Iron therapy for breath holding attacks in non-anemic infants and children

Breath holding attacks are common paroxysmal disorders in infants and children. Research trials showed good response to iron therapy. Most of these trials however, included anemic patients. To study the effect of iron therapy in the treatment of breath holding attacks in non anemic infants and children. This study has been carried out in the pediatric department, Sohag faculty of medicine in the period from 20 March 2005 to 20 February 2006. During this period all patients with breath holding spells were identified. Patients with anemia manifested clinically or with low Hb level or with low ferritin level were excluded from the study. We also excluded patients with abnormal neurological examination or abnormal electroencephalography [EEG]. The remaining patients [non-anemic neurologically normal patients] received oral iron in a dose of 6 mg/kg/day for 3 months. The response was determined either by disappearance [complete response] or decrease in the frequency and duration of attacks [partial response]. We identified 56 patients with breath holding spells. 27 patients were excluded from the study [20 were anemic, 4 had abnormal EEG and 3 had abnormal neurological examination]. The remaining 29 patients had been included in this study and received oral iron therapy. 3 patients received iron therapy but losses follow up. Concerning the 26 patients who had completed the study: 13 patients showed complete response, 4 patients showed partial response and 9 patients did not show any response. Iron therapy should be tried in all infants and children with breath holding attacks

Admissions and outcome in a newly established pediatric intensive care unit in a university hospital in Upper Egypt

Pediatric intensive care unit [PICU] allows continuous monitoring and offer intensive therapy for infants and children with severe and sometimes life threatening diseases. Our PICU was established in January 2006 and is located within the pediatric department. To study the admission and outcome of our PICU in the first 18 months of establishment. This is an observational retrospective study of admission and outcome of patients admitted to our PICU in the period from 1/2/2006 to 3 1/7/2007. The total number of admissions was 506 patients, their median age was 13 months [interquartile range = 4-88], their median duration of admission was 4 days [interquartile range = 2-144] and the total death rate was 45.5%. Common reasons for admission were Central Nervous System [CNS] problems [129 eases = 25.5%], severe pneumonia [113 cases = 22.3%], scpticemia [98 cases = 19.4%], heart problems [66 cases = 13.0%], severe gastroenteritis [54 cases = 10.7%] and accidents [29 eases = 5.7%]. The relatively high death rate is very alarming hut expected as we only admit patients who are severely ill or those who deteriorate despite treatment in our pediatric department. Despite this our PICU served many patients that were previously been referred to Assiut or Cairo PICUs. Based on the results of this study many changes in management protocols are currently being prepared to improve performance and hopefully decrease the death rate