Is there an association between type 1 diabetes in children and Gallbladder stones formation?

A number of studies in adults have evaluated the prevalence of gallstones in the diabetic population and showed a significant association with type 1 diabetes [T1D] and type 2 diabetes. The pediatric literature is limited to a single small case series. We conducted a cross-sectional study to evaluate for the presence of association between T1D in children and gallstones formation. Children diagnosed with T1D in a diabetic clinic have been examined for existence of gall bladder stone formation from November 2008 through November 2009. All have been subjected to the following: History, physical examination, blood tests [liver function tests, lipid profile, glycosylated hemoglobin [HbA1C]], and an ultrasound [US] of the gall bladder. One hundred and five children with T1D have been enrolled consecutively over a 1-year period: age ranged between 8 months and 15.5 years, 62 patients were females. The mean age at diagnosis was 6.3 +/- 2.9 years [range 0.85-11 years], mean duration of T1D was 2.2 +/- 2.1 years [range 0.2-8 years], mean body mass index was 16.5 +/- 3.4, mean HbA1c was 10.7 + - 2.4%, and 61.3% of patients had a HbA1c level >10%. The mean serum cholesterol was 4.16 +/- 0.75 mmol/L [normal 3.65-5.15 mmol/L] and mean serum triglyceride 1.02 +/- 1.3 mmol/L [normal 0-1.7 mmol/L]. Two patients had hyperlipidemia. US of the gallbladder did not show any case of gallstones or sludge formation. Data from our study do not show any association between T1D in children and gallstones formation, with diabetes duration of less than 8 years. The relatively short duration of diabetes and possibility that our study was underpowered might have been reasons for the absence of any association

case of pediatric gastrointestinal basidiobolomycosis mimicking Crohn's disease. A review of pediatric literature

Basidiobolomycosis is a rare fungal infection caused by basidiobolus ranarum. The vast majority of gastrointestinal basidiobolomycosis cases were reported from tropical and subtropical regions. We report a Saudi pediatric patient with ileal basidiobolomycosis and initial clinical presentation mimicking acute appendicitis before being misdiagnosed as Crohn's disease. Our case is the first to report effective treatment of pediatric gastrointestinal basidiobolomycosis using voriconazole mono-therapy. In addition, we present extensive review of pediatric gastrointestinal basidiobolomycosis in medical literature

Hepatoprotective effect of some drugs in experimental model of acute liver injury

Acute liver injury is a clinical condition that results from severe extensive damage of liver tissue associated with Jaundice and it is experimentally induced by hepatotoxic agents like ccl[4]. Thirty five healthy rabbits were involved in the present study. They were allocated to five groups. Each group was given one of the following agents: vitamin E, zinc sulfate, amlodipine besylate, distilled water two hours before administration of ccl[4]. The same doses of the tested agents were continued for two days after ccl[4] administration. The effect of drugs was evaluated at two occasions 24 and 72 hours after ALI induction on the basis of biochemical analysis of liver function tests as well as histopathological examination to the liver of treated animals. All the tested agents produced significant reduction in ALT, AST, ALP, and TSB with a significant elevation of TSP levels as compared with treated control group. The histopathological examination showed clear improvements in the sections of liver tissue that support the effect of these agents on the liver. The study showed that 30% of women were anemic; the effect of anemia on thyroid function was not clear as 98% of the studied women have normal thyroxin and only 1% has low thyroxin level while 1% showed high concentration of thyroxin level. All the tested agents proved to have hepatoprotective effect of varying degree on ALI model

Magnetic toy ingestion leading to jejunocecal fistula in a child

The accidental ingestion of a foreign body is a common problem in children, but ingestion of magnets is rare. When multiple magnets are ingested, they may attract each other and cause pressure necrosis through the bowel walls and eventually lead to serious complications like obstruction, perforation, and fistula formation. We report a case of a 5-year-old girl with jejunocecal fistula following ingestion of 2 magnet toys; it highlights the diagnostic challenge and the need for early surgical intervention in children especially when multiple magnets are ingested

Surgical outcome of canal wall up procedures with reconstruction versus without reconstruction

To compare the surgical outcome of canal wall up procedure with reconstruction versus without reconstruction, considering recidivism, otorrhea and hearing level. Fifty two patients with middle ear cholesteatoma were involved in this study. 26 patients were submitted to canal wall up with reconstruction and 26 patients, to canal wail up without reconstruction. cholesteatoma was attic in 32.7%, atticoantral in 36.5% and extensive in 30.8%. cholesteatoma residual or recurrence was found in 10 patients [19.2%] during the three years period of follow up. seven out of them were children, [2 in attic region with reconstruction, 2 in atticoantral with reconstruction and 3 in atticoantral without reconstruction, one in extensive with reconstruction and 3 in extensive without reconstruction. Otorrhea in attic was 45.5% in canal wall up with recons/ruction and 50% after without reconstruction, in atticoantral was 50% and 54.4% in canal wall up with and without reconstruction respectively and in extensive cholesteatoma was 42.9% after canal up with reconstruction and 44.4% after without reconstruction. There was statistically significant hearing improvement [8. 91dB] after canal wall up with reconstruction in attic cholesteatoma while decreased by [2dB.] after canal up without reconstruction, in atticoantral and extensive cholesteatoma the hearing gain was insignificant. surgery should be planned according to the site, size of cholesteatoma and age of the patient. One stage tympanoplasty is not recommended for childhood or for extensive adult cholesteatoma but only for attic cholesteatoma in adult

