Pattern of new-onset pancytopenia among Yemeni children aged 2 months to 15 years

Backgrotutd: pancytopenia refers to a reduction in all the three cellular elements of blood. The aim of this study was to identiy various causes of pancytopenia in Yemeni children and its clinical correlation with peripheral smear and bone marrow examination

Patients and Methods: this was a prospective cross sectional study which conducted at Hadhramout university hospital for pediatric and gynecology and obstetrics and enrolled 103 pancytopenic children aged 2 month to 15 years evaluated with criteria of recent pancytopenia on peripheral blood smear during the sttady period from January 2013 to Jmuary 2015. Demographic profile and clinical findings were taken,laboratory investigations performed at the time of admission for all cases included a complete hernogram, reticulocyte counts, and peripheral blood film. Bone marrow biopsy was performed wherever aspiration was inconclusive. Other investigations that were performed in selected cases

Results: a total of 103 patients of both sexes with pancytopenia were enrolled in the study. The mean [SD] age was 6.75 +/- 4.09 years and their ages rangedpom 2 months to 15 years. Among them 63 [61%] were males and 40 [39%] females with a male to female ratio of 1.58:1. Maximum number of patients 44[43%] were in the two month-5 years age group, 77ze most common clinicaEfiatures of pancytopenia at presentation, was pallor in 101 [98%], Prolonged fever or recurrent fever in 89[86%].The most common three causes were visceral leishmaniasis [kala zar] in 39 [37.9%], followed by acute lymphoblastic leukemia[ALL] in 21[20.5%], and then megaloblastic anemia 9 [8.7%].Nan- malignant pancytopenia which was found in 70 [68%] of patients, and malignant pancytopenia that was found in 33 [32%]

Conclusions: the three most common causes of pancytopenia in our study was visceral leishmaniasis [kala zar] followed with ALL and then megaloblastic anemia. Bone marrow examination is a useful technique for diagnosing the causes of pancytopenia There are varying trends in clinical pattern, peripheral hematological features depending on the prevalence of causes ofpancytopenia in the dgerent geographical locations

Fibrodysplasia ossificans progressiva; a case report

Fibrodysplasia ossificans progressiva is a rare and disabling genetic condition characterized by congenital malformation of the great toes and by progressive heterotopic ossification in specific anatomic patterns. It is inherited as an autosomal dominants condition with a high mutation rate. There is associated abnormality of the big toes [halux valgus] and short thumbs. There is no effective treatment for the condition. We report fibrodysplasia ossificans progressiva in a 4.5 -year-old girl with multiple palpable masses in different regions of the body [Scapular, medial aspect of the left humerus, back of the neck, and back]. We discuss the diagnosis, course and therapeutic modalities of the condition.

Superior mesenteric artery syndrome: a rare cause of upper intestinal obstruction in infants

Superior mesenteric artery syndrome is a rare congenital anomaly seen in infants. We recorded superior mesenteric artery syndrome in a 10 months old infant. He was suffering from vomiting, since birth. Investigations proved that the cause was pressure of the superior mesenteric artery on the third part of the duodenum. After failure of medical treatment, surgery was carried out by joining the upper jejunum to the first part of the duodenum

Prevalence of bronchial asthma among primary school-aged children in Hadhramout governorate

Asthma prevalence is increasing worldwide. Asthma is more common in developed countries than in developing ones. The main objective of this study is to determine the prevalence of asthma among primary school- aged children in Hadhramout governorate /Yemen. The sample was taken at multistage randomization during the period from 1St of February to 30th April 2006 using special questionnaires completed by parents of the children. Of the 2400 children who were included in this study, 2062 completed the questionnaires giving a response rate of 84%. The prevalence of bronchial asthma among primary school-aged children in the total sample was 15.2%. with 16.7% males and 13.5% females. In the urban areas the prevalence was, 16.1% and in the rural areas it was 14.2%. The main clinical presentations in asthmatic children were cough [100%] and breathlessness in 85.1%.The prevalence of asthma among primary school children in Hadhramout Governorate is 15,2%, which is similar to other countries. The prevalence of asthma in urban areas is higher than in rural areas.

Malignant osteopetrosis: a rare cause of anemia

Normocytic anemia is caused by bone marrow hyoproliferation, red cell maturation defects or decreased red cell survival [blood loss/hemolysis]. Osteopetrosis [OP] is a rare, inherited disorder leading to increased bone density on radiographs. It is classified as autosomal recessive [AR] and autosomal dominant [AD] types. AROP [malignant] is a life-threatening condition, which classically manifests in the first few months of life, by short stature, macrocephaly and frontal bossing, blindness, deafness, and facial palsy. The most severe complication of AROP is bone marrow suppression, resulting in pancytopenia and secondary expansion of extramedullary haeatop-oietic sites such as the liver and spleen. The present case report is a case study of a 4-year-old boy presented with severe anemia and other manifestations of malignant AROP with recurrent blood transfusion. After clinical, hematological and radiological evaluation, the diagnosis of osteopetrosis was established.

Oral squamous papilloma in children

Oral squamous papilloma [OSP] is a benign proliferation of the stratified squamous epithelium, which results in a verrucous or papillary exophytic mass. A female child patient 5 year old suspected to have an oral papilloma underwent excisional biopsy for histopathologic analysis. The lesions were round, whitish and softened/flaccid. The histopathologic examination revealed hyperparakeratosis, occasional basal hyperplasia, and koilocyte-like cells in the specimen.