frequency of type 2 diabetes mellitus among diabetic children in El Minia Governorate, Egypt

Type 2 diabetes mellitus [T2DM] in children and adolescents is becoming an increasingly important public health concern throughout the world. This study aimed to estimate the frequency of T2DM among diabetic young people in El-Minia Governorate, Egypt, and to detect its risk factors. A total of 210 diabetic patients under 18 years old in Minia Governorate were included in the study and underwent a thorough history-taking, a physical examination and laboratory investigations. T2DM was present in 28 patients [13.3%]; it was significantly present in 18 females [64.3%] and 20 [71.4%] of them had a positive family history of DM. T2DM patients had significantly higher BMI and waist circumference centiles for age and sex than those with T1DM. Also, haemoglobin A1c%, serum C-peptide and cholesterol levels were significantly higher in T2DM than T1DM patients. Finally, there were weak significant positive correlations between C-peptide level and both BMI and waist circumference. T2DM is no longer a disease of adults but can also occur in children and adolescents. The results suggested that obesity, female gender and a positive family history of DM are risk factors for T2DM. Also, patients with T2DM had poorer glycaemic control and hypercholesterolemia than those with other types of diabetes

Effects of exchange transfusion and phototherapy on neonatal thyroid functions

Hyperbilirubinemia is one of the most common problems encountered in term newborns. Phototherapy or exchange transfusion may be indicated for treatment at certain bilirubin levels. Aim of the work: Is to study the effects of exchange transfusion and phototherapy on thyroid functions in full term neonates with indirect hyperbilirubinemia by assessing thyroid functions before and after exchange transfusion and during phototherapy. The present study was carried on 60 full term neonates who were grouped as follows: Group I: Included 20 neonates with hyperbilirubinemia reaching the level that indicated exchange transfusion. Group II: included 20 neonates with hyperbilirubinemia at the level of treatment by phototherapy. Group Ill: included 20 healthy neonates as a control group. All studied groups were subjected to full medical history, clinical examination and laboratory investigations including Free T3, Free T4, TSH before, immediately after and 4 days after exchange transfusion in group I, Free T3, FreeT4, TSH before and 2 days after the beginning of phototherapy in group II, Free T3, Free T4, TSH in group Ill, Free T3, T4, and TSH levels were assessed in donor blood bags prepared for exchange transfusion. In addition liver function tests, complete blood count, Coombs' test, C reactive protein, blood group of baby and mother were assessed for neonates in group I and II. We found that the levels of thyroid functions [FT3, FT4, TSH] were statistically significantly higher in neonates before exchange transfusion than immediately after exchange while there was no statistical significant difference in levels of thyroid functions before exchange transfusion and 4 days post exchange transfusion. Furthermore, the study revealed no significant differences between thyroid function tests before and during phototherapy. Moreover, there were no significant correlations between thyroid function tests and either bilirubin or hemoglobin levels of group I before exchange transfusion and group II before phototherapy. We found that exchange transfusion causes a decrease in thyroid functions immediately after exchange than before exchange and they return to normal levels four days post exchange. On the other hand, phototherapy does not affect thyroid function tests

Urinary tract infection in infants with unexplained fever

This study included 150 infants [2 months to 2 years of age] presenting with fever [38.30C]; they were 68 males and 82 females. They were subjected to history taking, physical examination and laboratory investigations including complete blood count, erythrocyte sedimentation rate [ESR] and urine analysis and culture. Urine samples were obtained either by suprapubic aspiration or urethral catheterization. Renal ultrasound was done for infants with positive urine culture. Overall prevalence of UTI in the group was 11.3% [95% confidence interval "CI": 9.7-13.4]. The rate was higher in female infants [13.4%, 95% CI: 10.1-15.6], in infants less than one year [13%, 95% CI: 10.3-15.1] and I ill-appearing infants [15.6%, 95% CI: 11.5-17.9]. Prevalence was higher in infants with higher total leucocytic count [15.00/mm3] [20%, 95% CI: 15.9-23.1] and in infants with pyuria, >5 pus cells / HPF [50%, 95% CI: 44.2-51.8], hematuria, >5 RBCs / HPF [13.6%, 95 CI: 10.0-15.8] and positive nitrite test in urine [80%, 95% CI: 74.0- 87.2]. Among 17 infants with positive urine culture, 15 had infections caused by E. coli and 2 by Klebsiella and abnormal findings were encountered in 3 infants using renal ultrasonography