Supraventricular tachycardias [SVTs] in a university] children's hospital emergency department: a 3-year experience

In a 3-year retrospective review of 3780 patients who were treated in a University Children's Hospital [ED] along a 3 yr period, 90% were medical cases and 10% were surgical. Admissions due to cardiac diseases represented 20% of all medical cases. During the period of the study there were 55 cases of SVT, representing 1.5% of all admissions and 8.5% of admitted cardiac cases. They were 38 males and 17 females in the age range of 18 days to 12 years. There was a significant predominance of male sex [male: female 2.2:1; P = 0.029]. Age distribution showed that PSVT mainly affected infants more than children, with a mean age of 1.7 yr [P = 0.01]. Among the PSVT patients 3 cases [5.5%] had an underlying cardiac disease while the remaining had lone arrhythmia. In 100%, clinical examination and ECG were diagnostic. Out of all study group, 48 cases [87%] were referred from outpatients clinics while only 7 cases [13%] were referred from inpatient departments of community secondary hospitals. Most referrals were from outpatients [P = 0.02]. The highest admission rates were recorded in summer months and early winter than during spring and fall [P = 0.013]. Appropriate treatment with vagal stimulation, medical treatment, or synchronized DC cardio-version was applied as indicated. In this study 51 patients [92.7%] were able to be discharged to their homes after a mean duration of 2-5 days' hospitalization, while 4 patients [7.3%] died. Two cases died within 24 hours, and other 2 died within 48 hours. Mortality from PSVT after 24 hours of admission represented 0.4% of total mortality of ED admissions. Bad prognosis was associated with: younger age, male sex, outpatient referrals and presence of heart failure at presentation

Microscopical changes in the renal tissue due to schistosoma haematobium infestation in adult golden hamsters and the curative effect of myrrh [mirazid] on these changes

Mirazid is a trade name of the purified oleo-gum resin extract from myrrh of commiphora molmol tree. It is used for treatment of schistosomniasis either haematobium or mansoni. This experimental model was done to demonstrate the histological, histochemical and ultrastructural changes of mirazid on the kidney of both adult golden hamsters and those infested with schistosoma haematobium. Forty two groups. adult male golden hamsters were used in this study. Half of them were divided into The control animals were given normal saline and the, treated animals were given mirazid. The rest of animals were infested with schistosoma haematobium parenterally.Eight weeks post infestation they were divided into two equals groups, the infested non-treated animals were given normal saline and the fourth group infested treated animals were treated with mirazid. All animals were given the treatment by intraperitoneal injection once daily for 3 days. After 24 hours from the last dose, kidney specimens were prepared to demonstrate the histological, histochemical and ultrastructural changes. Light microscopic examination of kidney slices of the infested non treated animals showed variable degrees of glomerular degeneration. There was hyaline material deposition in renal tubules. There was an increase in collagenous fibers depsition in the glomerular capillary tufts and in Bowmanis capsule. PAS reaction was decreased in the basement membranes of renal tubules and in brush borders of proximal convoluted tubules. The infested treated animals showed an obvious improvement in the glomeruli with marked reduction in hyaline immaterial deposition. There was a decrease in collagenous fibers deposition and PAS reaction in the renal glomeruli and tubules. Electron microscopic examination of the infested non treated kidney showed enlarged and, broad podocytes around a thick basement membrane of the capillary endothelium. The filteration slits were markedly decreased in number or completely disappeared. After treatment, the majority of podocytes regained their numerous minor processes and filteration slits inbetween. In conclusion, mirazid could be considered a safe and effective schistosomicidal drug

Assessment of neonatal convulsions in intensive care units

This study was carried out on 30 neonates with convulsions. They were selected from Abu Elrish Pediatric Hospital and AlGalaa Teaching Hospital between September 2000 and August 2001. They were selected irrespective of the etiology of the convulsions and all of them underwent full clinical, laboratory and imaging procedures in order to reach an etiologic diagnosis and delineate possible diagnostic measures which can predict the outcome and prognosis of their convulsions. EEG was done for all patients and its results were compared to those of cranial ultrasound. Although cranial ultrasound is an easy, rapid and noninvasive mode of diagnosis, EEG proved to be superior to it and of more diagnostic value in case of neonatal convulsions since they may arise from functional derangement of the brain and not necessarily anatomic lesions

