clinicalepidemiologic study of heart disease in school children of Menoufia, Egypt

This study was conducted to determine the prevalence of rheumatic heart disease [RHD] and congenital heart disease [CHD] in primary schoolchildren of Menoufia, Egypt and to study the relationship between these two problems and socioeconomic conditions. A total of 8000 children were screened for cardiac disease in their schools. Children with confirmed RHD and CHD in addition to 200 healthy children [controls] were visited at their homes to assess their social environment and other factors according to a designed questionnaire. We found prevalence rates of 3.4/1000 and 2.6/1000 for the RHD and CHD respectively. The most common cardiac defects were double mitral and pulmonary stenosis in the RHD and CHD groups respectively. Nineteen [39.6%] of the patients were diagnosed for the first time during the study. Penicillin prophylaxis was received by only four [14.8%] of the RHD children and none of the CHD children. The number of other affected siblings, increased multiparity, repeated abortion, and intake of contraceptives by mothers were significantly higher in families of the children with CHD. The proportion of illiterate, unskilled, and heavy smoking fathers was higher in the two patient groups. Family income was lowest in the RHD group, while increased crowding index and low whole social environment were significantly related to both RHD and CHD. Effective programs at the community and health service levels are needed in Menoufia to solve the problem of heart disease in schoolchildren in the immediate future

Obstructive uropathy as a cause of renal failure in paediatric care unit in Egypt

Out of 245 infants and children admitted to the Pediatric Intensive Care Unit at the New Cairo University Children's Hospital because of renal failure, 40 [16.3%] cases were identified as having obstructive uropathy. They were 32 males and 8 females ranging in age from 20 days to 13 years which indicates a great delay in recognition of the obstructive uropathy in the majority of cases. Diagnosis of obstructive uropathy, its cause and site was based on sonographic scanning, plain x-ray abdomen, intravenous pyelography [when clinically indicated], ascending cysto-urethrogram, urinalysis and blood chemistry. The different causes of obstruction were: urinary lithiasis [23 cases, 27.5%] posterior urethral valves [6 cases, 15%], bladder neck obstruction [2 cases, 5%], bilateral ureteric stricture [2 cases, 5%], pelviureteric junction obstruction [1 case, 2.5%], narrow ureteric orifices [1 case, 2.5%] and huge hydrocolpos obstructing both ureters [1 case, 2.5%]. Twenty-two [55%] patients were discharged with complete recovery of their renal function, 9 cases [22.5%] were discharged with chronic renal failure and 9 cases [22.5%] died. Our findings stress the importance of obstructive uropathy as a cause of renal failure in pediatric patients and confirm the value of ultrasound as an excellent screening procedure in such patients