidase [TPO] antibodies levels. By ultrasound examination of thyroid gland, none of the obese cases had goiter
Conclusions: Thyroid function tests should be performed in obese children to define their thyroid hormonal status. Subclinical hypothyroidism appears to be the most common disturbance of the thyroid function in obese children. Further studies should be done to identify the effect of weight reduction on thyroid profile in obese children
ABSTRACT
The aim of this work was to study the frequency of transient tachypnea of the newborn [TTN] and the possible relation to the use of oxytocin and glucose 5% during labour Subjects investigated were enrolled into two groups: the first [study] group consisted of 100 newborn infants born to mothers who have received IV infusion of aqueous glucose solution 5% and oxytocin. The second [control] group consisted of 30 newborns whose mothers did not receive any IV infusion. In the study group, the amount and rate of infusion of oxytocin and glucose 5% were calculated. The blood samples [maternal and cord] were drawn just after delivery in the study and control groups. Newborns were diagnosed as having TTN if they fulfilled the following criteria: persistent tachypnea with onset within 1/2 hour after birth, minimal grunting and retractions, with or without cyanosis in room air, necessity for oxygen therapy, spontaneous improvement starting within 24 hours after birth, Fi02 not more than 0.4 and suggestive radiological findings. Our results showed that maternal and cord serum sodium levels of the study group were significantly lower than those of the control group with a significant negative correlation between the maternal and cord serum sodium and the amount of oxytocin and glucose 5%. No significant difference between maternal and related cord serum sodium in both groups. Hyponatremia developed in 25 out of 100 cases of the study group and in 2 out of 30 cases of the control group with a significant difference. TTN developed in 17% of the study group and in none of the control group. The difference was significant. Serum sodium in the newborns who developed TTN was lower than in those who did not develop TTN. Out of 25 cases with hyponatremia, 8 developed TTN [32%] while out of 75 cases without hyponatremia, only 9 [12%] developed TTN with a significant difference. The amount and rate of infusion of oxytocin were higher in the TTN group than the non-TTN group. TTN was more frequent when the amount of oxytocin exceeded 10 units and the rate of infusion exceeded 25 mu/min. The amount and rate of infusion of glucose 5% did not differ in the TTN group from the non-TTN group. We concluded that the amount of oxytocin and glucose 5% infusion are related to the development of maternal and neonatal hyponatremia and the amount and rate of infusion of oxytocin are related to the occurrence of TTN. To decrease the incidence of TTN, We recommend that the dose of oxytocin should not exceed 10 units at a rate of infusion of less than 25 mu/min