Skin manifestations in insulin dependent diabetes mellitus [IDDM]

This study included one hundred children with IDDM, 51 females and 49 males with mean age 9.15 years +/- 2.25. They were subjected to full history taking, thorough clinical examination and investigations including random urine sugar and acetone, random blood sugar, glycosylated hemoglobin level, and clinical examination of skin lesions. Bacteriological and mycological examinations were done when needed. No significant relation was detected between the occurrence of skin manifestations and either the blood glucose level or the presence of ketoacidosis. The pyogenic and fungal infections increased significantly in children with poor glycemic control as proved by measuring the glycosylated hemoglobin level [HBA1C] which raises the need for proper geycemic control in IDDM. In conclusion the diabetic children should be regularly followed up and examincd dermatologieally for early detection and treatment of any skin disorder associating IDDM

Electrolytes profile in IDDM: special emphasis on calcium metabolism

This study was carried out to detect the changes in serum electrolytes including calcium, phosphorus, sodium and potassium in children with IDDM. Kidney functions as well as full urine examination were done together with the calcium in 24 hours urinary specimens to detect hypercalciuria and its relation to any kidney damage in these children. The study included 40 children, 22 males and 18 females [mean age 9.1 +/- 2.2 years]. They were classified into Group Ia and Ib i.e. those who did not present clinically and those who presented clinically with diabetic ketoacidosis. Twenty healthy children of the same age and socioeconomic status served as control group [Group II]. All children were subjected to full history taking and thorough clinical examination. They were investigated for random blood glucose, serum creatinine, serum alkaline phosphatase, serum electrolytes [sodium, potassium, calcium and phosphorus]. Urine was examined for glucose, nitrites, ketones, albumin and casts. A 24 hours urinary specimen was tested for calcium as well as for creatinine levels. The results showed significant increase in level of serum alkaline phosphatase in Groups Ia +Ib when compared to controls. There was no significant difference in serum sodium level in group Ia while a significant decrease was detected in Group lb when compared to control. There was no significant difference in levels of both groups Ia, Ib when compared to control group. There was significant increase in serum phosphorus in group Ia but no significant difference in group Ib when compared to controls. Serum creatinine showed no significant difference in both groups Ia, lb when compared to control group. Hypercalcemia was detected in both groups Ia and lb when compared to control group. Correlation studies were carried out between variants and showed significant positive correlation between glycosuria and hypercalcemia in group Ia and significant positive correlation was detected between ketonemia and hypercalcemia in group Ib and perfect positive correlation between urinary calcium excretion in mg/kg/24 hours and urinary calcium/creatinine ratio in both groups Ia and lb. No significant correlation was detected between duration of IDDM and height or weight percentiles and urinary calcium excretion in groups Ia and Ib. So routine laboratory examination of urinary calcium excretion is recommended in diabetic children to avoid or to early predict hypercalciuria in these children which may result in bone mineral toss and to formation of stones

Vitamin D metabolism among Egyptian infants and children affected with beta thalassemia

Sixty-five patients suffering from beta-thalassemia major were studied [46 males and 19 females]. Their ages ranged between 6/12-12 years [mean 5.8 +/- 2.2 years]. Twenty-five children of comparable age, sex, and socioeconomic status were studied as controls. Patients were classified into newly diagnosed and long-standing, who were furtherly classified into cases without hyperspienism, cases with hypersplenism and splenectonized cases. Each patient was subjected to full history taking thorough clinical examination and determination of serum calcium, phosphorus, alkaline phosphatase both total and fractional isoenzymes [liver and bone], 25 [OH] vitamin D3 1, 25 [OH]2 vitamin D3 parathyroid hormone and urinary calcium excretion. Serum ca1cium was significantly decreased after splencctomy. Serum phosphorus was significantly decreased except in patients with hypersplenism who showed normal values. Parathyroid hormone was decreased after splenectomy. 25 [OH]2 VD3 showed high significant decrease except in patients with hypersplenism. 1, 25 [OH]2 VD, showed very high significant decrease in all patients. Calcium/creatinine ratio in urine showed a very high significant increase in all cases. It might be con eluded that follow up of the levels of serum Ca, P, 25 [OH] VD3 1, 25 [OH]2 VD3, and alkaline phosphatase should be carried out in all thalassemic patients for early supplementation with vitamin D to avoid any bone mineralization defect together with the regular follow up of parathyroid hormone level especially after splenectomy