Risk factors and clinical patterns of cerebral palsy in children welfare teaching hospital in Baghdad

Cerebral palsy [CP] is a disorder of posture, movement and tone due to a static encephalopathy acquired during brain growth in fetal life, infancy or early childhood. To identify the risk factors of CP and its clinical patterns. This case control study was done from the 1st of January 2009 to the end of September 2009, on 100 patients with CP who attended the neurology clinic or have been admitted to the neurology ward in Children Welfare Teaching Hospital in Medical City complex, Baghdad. For comparative purposes,100 control individuals matched for sex and age were selected. Some of those patients were referred to pediatric clinic and registered with a diagnosis of CP and some of them were brought by the parents or caregivers without referral for various complaints, then we reviewed their full history and examination [mainly neurological] to confirm the diagnosis of CP. A specially designed questionnaire form was used. Out of 100 patients with cerebral palsy, male:female ratio was [1.3:1], 89% of the patients were born at term whereas 11% were preterm. Those patients were found to have history of normal vaginal delivery in 70%, with one patient only delivered by assisted delivery, while 29% of them delivered by caesarean section mode of delivery. History of intrauterine growth retardation found in 21% patients, 4% were twin. The mothers of those patients had history of pre-eclampsia in 8% of the cases, regular antenatal care in 65%, history of antipartum haemorrhage in 4%, premature rupture of membrane in 13%. Abnormal presentation was found in 8%, cord prolapse in 4%, neonatal jaundice in 62%, neonatal seizure in 8%, history of head trauma in 4% and history of central nervous system infection in 20%. Spastic CP was the commonest type [67%], while mixed and atonic CP were the least type [1% for each]. Quadriplegic CP was the commonest topographical subtype [56%]. Delayed social milestone was found in 46%, speech difficulty in 94%, deafness in 2%, ocular problem in 29%, seizure in 58% and all of them had delayed milestone and weakness. Neonatal convulsion, neonatal jaundice, neonatal infection, antepartum hemorrhage and head trauma are significant risk factors for cerebral palsy while precipitate labour, caesarean section, twins, toxemia, breech delivery, low birth weight and cord prolapse were not found to be significantly associated with cerebral palsy. The most common clinical pattern of CP was spastic quadriplegic CP

Demographic and clinical presentations of pediatric hydrocephalus in medical city

Hydrocephalus is distension of the ventricular system of the brain related to inadequate passage of cerebrospinal fluid from its points of production within the ventricular system to its points of absorption into the systemic circulation. To study the demographic and clinical presentations of pediatric hydrocephalus in medical city complex, Baghdad. This is a prospective study ,which was carried out on 100 children with a mean age +/- standard deviation [24.3 +/- 16.06]months and median 16 months, who were admitted to Children Welfare Teaching Hospital and neurosurgical department [Surgical Specialties Hospital] / Medical City complex, Baghdad in the period from April first 2009 to October first 2009. A specially designed questionnaires were used to aid the investigators in performing a family interview. General and neurological examinations, and investigations including neuroimaging studies were done. Of 100 patients,[62%]were males and [38%] were females, with male to female ratio of 1.6:1. Family history of congenital anomaly was positive in [26%] of patients, while hydrocephalus was positive in [14%]. Seventy-Two percent of patients had congenital hydrocephalus. Eighty-Seven percent of patients were full term. Fifty-Seven percent of patients were products of NVD ,while [43%] were products of CS,[2%] of them were emergency CS and [41%] were elective. The macrocephaly was diagnosed or noted at birth in [32%] of patients. The study showed that U/S finding of hydrocephalus was positive in [49%]. The majority of the patients had congenital hydrocephalus, but there was delay in the diagnosis of macrocephaly. Prenatal ultrasound diagnosis yield was low in this study. Family history of hydrocephalus and other neural tube defect was important to be elicited

clinical study of vibriosis during 1999 in Al-Mansour childrens teaching hospital

Cholera is an acute infectious disease characterized by profuse watery diarrhea and vomiting. lt is caused by Vibrio Cholerae Ol and O139 sero-group. To find out clinical variety of the admitted cases of Vibriosis. Clinical features of the illness were studied, and fresh stool specimens were sent for culture. The stool is taken in seawater containers to the laboratory where further processing of the stool is done on alkaline peptone and TCBS medium. All patients presented with diarrhea and the majority had vomiting [65%], [37.5%] of the patients presented with severe dehydration and no patient died during this study. The epidemic mainly caused by Ogawa serotype [75%], and there was different antibiotic resistance recorded especially for trimethoprim [47.5%] and tetracycline [25%]. Nearly all cases in vitro were susceptible to cefotaxime