Esophageal trachealization: a feature of eosinophilic esophagitis

Eosinophilic esophagitis [EE] is an inflammatory condition characterized by intense eosinophilic infiltration of the esophagus. EE is frequently misdiagnosed as gastroesophageal reflux disease. Here, we present a child with EE and a characteristic endoscopic finding, "ringed esophagus". An 11-year-old Saudi boy presented with dysphagia for 1 year. He had experienced an intermittent sensation of solid food sticking in his chest, which was relieved by drinking liquids. A barium swallow excluded anatomical causes of dysphagia, but revealed multiple-ringed esophagus. Endoscopy showed a furrowing and trachealizing appearance of the entire esophagus. Hisologically, extensive eosinophilic infiltration was a feature in biopsies obtained from the esophagus. The child responded well to a 2-month course of inhaled fluticasone. Symptoms recurred 3 months after discontinuation of therapy, which necessitated resumption of inhaled fluticasone. The endoscopic appearance of multiple esophageal rings should raise suspicion of EE and be confirmed by esophageal biopsies

Carcinoma of breast co-existing with non-Hodgkin's lymphoma of axillary lymph nodes

The co-existence of breast carcinoma and lymphoma in the axillary lymph nodes, without a history of previous chemotherapy or radiotherapy is rarely described. We present a case of a 50-year-old female with right breast mass, proved by pathological examination to be invasive mucinous carcinoma. Examination of the axillary lymph nodes as axillary clearance showed concomitant small lymphocytic lymphoma and chronic lymphocytic leukemia, with no evidence of metastatic mammary carcinoma deposits

Profile of child and adolescent psychiatry in Oman

To find the common behavioral problems in youth, their co-morbidity, treatment, and other variables in Oman. All patients who attended the child psychiatric clinic in Sultan Qaboos University Hospital [SQUH], Muscat, [the only child psychiatry clinic in Sultanate of Oman] for a 3-month period were investigated for behavioral problems, particularly hyperactivity [by Conners' Questionnaire]. The diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Of the total 212 cases, Omani nationals constituted 89% and the rest were expatriates. Sixty five% were boys, 57% were of school age, 26% were adolescents, 9% were preschoolers and 5% were toddlers. Consanguinity among their parents was high at 52%. The majority [60%] of the patients exhibited hyperactivity. Aggression was found in 49%, while stealing and lying were found in 25% and 22%. Approximately one-third suffered from headache and abdominal pain. The majority [62%] were of below-normal intelligence. Anxiety affected 14%, depression 4%, and conduct disorders 8%. One-third of the patients were taking psychostimulants and another one-third were taking tricyclics. The results were compared with those from other developing countries. Behavioral problems among children and adolescents are high in Oman, same as other developing countries, though the type of disorders is different here. This calls for the attention of the health policy makers for diagnosing and treating such disorders in Oman as well as in the other developing countries

Psychological morbidity in primary health care in Oman. A preliminary study

To study the applicability of simple field measurements of physical fitness in a sample of Omani boys and their relationships to selected variables. Two field measures of physical fitness-the time to complete 1.6-km run/walk and the sum of 5 skin fold thicknesses-were correlated with personal and family physical activity-related and other variables in a sample of 109 Omani boys aged 9-11 years. Obesity in parents, especially in the mother, showed significant correlation with both fitness measures. The waist/buttocks ratio showed no significant correlation with the 1.6-km time. The number of siblings and siblings sharing a room, number of T.V-watching hours and the number of servants in the family showed no correlation with the chosen fitness indices. The results of this pilot study indicate that simple field fitness tests can be used in children and they can yield valuable information related to physical fitness. The same protocol used in this study could be applied to a national study in Oman

Clinical and histopathological study of an inflammatory aural polyp and its relation to underlying cholesteatoma

Aural polyp is a sign of chronicity of otitis media. Cholesteatoma as underlying disease may be difficult to be diagnosed. Clinical, radiological and bacteriological examinations did not help much to diagnose the underlying cholesteatoma. Histological examination was a good predictor of the presence or absence of cholesteatoma in some cases. The aural polyp that showed excess polymorphs and haemosiderin in its stroma and was uncovered with surface epithelium had a probability of 89.6% to be associated with cholesteatoma. This probability was raised to 93% if it showed, in addition to the previous findings, giant cell formation and dystrophic calcification. High -incidence of underlying cholesteatoma, complications and recurrence with granulation polyp with acute exacerbation necessitates surgical exploration

Foreign bodies in the air way: a study of 67 Cases

Aspirated foreign body may be a fatal accident particularly in young children. Bronchoscopy is usually required for treatment. During bronchoscopy, as the air-way is shared by both the endoscopist and anaesthetist, close cooperation is mandatory and can make the procedure simple and almost free of complication. This work outlines some of statistics and management of 67 children admitted to ENT Department, Assiut University Hospital, during the last two years

Cervical mycobacterial lymphadenitis

Cervical lymphadenopathy may arise from infections with mycobacteria other than mycobacterial tuberculosis. These infections are being diagnosed more frequently, and reported to be an important cause of cervicofacial lymphadenitis in Western countries and United states. These infections resemble mycobacterial tuberculosis in its clinical picture, but it is important to make a distinction between them, for their clinical courses and treatments, are different. This work discussed the differential diagnosis of mycobacterial lymphadenitis and illusterated five cases of non tuberculous mycobacteria out of forty three cases examined, and showed that tuberculosis still having a higher incidence among our patients

Otitis media with effusion and pneumatization

A study of 106 ears with effusion showed that otitis media with effusion prevailed in children with poorly pneumatized ears. The chronicity of the disease and viscosity of the secretion had significant correlation with the degree of hypocellularity