Role of transesophageal echocardiography in diagnosis of selected cases of congenital heart diseases in pediatrics

The development of pediatric transesophageal echocardiography [TEE] represents an important advance in the diagnosis and management of the patient with congenital heart disease. As with TEE a new echocardiographic window is obtained which enable cardiologist to explore the heart from esophagus and stomach. The purpose of this work is evaluation of the role and efficacy of transesophageal echocardiography [TEE] in diagnosis of selected cases of congenital heart disease whether cyanotic or non-cyanotic in the pediatric age group. TEE [biplane 14mm width] was performed in 25 patients at pediatric cardiology unit in Abou El-Rich hospital, Cairo University between December 2003 and December 2004. The mean age of 16 males [64%] and 9 females [36%] patients was 7.1 years. The anaesthetic protocol which used was Ketamine followed by midazolam. The procedure had terminated early in 2 cases only due to O2 desaturation [upper air way obstruction] in one and the other case need over sedation to sleep. TEE proved significant additional in formation in 22 patients [88%], ASD comprised 32%of them and other CHD 86%. TEE proved a more detailed evaluation of the morphology and function of systemic and pulmonary venous return, the atria, inter-atrial baffles, atrio-ventricular valves and the left ventricular outflow tract. Based on our experience the transesophageal echocardiography is safe and reliable but still semi-invasive, it should be done in selected cases of CHD especially cases of ASD to evaluate size of the defect probably

Disturbances of some plasma elements in juvenile diabetes mellitus and diabetic ketoacidosis

The level of six plasma elements including sodium, potassium, calcium, phosphorus, iron and selenium have been studied in 20 children suffering from juvenile diabetes mellitus [JDM] and 10 ketoacidotic patients both in acute stage and after control, in an attempt to study some aspects of this complex metabolic disease. The value of these plasma elements could be grouped into three categories: In the first group, Plasma elements were significantly lower than the control, before treatment and these included sodium and iron. In the second group, plasma elements values showed no significant change in comparison to control and these included selenium and potassium. In the third group, these values were significantly higher than the control group and these included phosphorus and calcium. The different results with their implication on treatment are discussed

Incidence, clinical picture and treatment of giardiasis in childhood

A random sample of 300 children attending the inpatient clinics of Banha and Tanta Universities Hospitals were examined for Giardia lamblia infection. 71 were positive for Giardia giving an incidence of 23.6%.Mixed infection with other parasites were found in 12 cases. The clinical picture was variable 22.5% were asymptomatic. Foul smelling stools, anorexia, abdominal pain and diarrhea were the frequent symptoms of infection specially in the pre-school aged children. Anemia and eosinophilia were also present. The children were given metronidazole as treatment which proved effective in 80.2% of them