Clinical presentations and complcations of Guilain barre syndrome in Children Welfare Teaching hospital

To study the clinical presentations and complications in patients with Guillain Barre syndrome [GBS]. A retrospective study was done on 70 patients with GBS from different parts of Iraq, who were admitted to children Welfare Teaching Hospital in Medical City, Baghdad in the period between January 2002 to December 2006. Of 70 patients with GBS, 40 [57.14%] were males and 30 [42.86%] were females, with a male to female ratio of 1.33:1. Antecedent events were found in 44 patients [62.86%], wherease 26 patients [37.14%] had no history of antecedent events. There is no specific pattern of motor weakness involvement and all cases show symmetrical muscle weakness. Bulbar nerves involvement is the commonest cranial nerve involvements. Autonomic nerves and respiratory muscles involvement are the main cause of death in GBS

Neurological manifestations in type- 1 diabetes mellitus in children

Diabetes mellitus type-1 is the most common endocrine metabolic disorder in childhood. Mononeuropathy, generalized polyneuro-pathy and autonomic neuropathy are frequent complications of diabetes mellitus and may give rise to troublesome manifestations. Sixty children suffering from type 1 diabetes mellitus admitted in Children Welfare Hospital- Medical City-Baghdad in the period from 1st Dec2 000-31st July 2001 were included in this prospective descriptive study. History, especially symptoms of peripheral neuropathy, examination specially signs of peripheral neuropathy, absent sinus arrhythmia and postural hypotension and investigations like nerve conduction study were all performed and analyzed. The study showed that out of 60 diabetic children 26[43.3%] had symptomatic polyneuropathy, 18 [30%] had postural hypotension and 16 [26.6%] had absent sinus arrhythmia. Neurological manifestations of diabetes mellitus occur frequently in diabetic children with long duration of illness. Polyneuropathy is sensory more than motor and affected the lower limbs more than the upper limbs. Early diagnosis of autonomic neuropathy in diabetic children is simple easy and requires minimum cooperation, so as detection of peripheral neuropathy in asymptomatic by nerve conduction study

Clinical presentations of systemic lupus erythmatous in Iraqi children and adolescents

To study the clinical presentation of systemic lupus erythematosus in children up to the age of 16 in our region and to compare it with reports on children and adults from other parts of the world. Patients and The records of 68 patients who were admitted to 2 large hospitals in Saddam Medical City, Baghdad with a diagnosis of systemic lupus erythematosus were analyzed retrospectively 51[75%] were female and 17[25%] were male. The mean age of onset was 13.4 years. Eight patients were 10 years old or younger. The disease pattern in those under the age of 10, apart from the higher incidence of fever, hepatomegaly, and lymphadenopathy, was very similar to that in the older group Discussion: The results were compared with similar studies from other parts of the world and with studies of the disease in adults. Our patients were found to have a lower incidence of arthritis and mucocutaneous manifestations and a higher incidence of cardiovascular manifestations than adults

Epidemiological, clinical and laboratory studies of favism [G6PD] in children

This study reports the epidemiological analysis, clinical presentation, laboratory findings and progress of fifty children admitted to "Al-Mansur Teaching Children Hospital", "Saddam's Medical City" during the period from 1st. January 1990 - 31st December 1994, with G6PD deficiency and acute hemolytic anemia after fava bean ingestion. No cases of favism were observed in breast fed babies whose mothers had eaten fava beans, or from pollen inhalation. 10% of the patients had a previous similar attack, 18% had a family history of favism. [86%] of the patients were males. The main age group affected was 2-4 years [66%]. 90% of cases were from Urban and 10% were from Rural areas. 76% presented during the fava bean season, the onset of symptoms started within three days after fava bean ingestion in 94%, the mean value of Hb was 6gm/dl, Hct 19.9%, Reticulocyte count 8.2%, Total bilirubin 5.2mg/dl, Indirect bilirubin 4.3mg/dl. All patients received blood transfusion and achieved good progress