Pediatric heart diseases in Madina, Saudi Arabia. Current status and future expectations

To demonstrate the magnitude of pediatric heart disease problem in Madina, current situation of heart service, obstacles and future expectations. We conducted this cross sectional study in Madina Maternity and Children Hospital, Madina, Kingdom of Saudi Arabia from January 2007 to June 2008. The study was approved by the Ethical Committee. A computer based program was established to register the data of all children attended the pediatric cardiology unit. A total of 4348 children were seen in the study period; 2301 were follow up cases while 2047 were new cases. Of the new cases, 794 [38.8%] were found to have heart diseases. Of this, 705 have CHD [cardiomyopathies 34, rheumatic heart disease 26, mitral valve prolapse 15, Kawasaki disease 9, and arrhythmia 5]. Ventricular septal defect was the most common CHD [34.5%], and followed by atrial septal defect [8.9%]. Other CHDs were as follows pulmonary stenosis [7.9%], patent ductus arteriosus [6%], atrioventricular septal defect [3.8%], aortic stenosis [3.5%], dextro-transposition of great arteries [3.5%], tetralogy of fallot [3%], coarctation of aorta [2.8%], and others [26%]. Three hundred and ten patients required referral to the cardiac centers in Riyadh for catheterization or surgical intervention. Urgent referral was required in 128 patients. All patients were transferred via medical evacuation service. Pediatric heart disease constitutes a major health problem in Madina. The majority of patients have CHD. The need for cardiac centre in Madina was emphasized to avoid problems of transportations

Epidemiological and clinicopathological study of childhood idiopathic nephrotic syndrome in Sohag-Egypt

To study the epidemiological, clinical and histopathological parameters of childhood idiopathic nephrotic syndrome in Sohag. This is a prospective cohort study conducted at Pediatric Nephrology Unit, Sohag University Hospital from Sept.2004 to March 2006. All patients with newly diagnosed nephrotic syndrome were eligible to this study. In addition to full history and clinical examination all patients were subjected to urine analysis, urinary albumin creatinine ratio, serum albumin, serum cholesterol and triglycerides, kidney function tests and complement [C3]. All patients received the conventional treatment of nephrotic syndrome [oral prednisolon 2 mg/kg/day in 3 divided doses for one month]. If the patient is respond the total daily dose of prednisolon was given as a single dose with breakfast every other day for 6 months]. If the patient do not show any response despite one month of daily treatment we did a renal biopsy. Patients who responded but have frequent relapses were also subjected to renal biopsy. A total of 134 children [84 males: 50 females] with nephrotic syndrome were enrolled into this study. Their mean age was 8.4 years +/- 1.8. Male to female ratio was 1.7:1. 110 patients [82.1%] showed initial response to steroid [steroid sensitive]. On follow up of these patients 28 patients [25.5%] had no relapse, 34 patients [30.9%] had infrequent relapses, 39 patients [35.5%] had frequent relapses, and 9 patients [8.2%] became late steroid non responders. 24 patients [17.9%] show resistance to steroid from the start [steroid resistant nephrotic syndrome]. Steroid dependency noted in 57 patients [51.8%] of all categories. 47 patients have been subjected to renal biopsy: 25 patients [53.2%] have Focal segmental glomerulosclerosis [FSGS], 11 patients [23.4%] have minimal change nephrotic syndrome [MCNS], 9 patients [19.1%] have mesangioproliferative [MPGN], and 2 patients [4.3%] have membranous glomerulonephritis [MGN]. Nephrotic syndrome is common in our locality. Clinical aspects and rate of response to treatment of our patients are similar to published studies. However our patients are different in histopathological aspects. Renal biopsy is an important, safe, and an accurate method for the diagnosis of selected cases of nephrotic syndrome