[Study [knowledge, behaviour practices] of 116 mothers on vitamin D supplementation]

In our country, the prevention of rickets is based on daily vitamin D intake from birth to eighteen months .This vitamin D intake has decreased according to our hospital practice. To assess vitamin D supplementation prevalence and to study mother knowledge, attitude and practices about vitamin D and factors that influenced them and to define target population who needs further education. A predefined questionnaire was submitted to 116 mother's child who was aged from two months to three years and were hospitalised for acute disease in Tunis children hospital. The questionnaire was filled by the paediatrician. He included as well questions on vitamin D supplementation and questions on socio- demographics characteristics. 68% of the infants had received vitamin D. The various significant factors who influenced the knowledge about vitamin D were father and mother out of work, low education level, and the living in a deserited area, The factors that influenced significantly the practices were the one parity and the living far away, up to five kilometer, from a primary health care. Given that the supplementation of vitamin D is recommended for all infants the study show that supplementation prevalence is unsatisfactorily low. Various risks factors were identified. In view of the new evidence emerging on additional preventive properties of vitamin D and the resurgence of rickets, its promotion must be discussed anew

[Primary lung abscess: unusual situation in child a case report and review of literature]

Lung abscess is a localized area of non tuberculosis suppurative necrosis of the parenchyma of lung, resulting in formation of cavity containing purulent materiel. It is uncommun in child. A 3 years boy was admitted with prolonged fever and dyspnea. Chest X ray showed a thick walled hydric cavitation opacity containing an air-fluid level. Chest ultrasound examination showed collection of 6,8 cm of diameter in the right pulmonary field with an air-fluid level. Hemoculture showed Staphylococcus aureus. Patient presented septic shock and surgical drainage was indicated. Histological examination confirmed diagnosis of lung abscess. Any inderlying condition was noted and diagnosis of primary abscess was made. Patient demonstrated complete recovery. He's asymptoamtic with normal chest X ray and pulmonary function after 3 years of evolution. Lung abscess represent a rare cause of prolonged fever in child. An underlying condition must be excluded to eliminate secondary abscess. Long term follow up of pulmonary function is capital

[Barakat syndrome a report of two cases]

Barakatsyndrome or HDR syndrome [Hypoparathyroidism, sensorineural deafness and renal disease] is an inherited condition. It's a very rare disease. Patients may present with tetany or convulsions due to hypocalcemia at any age. Deafness is usually bilateral and may range from mild to profound impairment. Renal disease has several manifestations. We report the cases of a girl [Ferdaous] and a boy [Taha] which are respectively of 16 years old and 6 years old. The girl only was born of intermarriage. Her brother and sister were treated for hypoparathyroidism. Both of our patients had sensorineural deafness and a nephropathy: a nephrotic syndrome in Ferdaous's case and a proteinury in Taha's case. The girl was treated for hypoparathyroidism since she was 12 while the boy was admitted in emergency for tonico-clonic seizures, reported to a profound hypocalcaemia. Hypoparathyroidism was confirmed by a very low parathormone rate. The endocrinal and cerebral radiological investigations were normal. By this case report, the authors remember the Barakat syndrome: its clinical and biological features, and its different possible progressions. The mode of inheritance is believed to be autosomal dominant. Mutations in the GATA3 gene, mapped to chromosome 10p [gene map locus 10p15, 10p15.1-p14], have been identified in several families with Barakat syndrome. Possibilities of antenatal diagnostic are offered to theses families

[Inaugural diabetic acido-ketosis: rare endocrine complication in thalassemia child]

Diabetes is a sparse endocrine complication of f3 thalassemia major. We report the case of a 14year-old boy with beta thalassemia major, who was polytransfused without regular iron-chelation therapy. He was admitted to hospital with acidosic dyspnoea and severe deshydratation without signs of cardiac failure. Urine examination showed glucosuria and acetonuria. On laboratory exams, glycemia was 39 mmol/l with severe metabolic acidosis. The diagnosis was a diabetic acido-ketosis requiring insulin therapy. Diabetes was hardly controlled; serum ferritin level was 4500 mg/l. Serum ferritin level is the main risk factor for diabetes in patients with beta thalassemia. Thus, an adequate iron-chelation therapy can prevent this complication

[Digeorge syndrome in a new born: DEL22q11.2 IN Tuple1 Locus]

The DiGeorge syndrome is a genetic anomaly due to the microdeletion 22q11.2. This syndrome is characterized by a large variability in the clinical features. In this report we describe a DiGeorge syndrome diagnosed in a new born of a diabetic mother. He presented mild dysmorphia, ventricular septal defect and hypocalcaemia due to hypoparathyroidism. The diagnosis was confirmed by the cytogenetic study