Prevalence of lead toxicity among secondary school students in Sohag city and its impact on cognitive functions

Lead is an extremely toxic metal. Lead intoxication in children has been associated with cognitive impairments. This study was designed to determine the prevalence rate of lead toxicity among secondary school children in Sohag City [Upper Egypt], sources of lead toxicity and the impact of lead toxicity on cognitive function of studied student. The studied students [600] were recruited from three schools, 200 students from Elaskaria school [main stream school] and 400 students from two technical schools [200 from industry and 200 from Elzekhrofia]. A control group was selected from the same sample of studied school, who proved to have normal urinary lead level [<50 micro g/L]. All studied students were subjected to body measurements, clinical evaluation, soft neurological signs, social level, psychometric tests [WAIS, CASI and WMS]. Urine sample were collected for assessment of lead level. The study revealed that the prevalence rate of lead toxicity was 50.5% and the highest rate among studied schools was reported in Elzekhrofia school [62%]. Sources of lead toxicity in this community were old houses [77.9%], presence of repair shops [60.8%], and garbage combustion 60.3%, and smoking [62.1%]. Soft neurological signs were significant abnormal among student with toxic urinary lead level [> 80 micro g/L] in comparison to student with normal lead level [<50 micro g/L] except in one test [standing on one foot]. Student with toxic urinary lead level [> 80 micro g/L] had inverse proportion with social level. There were statistically significant lower scores among students with pre clinical toxicity [>50-80 micro g/L] and toxic level than students with normal urinary lead [<50 micro g/L] in total, verbal and performance Wechsler adult intelligence scale [WAIS], in all Wechsler memory scale [WMS] subitems and in all cognitive abilities screening instrument [CASI] subitems

Prognostic value of systemic stress in acute stroke

40 patients presenting with acute cerebral infarction were included in the study. 29 were males and 11 females They ranged in age between 14 and 87 years with a mean of 57.4 years. Their neurological deficit was assessed, according to Ramirez - Lassepas et at, [1986] neurologic scale, initially and 3 weeks thereafter. Accordingly, they were classified into 3 prognostic groups; good recovery group [GI], bad recovery group [GIl] and deaths group [GIII]. They were tested for the different systemic stress responses including Cardiac abnormalities; stress hormones [adrenaline and cortisol]; blood glucose and stress gastric ulcer [using upper GIT endoscopy]. Also, they were evaluated for the different haemorrhogical parameters including: erthrocyte defornability; blood and plasma viscosity; platelet factor 4 [PF4]; WBCs count and plasma fibrinogen. Correlations have been made between the different prognostic groups and the associated systemic stress responses together with their reflection on the different haemorrhogical parameters. Our results revealed that cardiac abnormalities; stress gastric ulcer and stress hyper-glycaemia were significantly more prevalent among deaths [GIII], and patients with bad recovery [GIl]. Also, plasma levels of stress hormones [adrenaline and cortisol] were significantly higher in the same patients. Haemorrogical parameters dysfunction showed inverse correlations with prognosis. These correlations were weak and significant except with WBCs count and PF4 being highly significant. We conclude that, acute phase of cerebral infarction is unique by certain acute and dynamic systemic changes which can accurately predict the prognosis than factors which are related to premorbid state

Role of leukocytes in acute cerebrovascular stroke CVS

50 patients presenting with acute CVS and 30 controls were studied for the possible role of leukocytes in such an illness. They were tested for total and differential leukocytic count together with leukocytic aggregation. Results were correlated with stroke subtype [ischaernic or haernorrhagic]; brain insult size [large or small], initial neurological deficit [initial glasgow coma score and ADL score] and finally with short term outcome [one month follow up ADL score]. We found significant differences between patients and controls regarding leukocytic count and aggregation being higher in patients. Furthermore, leukocytic count and aggregation were directly proportional to stroke severity and poor outcome. Also, significantly, leukocytic count and aggregation were higher in patients with ischaemic than haemorrhagic strokes. We conclude that leukocytic count and aggregation would be an easy but valuable parameter in assessing stroke severity and predicting its outcome

Systemic intravenous streptokinase [SK] administration in acute stroke

30 patients presented with acute cerebral infarction of less than 6h. duration were randomly assigned into two equated groups [15 patients each]: G1 = SK-treated and G2-Non-SK treated. SK was administered in a sepeially-desinged regimen that would allow the highest possible benefit /risk ratio. 80% of the patients of G1 showed improvement within hours following treatment, while non of G2 showed such improvement implying treatment effect being unique to such therapy. Furthermore, the degree of improvement after 3 weeks was much better among all SK-treated patients. Hence, thrombolysis in acute cerebral infarction whenever indicated and successful is the ideal therapy for such an illness

Headache among a sample of preschool Egyptian children

To identify different types of headaches among preschool children, sixty children below seven years of age, who attended the headache and Migraine Clinic of A1- Hussein University Hospital over the first six months of 1993, were included in the study. Headaches could be classified in 90% of cases. The most common headache type in this population was migraine that constituted 53% of cases. An interesting finding was that 6 [10%] of the children had post traumatic headache which is widely debated. On the other hand other types of headaches were; 7% of ENT origin; 5% of ophthalmic origin; 5% of increased intracranial pressure; 5% psychodenic; 4% epileptogenic and 1% of dental origin. Neuroimaging studies revealed three cases with posterior fossa brain tumours. Laboratoy tests did not reveal any significant abnormalities. We conclude that headaches in young children are generally benign although in this age groups posterior fossa brain tumours are of particular concern and have to be excluded

clinical study of minimal dysfunction as a cause of retarded education

The present study aimed at evaluating the value of clinical and psychological assessment in diagnosis of minimal brain dysfunction [MBD] syndrome as a case of educational retardation. The educationally retarded pupils were chosen by school personnel from pupils of the 5[th] and 6[th] grades of 6 primary schools belonging to South Cairo Educational area in the scholastic year [1984-1985]. The total number of pupils in these grades was 1819 pupils, of whom 513 [28.30 percent] were chosen as educationally retarded. Out of the last group a random sample of 125 was selected for thorough investigations. They were classified into two age groups, the first comprised [65] children ranging in age between [9-12 years], and the second included [60] children between [12-15 years]. They were subjected to clinical evaluation and psychometric assessment. EEG was carried out for [43,], and C.T. scan of the brain for [14]. Moreover, [40] subjects served as a control group, well matched with the study group regarding age and sex, but of normal educational achievement. Out of the studied [125] educationally retarded pupils, [56] were clinically diagnosed as having MBD syndrome whereas, [69] have no clinical evidence of MBD. On the other hand, psychometric testing disclosed MBD in [52]. This confirmed the clinical diagnosis in only [39] pupils, whereas the remaining [13] had no clinical signs

Electroencephalographic abnormalities in children with cardiovascular diseases

The present work aimed at evaluating EEG abnormalities among children with congenital and rheumatic heart disease. Forty-eight children with cardiovascular disease were studied, of whom [34] had congenital heart disease, which was cyanotic in [16], and acyanotic in [18]; and [14] had rheumatic heart disease. They ranged in age between 20 months to 12 years. All were subjected to clinical assessment and electroencephalographic examination. The cyanotic group showed higher incidence of EEG abnormalities [62.5 percent], than the acyanotic [22.2 percent], and still much more higher than the rheumatic [7.1 percent]. The vast majorities of E.E.G: changes were diffuse, and to a lesser extent, diffuse with focal abnormalities. They were mostly observed in Fallot tetralogy and Eisenmenger syndrome in the cyanotic, and V.S.D. in the acyanotic group