Predictors of hypoxemia in children with acute lower respiratory tract infections

Acute lower respiratory tract infections [ALRI] are the leading cause of morbidity and mortality among children in developing countries, causing one - third of all deaths in childhood. Pulse oxymetry is a simple technique to determine the oxygen saturations. It is important to accurately identify hypoxemic children by use of clinical signs alone. A well matched case control study was performed on 104 children from 2 months to 5 years ot age admitted with ALRI to the emergency department of Children Welfare Teaching Hospital -Medical City - Baghdad in the period from 15[th] March -15[th] June 2006. Clinical symptoms and signs were recorded. Hypoxemia was defined as oxygen saturation less than 95%. The ability of various clinical symptoms and signs to predict the presence of hypoxemia was evaluated. Fifty [48.1%] children were hypoxemic. The median O[2] saturation was 91.2% with a range of 82-94% Physical signs including tachypnea, intercostal and subcostal retractions, supraclavicular recessions, grunting and nasal flaring were statistically significantly associated with hypoxemi. Use of combinations e.g. Tachypnea or head nodding [P. 0.02, sensitivity 70%, specificity 48%], tachypnea or suprasternal recessions [P.0.05, sensitivity 70%, specificity 44%] only slightly improved the predictive ability. None of the clinical features either alone or in combinations have sufficient sensitively and specificity to predict hypoxemia in children with acute lower respiratory tract infections, therefore pulse oxymetry is desirable for identification of hypoxemia

Epidemiological, clinical profiles and outcome of bronchiolitis in Iraqi children

Bronchiolitis is the first episode of wheezing associated with low-grade fever, rhinitis, tachypnea, and increase respiratory effort in a previously healthy infant during the winter months. It is the most common disease of the lower respiratory tract. This is a case control study carried out on one hundred infants with a mean age of 3.9 months +/- 2.2 months admitted to Children Welfare Teaching Hospital in Medical City -Baghdad with acute bronchiolitis during the period from 1[st] January 2006 to 1[st] April 2006. epidemiological risk factors, clinical presentations, chest X-ray findings, treatment, complications and outcome were analyzed. Another one hundred infants [age and sex matched] were seen in the outpatient clinical in the same period and for health problems other than bronchiolitis were taken as a control group. Chi square test was used and a P<0.05 was considered significant. It was found that 64% of patients were males and 36% were females M/F: 1.9/1, 80% were <6 months and 20% were >6 months of age. Most cases [87%] were admitted on January and February. Bronchiolitis was uncommon and less severe in neonatal period. There was a significant association between urban residence and acute bronchiolitis. There was no significant association between each of family history of atopy, parental smoking, pets at home and crowding index > 30 with bronchiolitis. Fever >38.1C was significantly more common in infants with bronchiolitis > 6 months of age than those less than 6 months. The mean clinical scores of severity, the mean duration of hospitalization and Chest X-ray findings were higher in: male sex, age <6 months, infants who were on exclusive breast feeding. Corticosteroids did not reduce the duration of hospitalization in children with acute bronchiolitis

Latent and subclinical hypothyroidism anti-thyroid antibodies in patients with simple multinodular goitre prior to surgical intervention

The current study included 139 patients with simple nodular goiter with normal free T3 and free T4 studied prior to any surgical intervention. Thirty-three cases had raised serum TSH above the normal limit of 5 muU/ml, 16 of them had a raised TSH above 10 muU/ml reflecting a latent hypothyroid state. In all cases, the postoperative pathology report confirmed the presence of simple nodular goiter with the exception of six cases, in whom the histopathologic examination of the surgical samples confirmed the presence of thyroiditis. The autoimmune profile as well as antithyroid antibodies [antimicrosomal and antithyroglobulin antibodies] of theses patients were studied. In five cases, the antithyroid antibodies were positive