Pattern of major congenital anomalies

Currently, in the Arabian Peninsula, genetically determined disorders account for an increasing proportion of death, morbidity, chronic handicap, and disability. To study the pattern and classification of MCAs in Asir region, during six-year period, in order to allow proper genetic counseling, early management and rehabilitation. The study included all neonates with congenital anomalies referred to Asir Central Hospital from 1997 to 2002. Cases with genetic syndromes were diagnosed by review of Mandelian inheritance in man and the London dysmorphology database. The major congenital anomalies were classified according to the ICD-10 system, and multiple MCAs were counted only once by the system of the most major anomaly. Of 1171 newborns admitted to neonatal intensive care unit [NICU] at Asir Central Hospital, 691 newborns were proved to have congenital anomalies, constituting 59.1% of all admissions. According to ICD-10 classification of congenital anomalies, the systems involved in the MCAs investigated were [in descending order of frequency] as follows: digestive 28.6%, central nervous 26.1%, circulatory 16.5%, urogenital 7.1%, face and neck 4.1%, respiratory 6.2%, musculoskeletal 3.6%, chromosomal 3.3%, and other anomalies 4.5%. Congenital anomalies represent the main reason for referral to NICU in Asir region, and this implies that congenital malformations constitute significantly to perinatal and infant morbidity in the region. Premarital counseling should be advised, especially in the presence of parental consanguinity and family history of a congenitally malformed child

Comparative study of different inhaler devices in asthmatic children

The inhaler is an important drug delivery system in the treatment of asthma, but inhaler technique is often inadequate. We assessed technique in children diagnosed with asthma, comparing the performance of three devices. Patients and In a cross-sectional survey, 523 children [271 boys, 252 girls, ages 5 to 12 years; mean SD 7.53 1.79 years] demonstrated inhalation technique according to Netherlands Asthma Foundation criteria during a first visit to a primary care clinic in Abha, Saudi Arabia. Patients used the device with which they were most familiar [either pMDI, Turbuhaler or Diskus]. Two hundred children [38% of total population] used a pMDI, while 323 [62% of total population] used one of the dry powder inhalers

Assessment of inhalation technique in children with asthma, Abha, Saudi Arabia

The inhalation technique of asthma in children was assessed using the criteria defined by the standardized inhaler checklist of the Netherlands Asthma Foundation and Dutch asthma foundation. Four hundred and thirty seven newly referred patients to chest clinic, department of pediatric, Assir Central Hospital, Southwestern Saudi Arabia were instructed to demonstrate their inhalation technique and to fill out a questionnaire related to the inhalation instructions received before their referral. Four hundred and thirty seven patients newly referred for evaluation of their asthma 5-12 years of age with mean age of 7.16+1.69 years, 202 [46.2%] girls, 235 [53.8%] boys were included in the study. Two hundred two [46.2%] patients use MDI. The remaining [53.8%] patients use the DPI, 123 [52.35%] of them use turbohalers white 112 [47.65%] use diskhalers. Only 36 patients [8.2%] completed the assessment without making any mistake. Of the remainders, 399 [91.8%] made one or more mistakes. Of the MDI users, eleven patients [5.4%] performed correctly all the steps, and 54 [26.7%] performed correctly four or more steps. Ten [8.9%] of the diskhaler users performed all the steps correctly and forty nine [43.8] performed correctly four or more steps. Fifteen [12.2%] of the turbohaler users performed correctly all the steps and ninety five [77.2%] performed correctly four or more steps. One hundred five of the male patients [44.7%], performed correctly more than three steps as compared to 93 of the female patients [46.5] with p value=0.704. One hundred and one patients [67.3%] between the age of 8-12 years performed more than three steps correctly as compared to 97 [33.8%] of patients aged 5-7 years p=0.001. In conclusion, many asthmatic children use their inhaler devices too poorly with the result of an unreliable drug delivery. Turbohaler device inhalation technique was the easiest, followed by diskhaler then lastly the MDI. Education of asthmatic children and their families is highly needed to make sure the patient perform the correct inhalation technique