Acute chest syndrome in children with sickle cell disease in basra, southern Iraq

To look for the frequency of acute chest syndrome among children with sickle cell disease, and to evaluate the clinical, hematologic, and radiological features, and outcome of these children. A prospective study was carried out on 154 children with sickle cell disease, who presented with fever and respiratory symptoms. Clinical data were obtained, in addition to pulse oximetry, full blood count and chest x-ray. Twenty nine sickler children [18.83%] fulfilled the criteria of acute chest syndrome. Dyspnea and chest pain are found to be significant predictors of acute chest syndrome, P<0.05. In addition to asthma, history of splenectomy and surgery [P= 0.001, and <0.05 respectively]. Hypoxia was present in a significantly higher percent of sickler children with acute chest syndrome [27.58%] compared to patients without acute chest syndrome [4%], P= 0.001. Acute chest syndrome was associated with longer mean duration of hospitalization [2.9 +/- 4.3] days compared to those without acute chest syndrome [1.6 +/- 1.8] days, P<0.05. The frequency of acute chest syndrome is high among sickler children in Basra. Further studies are needed to look for the etiologic factors, recurrence rate and role of hydroxyurea and incentive spirometry in the prevention and treatment of acute chest syndrome

Intestinal parasitic infections including cryptosporidiosos and immunological aspects among malnourished children

This is a case control study which involved 194 malnourished children below 5 years of age who were attending Basrah Maternity and Children Hospital during 2001 About 84% have marasmus, 8.24% marasmun kwashiorkor 6.18% kwashiorkor and 1.55% under weight Parasitic infections were more frequent among malnourished children [59.8%] than wellnourished children [33%] with increased frequency among malnourished children with diarrhea [32.5%] Cryptosporidiosis was found in 6.85% of children below 5 years with increased frequency among malnourished children with diarrhea 14.89% compared to 11% in malnourished children without diarrhea Only 2% were noticed among wellnourished children with diarrhea while no case has been recorded in wellnourished children without diarrhea. Depressed cellular immunity characterized by decrease in total lymphocytes [particularly T-lymphocytes] was found among malnourished children either with or without diarrhea While humoral immunity [IgG, IgM, IgA] was significantly elevated among malnourished children with or without diarrhea in comparison to wellnourished children. C3 and C4 were increased in malnourished children without diarrhea with significant difference in C4 only. While they were decreased in malnourished children with diarrhea, with significant difference in C3. In addition, Phagocytic activity showed a significant decrease in malnourished children with or without diarrhea compared to wellnourished children