Human cytomegalovirus immunoglobulin-G and immunoglobulin-M as serologic markers for human cytomegalovirus infection in immunocompromised children

Determination and estimation of levels of cytomegalovirus [immunoglobulin-G [IgG] and cytomegalovirus immunoglobulin-M [IgM]] in immunocompromised children suffering from leukemias and lymphomas will be of help in controlling the spread of infection of this virus among the community. One hundred and four children [74 immunocompromised patients and 30 control children] were enrolled in this study. Patients and control children were between 1-15 years old with a mean age of 8.6081 years [ +/- 3.9249 SD] and 7.5500 years [ +/- 3.3650 SD], respectively. All patients and controls were subjected to full history taking, complete blood picture, liver function tests and CMV markers [IgG and IgM] by ELISA technique. The results of this study concluded that immunocompromised children, especially those taking blood transfusion, are more liable to have CMV infection. The present study showed that, ELISA technique is highly sensitive method, easily to perform, reliable, not time consuming [takes only few hours] and simple in its interpretation

Infection prophylaxis in the myelosuppresed patient with cancer

The present prospective study included 29 patients attending the Paediatric Unit of Kasr El-Aini Center of Radiation Oncology and Nuclear Medicine. Eligible patients were randomly allocated to receive or not to receive oral prophylactic antibiotics as well as miconazole [2%] oral gel. Incidence of infection was higher among the control group [77.8%] than the antibiotic group [61%]. However, the difference was not statistically significant. On the other hand, more patients among the control group [86%] significantly developed oral moniliasis than those among the antibiotic group [55.5%] [P = 0.001]

Etiological basis of some chronic chest problems of obscure nature in infants and children

Patients with chronic chest problems where no specific diagnosis has been made by non-invasive methods present a diagnostic problem. In this work, 17 patients with chronic chest problems of obscure nature had been studied. Computed tomography delineated the nature of both the bronchogenic and post-traumatic lung cysts while lung biopsy proved useful in the diagnosis of pulmonary hemosiderosis, congenital bronchiectasis, as well as the miliary shadows in the case of miliary T.B. Chest X-ray with barium swallow revealed indentation and kinking of the esophagus by the aberrant left subclavian artery in the cases of Dysphagia lusoria which was subsequently confirmed by echocardiography. Echocardiography also elicited dilated cardiomyopathy and mitral regurge in another case while immunological deficiency syndromes were detected in four cases after thorough immunological study

value of blood cultures in the management of febrile patients later found to have septicaemia

Septicaemia, a common problem among the pediatric patients in the preantibiotic era, has been identified recently in several reports amongapparently healthy children. The impact of blood cultures in detection and early management of 13 cases with septcaemia was evaluated. The blood cultures proved to be of diagnostic value in 77% of cases of septicaemia as clinical assessment is not always reliable in identifying these children, yet its value is negligible in those with serious complications

Diagnosis of peritoneal tuberculosis among cases of ascites in children by estimation of ADA in ascitic fluid and serum

Peritoneal tuberculosis is still a very important cause of ascites in Egypt. This study used the estimation of adenosine deaminase [ADA] activity in ascitic fluid of variable etiology as a diagnostic aid in peritoneal tuberculosis. Simultaneous estimation of serum and ascitic fluid ADA level was done with subsequent calculation of the ratio [A/S] between them. A value above 50 U/L in ascitic fluid is highly suspicious for TB if other causes of ascites with false positive results [e.g. malignancy] are excluded. A value of more than 60 U/l in ascitic fluid can be considered a cut off point and values above this would clearly denote tuberculosis. Ascitic fluid /serum ADA ratio above 3 is also diagnostic for peritoneal TB