Causes of global developmental delay in Children Welfare Teaching Hospital-Baghdad

There are wide ranges of causes behind global developmental delay in Iraqi children but most of these causes were not diagnosed as a result of unavailable diagnostic tools. To study the etiology of global developmental delay in Children Welfare Teaching Hospital / Baghdad. A descriptive study was done on 75 patients, their age range from 8 months to 5.5 years with global developmental delay, who consult Children Welfare Teaching Hospital/Baghdad, from 1[st] of May 2010 to 1[st] of October 2010. A full history, thorough physical examination, and developmental assessment according to Denver Developmental Scale two were done to all cases. A group of selected investigations including neuroimaging [CT and MRI], EMG, EEG, visual and hearing assessment, screen for metabolic diseases, and thyroid function test were done as needed for the diagnosis. A total of 75[preschool] patients with age range from 8 months to 5.5 years were studied; 45[60%] of them were males and 30[40%] were females, 9[12%] were preterm, 26[34.6%] were born with LBW, 3[4%] of patients acquired the infection with TORCH from their mothers [2[2.7%]CMV, 1[1.3%] toxoplasmosis], 8[10.7%] had their mothers complained from chronic diseases [hypertension and diabetes mellitus], 11[14.7%] suffered birth asphyxia, 2[2.7%] with high bilirubin level exceeding 20mg/dl, 2[2.7%] patients suffered RDS and 1[1.3%] suffered sepsis diagnosed by blood culture during neonatal period .Family history of developmental delay was reported in 11[14.7%] and consanguinity was reported in 46[61.3%] of cases, in 33[43.9%] no cause could be identified, CNS infections 9[12%], Down syndrome 7[9.3%], hypothyroidism 2[2.7%], intracranial hemorrhage 2[2.7%], infantile spasm 2[2.7%], phenylketonuria 2[2.7%], Myotonia Dystrophica 1[1.3%], and Seckel syndrome 1[1.3%]. Global developmental delay in pediatric practice has wide etiology. The majority of cases were not diagnosed because of deficient diagnostic tools like cytogenetic analysis. High percent of perinatal etiology raises the importance of good maternal and neonatal care. Under diagnosis of inborn error of metabolism due to lack of routine screening in neonatal period, aggravated the problem.

Shigella gastroenteritis in children with a cute diarrhea in children welfare teaching hospital

Shigellosis is the most common cause of epidemic dysentery and affecting all age groups especially in the first [2] years of life, It is a major cause of childhood mortality and morbidity in developing countries. To study the extent of shigella gastroenteritis among children presented with acute diarrhea. Three hundred sixteen patient were included in the study [186 males and 130 females],admitted to the children welfare teaching hospital, medical city complex, Baghdad, suffering from diarrhea and their ages ranged from 2 months-10 years, over a 4 months period [from the first of December 2007 till the end of March 2008], History and physical examination were carried out, general stool examination and stool culture were done by taking fresh stool samples collected from these children and submitted to serial investigations. The study showed that out of 316patients suffering from diarrhea, 22[6.9%] patients with shigella positive, 16[6.2%]had watery diarrhea, 6[10.7%] had bloody diarrhea, 262[82.9%] were less than 2 years. Out of 22patients with shigella positive 12[54.5%] of them were less than 2 years. Most of the patients presented with diarrhea consume unboiled tap water 192 [60.8%], with 8 [36.4%] of them are Shigella species positive. The use of filtration and chlorination of water at home shows no shigella species diarrhea and only 2 [0.7%] Shigella species negative diarrhea. Diarrhea is the presenting symptom followed by fever 20[90.9%], vomiting 14[63.64%], Then abdominal pain 4[18.18%]. Shigellosis was found to be the third most common cause of infectious bacterial diarrhea following Escherichia coli and campylobacter jejuni and also the third most common cause of bloody diarrhea following entamoeba histolytica and Campylobacter jejuni, and the relationship between water supply and its sterilization with shigella infection is significantly different between people who consume purified and sterilized water than those who did not