[Biologic profile in tunisian infants [0 - 2 years] malnourished]

The malnutrition of the infants could be explained by a delay of the growth and the perturbation of biological parameters. To establish the nutritional profile of the Tunisian infant of less than two years. To specify the principal deficiencies and the possible origins of these deficiencies. In our transverse exploratory study, carried out in period of 9 month. This study was conducted in two groups of Tunisian young children less than two years old: a control group and a malnourished group [Z score >/= -2SD]. Our data consolidate the important impact of pregnant women nutritional state and of breastfeeding on the foetus ant infant growth.Compared to control infants, the malnourished young showed a significant alteration of different biologic parameters. This alteration appeared positively linked to the gravity of malnutrition as indicated by the positive relation obtained between the weight/height ratio and many studied parameters. The malnourished infants showed, notably, a significant reduction of the average values of Chol-HDL, apo AI, Vit E, TSH and TF4 levels and Chol-HDL/Chol LDL ratio. Chol-HDL, apo AI and HDL/Chol-LDL are found positively and significantly correlated with TF4. So, their reduction in ill children would be, at least in part, a side effect of the thyroid function reduction. Our results confirm the existence of an important change of biological profile in malnourished young children. Besides, they emphasize that studies about young children could be helpful, notably, in the prevention and the fight against atherosclerosis

[Epidemiological, etiological and evolutionary aspects of children cirrhosis in a develping country: Experience of the pediatric department of SFAX University hospital, Tunisia]

Cirrhosis is rare in pediatrics. The children cirrhosis is particular by the ascendancy of biliairy cirrhosis and cirrhosis due to an innate error of metabolism and by the relative frequency of the cases where an etiological treatment is possible. However in developing countries, the children cirrhosis still put problems of etiological diagnosis and of therapeutic coverage. To study epidemiological and etiological particularities, therapeutic modalities and outcome of cirrhosis in the sooth of Tunisia. We led a retrospective study over 15 years [1990-2004] having allowed to depict 71 cirrhotic children followed in the service of general pediatric department of SFAX University hospital [Tunisia]. Our patients divide up into 36 girls and 35 boys. The age of revelation of the disease was variable [15 days to 15 years]. Jaundice and hepatomegaly were the most two clinical signs frequently found in the clinical exam. On the etiological plan, biliairy cirrhosis [Extra hepatic biliary atresia, dilatation of choledocal cyst, progressive familial intrahepatic cholestasis...] were the most frequent [40%] followed by metabolic cirrhosis[tyrosinemia type I, Wilson disease...] [17%] and post-hepatitic cirrhosis [17%]. In 27%of cases, no etiology was found. Besides the symptomatic treatment, an etiological treatment was tempted in some cases. No patient benefited from hepatic transplantation. The follow-op of the children cirrhosis was grave becaose 30 children [42%] died, 19 children are lost-sight and 22 children [31%] are still alive. The children cirrhosis pose still in our country of the problem of etiological diagnosis because of the not availability of some specific additional exams and especially problems of coverage for lack of a program of hepatic transplantation

mucoviscidose chez l'enfant: Experience d'un service Tunisien de pediatrie generale

Cystic fibrosis was regarded a long time as exceptional in the Nord Africaine population and in particular in Tunisia what was at the origin of the ignorance of its various diagnostic and 'therapeutic aspects in our country. Nevertheless, with the development of the means of the diagnosis, several cases of cystic fibrosis were diagnossd these last years what will pose true problems of assumption of responsibility of these children like illustrates it well our experiment in the pediatric department of Sfax university hospital. In 10 years going of 1991 to 2000 we reported 7 cases of cystic fibrosis in the peditric department of Sfax university hospital. Our patients are 3 boys and 4 girls. The age of revelation of the disease varied from 3 months to 14 years with 4 years and 10 months an average age. All our patient had a respiratory symptomatology in the Foreground. The evolution was marked by the death of 4 patients at an average age of 5 years and half whereas the 3 surviving patients for the moment are more or less balanced on the nutritional level, digestive and respiratory. Cystic fibrosis is not exceptional in our area, its assumption of responsibility therapeutic is difficult, and it requires the collaboration of several experts and a good compliance of the child and of his family

Les hemorragies digestives haustes chez l'enfant: a propos de 166 cas

We report about a retrospective study concerning 166 cases of gastro intestinal tract of children aged from 1 day to 13 years with an average age of 3 years. The gastro-intestinal endoscopy was applied in 66.3% of the cases and it allowed to have a direct diagnosis showing the origin of bleeding in 15.4% of the cases and an indirect diagnosis in 74.6% of the cases. It was considered to be normal for 10 patients. The analysis of the etiologic distribution has shown the predominance of three etiologies: the oesophagitis [21.3%], the gastritis [31.3%], and the stress bleeding [28.6%]. The evolution was fatal in 22.9% of the cases but death directly caused by the bleeding occured in only three cases. For those who managed to survive, the relapce of the gastro- intestinal tract bleeding was observed only in 1.8% of the patients all of them suffering from portal hypertension

Aspects epidemiologiques et e'volutifs des cardiopathies congenitales dans le service de pediatrie de Sfax: a propos de 123 cas

We report 123 cases, of congenital heart disease treated and followed in the department of general paediatrics in the University Hospital of SFAX during a period between January 1992 and December 1996. The ventricular spetal defect was the most frequent congenital cardiac malformation [28.45%] followed by the atrial septal defect [15.44%]. Only 19 children have had a surgical intervention within a median age if 2 years 9 months. The surgery has been realized in Tunisia in 84.2% of cases and abroad in 15.8% of cases. One child has died during a pallliative intervention for a complex cardiopathy. For the other children that haven't been operated, the mortality was very important [59.5%]. We analyze particularly the epidemiological and evolutive aspects of the congenital cardiopathies in our region and we propose the modalities of treatment and surveillance adapted our conditions

Le purpura thrombopenique idiopathique de l'enfant [a propos de 52 cas]

The ITP is defined as a hemoragic syndrom caused by an acquired thrombopenia without affecting other cells, and with out number of normal or increased medular megacaryocytes and this in the absence of known systemic disease. Thus, its diagnosis is an eliminatory one. Its pathogeny is not entierly illucidated but an immunological mechanism is often evoked. We report the results of a retrospective study about 52 patients examined in the pediatric ward of Sfax hospital for ITP within a period of 10 years [1985-1994]. Those patients are 27 boys and 25 girls aged between 3 and 13 years. 42 Patients have shown a sharp ITP with an evolution inferior to 6 months while only 6 other patients have shown a chronic ITP with an evolution superior to 6 months. One patient died after a six week evolution and three children have disappeared. No correlation with age, sex, importance of initial symptomatology and the evolutive mode of the disease has been noticed. Where as the mode of progressive fitting is linked to a chronic evolution. The corticotherapy has been used during the sharp phase with 11 cases [21,6%] which had no influence on the evolution. Throughout this study, we propose the following: to analyze the different epidemiological, clinical, evolutive and therapeutic aspects of ITP among infants. to look for the predictive factors of the chronocity to propose a therapeutic method adequate to our working conditions