Pattern of distribution of congenital anomalies in the newborn in damietta general hospital

the study was conducted at Damietta general hospital in the period from 1/ june / 2015 till 31/ may / 2016, 50 cases of neonates borne with dysmorphologic congenital anomalies and 50 control neonates were included in the study, Mothers of cases and controls were interviewed face to face, the pre-performed structured questionnaire was used, information were collected about families socio-demographic characteristics, life style, habits, history of chronic illnesses, long term medications, exposure to expected risk factors [ toxic substances, industrial hazards, environmental factors], consumption of certain foods, through general and systemic examination for included cases and controls, some investigations were done when needed. Results showed that the number of babies borne with dysmorphologic congenital anomalies in Damietta general hospital during the period from 1/ june/ 2015 till 30 may 2016 was 50 cases out of 1823 deliveries [ 1063 cesarean deliveries and 760 vaginal deliveries], this means that the pervalence rate was 2.7%

Systemic distribution of these anomalies was: digestive system anomalies 30% [the most common diagnosis among studies cases was tie tongue representing 28% of cases], musculosketal anomalies 20%, skin anomalies 14%, eye, ear, face and neck 10%, cardiovascular system anomalies 10%, genital organs anomalies 8%, cleft lip and palate 4%, chromosomal abnormalities 2%.the study showed that there is an increased risk of dysmorphologic congenital anomalies as: parental smoking [ active paternal and passive maternal] [OR=6.52], frozen food intake [OR=6.52], fast food intake [OR=3.08]

descriptive study of diabetes mellitus among school children attending health insurance clinic

Background: Diabetes mellitus in children is a major health problem changing the lifestyle of affected children and their families

Objective: to describe the pattern of diabetes mellitus in the affected children including age, sex distribution, associated risk factors, presenting symptoms, presence or absence of complication, associated medical problems, management plan and therapy

Methodology: This study is a descriptive study, conducted on 83 children seeking for health insurance services for follow up and treatment of diabetes mellitus, their ages ranged from 5 to 17 years old attending Sherbein Health Insurance clinic from January, 2015 to April, 2015. Full history and clinical examination were taken. Laboratory investigation of routine urine, stool analysis, blood sugar, CBC and glycated hemoglobin were performed

Results: Results show that girls were more affected than boys. Increased incidence of onset of diabetes mellitus at age group [11-14] years. The associated risk factors were positive family history 39.8%, positive consanguinity 24.1% and early introduction of cow milk 27.7% of cases. Polyuria occurred in 90.3% of cases. Coma is the most common recurrent complication. School absence found in 21.7% of cases. Only 38.6% of cases have a dietary regimen. Regular activity found in 41% of cases. Results show that 90.4% of cases follow their insulin regimen and 38.6% of cases has a bad glycemic control

Conclusion: Positive family history of diabetes mellitus, positive consanguinity and early introduction of cow milk are considered risk factors for the incidence of diabetes mellitus in children. Lack of healthy diet and healthy life style increase the occurrence of complication

Lipid peroxidation and antioxidants in chronic liver disease in children

Background: Oxidant stress is defined as either an overproduction of free radicals or diminution in antioxidant defenses. Determination of lipid peroxide products is used as a measure of oxygen radical activation. Vitamin E [alpha- tocopherol], a nutritional antioxidant, blocks the chain reaction of lipid peroxidation

Aim: To determine lipid peroxidation as measured by malondialdhyde [MDA] and the level of an enzymatic antioxidant glutathione reductase [GSH-reductase], as well as, ci-tocopherol in children suffering from chronic liver disease [CLD] and try to find out if they are affected by the etiology or the severity of liver disease

Methodology: Thirty seven children suffering from CLD aged [1-15] years were selected from the specialized hepatology outpatient clinic, Children's Hospital, Ain Shams University. They were divided according to Child-Pugh classification to [A=18, B=11 and C=8]. Thirty healthy children of similar age and sex, were selected as controls. All children were subjected to history taking, clinical examination, laboratory investigation: complete blood picture, liver function tests, hepatitis markers, urine and stool analysis; and abdominal ultrasonography. Plasma alpha-tocopherol, GSH-reductase and MDA were also measured

Results: Malondialdhyde showed significantly higher mean plasma level in CLD patients [0.71 +/- 0.20 nmol/ml] than healthy children [0.38 +/- 0.09 nmol/ml] p<0.001, while GSH-reductase showed significantly lower mean plasma level in CLD patients [45.7 +/- 17.4 U/L] than healthy children [125.8 +/- 30.4 U/L] p<0.001. Also, alpha-tocopherol, was significantly lower in diseased children [0.78 +/- 0.44 umol/L] than healthy controls [0.98 +/- 0.28 umol/L] p0.029. There were no significant differences between mean plasma levels of MDA, alpha-tocopherol, and GSH-reductase among CLD patients with different etiologies. alpha-tocopherol showed significantly higher mean plasma level in CLD patients with Child's grade A [1 +/- 0.52 umol/L] than patients with more severe CLD, grades B+C [ 0.57 +/- 0.2 umol/L] p = 0.003, while there were no significant differences in MDA nor in GSH-reductase between Child's grade A and grades B + C. There were no significant correlations between MDA, GSH-reductase, nor alpha-tocopherol and liver function tests in CLD except for alpha-tocopherol which significantly negatively correlated with the bilirubin level [r = -0.33, p 0.49]

Conclusion: Children with CLD, irrespective of the underlying etiology, were having a clear evidence of oxidant stress in the form of significant increase in lipid peroxidation and significant decrease of some antioxidants as alpha-tocopherol and GSH-reductase enzyme. Lipid peroxidation did not reflect the severity of CLD while alpha-tocopherol was lower in grades [B+C]. Thus, it is recommended that efforts to improve the hepatic antioxidant system should be taken eg. optimizing the patient's diet, by supplementation with precursors for antioxidants, or by supplementation with essential metals and/or antioxidants