Epilespie de l'enfant et de l'adolescent au Senegal

Introduction L'epilepsie constitue un probleme de sante publique au Senegal avec une prevalence de 8;3 a 14/1000. Elle concerne principalement les enfants. L'objectif de ce travail est d'etudier les aspects biographiques; phenotypiques et evolutifs de la maladie epileptique dans une cohorte d'enfants au Senegal. Methodologie Il s'agit d'une etude retrospective de dossiers d'enfants epileptiques suivis regulierement au CHU de FANN et a l'Hopital d'Enfants Albert Royer; de Juillet 2003 a decembre 2010. Les criteres d'inclusion etaient: epileptiques ages de moins de 18 ans; regulierement suivis depuis au moins 3 ans; ayant un traitement adapte; a dose efficace; avec une bonne observance therapeutique. Resultats Nous avons collige 522 enfants; ages de 3 mois a 16 ans; avec un sex-ratio de 1;7 en faveur des garcons. L'epilepsie etait idiopathique chez 57% des enfants et non idiopathique chez 43% des patients. Les facteurs etiologiques etaient domines par la consanguinite parentale; les anomalies de la grossesse et de l'accouchement; les infections du systeme nerveux central. Dans le groupe des epilepsies idiopathiques la consanguinite parentale et l'epilepsie familiale etaient retrouvees respectivement chez 64 enfants (21;62%) et 20 enfants (6;75%). Neuf enfants (3%) presentaient un trouble du langage isole; alors qu'un seul enfant (0;33%) avait un deficit cognitif global. Dans le groupe des epilepsies non idiopathiques; les signes associes a l'epilepsie etaient les troubles du langage (15;70%); du comportement (15%) et des deficits moteurs (10;32%). 22;41% des enfants scolarises avaient des difficultes d'apprentissage menant parfois a des redoublements scolaires ou une exclusion. Conclusion La classification syndromique a l'epilepsie est necessaire pour une bonne prevision pronostique et therapeutique. Le caractere idiopathique ou non en est pour une grande place; correle le plus souvent a une epilepsie familial ou une consanguinite ou affection perinatal ou infectieuse du systeme nerveux central

Study of some adolescents health problems and application of educational program among adolescents students in Sharkia govemorate-Egypt

Adolescence is a difficult and dangerous period of transition from childhood to adulthood. This population segment is exposed to a variety of health problems including; iron deficiency anemia, obesity, and dental caries, under nutrition, smoking, substance abuse and psychological problems. Objectives: This study is conducted to assess some of adolescents health problems and to explore their underlying factors. Also, it assesses the impact of an applied educational program for the most feasible problem. The study is composed of two phases, the first one is a cross sectional study that is conducted on a suitable sample size of preparatory, secondary school and university adolescents during the academic year 2004-2005. A multistage sampling technique is used for sample selection. A self-administered questionnaire is used to collect the following data; sociodemographic, dietary history, some lifestyle factors and depressionanxiety scale. Clinical examination, anthropomctric measurements and some laboratory tests arc done for the students. The second phase is an intervention one that is conducted after data collection, analysis and prioritization of health problems. Parasitic infection took the first priority to be solved, and the infected students are divided into intervention and control groups. A self-administered questionnaire is used to assess knowledge and practice of both groups regarding parasitic infection. The intervention group is subjected to medical treatment and an educational program while the control one is subjected to medical treatment only. After 2 months all participants are asked to complete the same questionnaire and stool analysis is done for them. The first phase of study showed many health problems among the studies adolescents, which are in sequence; dental caries, anaemia, parasitic infection, obesity, underweight, smoking, anxiety and depression. It was found that dental caries, anaemia, parasitic infection, underweight and depression were significantly associated with rural adolescents belonging to low social class. While, obesity and smoking were significantly associated with urban ones belonging to high social class. Anemia, obesity, anxiety and depression were more prevalent among females, while underweight and smoking were more among males. The problem of obesity was associated with those taking snacks and four meals or more, and not practicing exercise regularly. However, underweight was associated with those were taking less number of meals not and were not taking snacks. Finally, anxiety and depression, both were associated with smoking and absence of qxercise practice. The second phase showed reduction in the percentage of students who were infected by parasitic infection in both control and intervention groups with significant reduction in the intervention group reflecting the great impact of the educational program. The adolescents are exposed to some health problems and by assessing their knowledge about parasitic infestation, it was found to be relatively deficient. So, the study recommended a regular health appraisal for early detection, management in addition to application of a sustained health education program aiming to improve their knowledge, attitude and practice regarding the common health problems

Urinary N-acetyl-beta-D-glucosaminidase: as a marker for early detection of renal tubular disturbance in patients with IDDM [type 1]

Clinical diabetic nephropathy represents one of the major forms of microangiopathy complications of diabetes. This condition is associated with renal tubular as well as glomeruiar damage. The aim of this study is to N-acetyl-Beta-D glucosaminidase [NAG] and glomeruiar integrity was evaluate the level of NAG in IDDM patients [type1] and its relation to microalbuminuria, duration of diabetes and diabetic control. Tubular cell structural integrity was evaluated by measuring urinary measured by evaluating the level of microalbuminuria. in addition serum creatinine was evaluated as a common test for renal function. Moreover, the level of serum fructosamine and blood HbA1c were measured to assess the degree of the control of blood glucose along a short and long periods respectively. The study was done on three groups of male diabetic patients, type 1 [IDDM] according to disease duration. They were selected with aging up to 30 years old and of the same socioeconomic levels. In addition, age-matched healthy male persons were taken as controls. In conclusion, this study indicates that urinary NAG measurement is a sensitive, non-invasive test for early detection of diabetic patients at risk of developing diabetic nephropathy and as a good marker for long term period glycemic control in IDDM patients