Risk factors for type 1 diabetes mellitus among children and adolescents in Basrah

Environmental factors play an important role in the pathogenesis of type 1 diabetes mellitus, many of these factors have been uncovered despite much research. A case-control study was carried out to determine the potential maternal, neonatal and early childhood risk factors for type 1 diabetes mellitus in children and adolescents in Basrah. A total of 96 diabetic patients who have been admitted to the pediatric wards at 3 main hospitals in Basrah, and those who have visited primary health care centers over the period from the 4th of November 2006 to the end of May 2007 were recruited. In addition, 299 non-diabetic children were included, their age ranged from 18 months to 17 years. Family history of type 1 diabetes mellitus and thyroid diseases in first and second degree relatives was found to be an independent risk factor for type 1 diabetes mellitus, [p<0.001]. Regarding maternal habits and illnesses during pregnancy, the study has revealed that tea drinking during pregnancy is a risk factor for type 1 diabetes mellitus in their offspring, [p<0.05]. In addition, maternal pre-eclampsia and infections were found to be significant risk factor for type 1 diabetes mellitus, [p<0.001]. Neonatal infections, eczema and rhinitis during infancy were also significantly associated with development of type 1 diabetes mellitus. Moreover, the results revealed that duration of<6 months breast feeding is an important trigger of type 1 diabetes mellitus. Exposure to environmental risk factors during pregnancy [tea drinking, pre-eclampsia, and infectious diseases], neonatal period [respiratory distress, jaundice and infections] and early infancy are thought to play an important role in triggering the immune process leading to B-cell destruction and the development of type 1 diabetes mellitus

Predictors of mortality outcome in neonatal sepsis

A prospective study was carried out to determine the predictors of outcome in neonates with sepsis admitted to neonatal care unit at Basrah Maternity and Children Hospital over six months [from the first of November 2004 till the end of April 2005]. One-hundred twenty neonates were studied, sepsis was confirmed by clinical and laboratory measures. Seventy four [61.7%] neonates were males and 46 [38.3%] were females. Thirty three [27.5%] were preterm and 87 [72.5%] were full term. Sixty seven [55.8%] neonates were still alive during period of hospitalization and discharged home, while fifty three [44.2%] neonates died. Early onset sepsis was detected in 35[29.2%] neonates while late onset sepsis was detected in 85[70.8%] neonates, however, the mortality rate was higher in early onset sepsis [62.9%] compared to late onset sepsis [36.5%]. The mean body weight was significantly lower in neonates who died [1.97 +/- 0.67], compared to those who survived [2.79 +/- 0.6]. A significantly higher mortality rates were among premature neonates [69.7%], and those with intrauterine growth retardation [70.8%]. In addition, the death rate was higher in neonates with maternal history of prolonged rupture of membrane >/= 24 hours [61.5%] compared to [39.4%] in neonates with maternal history of rupture membrane of < 24 hours before labor. The clinical signs that predict high mortality were sclermic skin [94.2%], signs of dehydration [82.8%] and prolonged capillary refilling time [68%]. Highest mortality was associated with positive blood culture for Pseudomonas aeruginosa and Staphylococcus aureus, where all neonates died [100%], followed by klebsiella spp. and Escherichia coli [71.1%] and [48.5%] respectively in comparison with neonates who have positive blood culture for Proteus and Enterobacter aeruginosa where only 7.9% and 11.1% of neonates died respectively. A statistically significant higher mortality was reported in neonates having thrombocytopenia, neutropenia and C-reactive protein >/-10 mg / dl. Regression analysis of different neonatal and maternal variables, hematological and microbiological tests, revealed that body weight, gestational age, thrombocytopenia, neutropenia, positive blood culture for klebsiella spp., prolonged capillary refilling time, sclerma and signs of dehydration are predictive factors of the outcome of death in neonatal sepsis

association of maternal nutritional status, socio-demographic variables and birth weight

To determine the influence of sociodemographic and maternal nutritional status on birth weight. The study was carried out in Basrah Maternity and Children Hospital. A total of 378 newly delivered newborns and their mothers were included in the study. Data collection was achieved through a structed interview for collection of sociodemographic informations and measurements of maternal anthropometry. Data were analysed using SPSS system, P value< 0.05 was regarded as significant. The study has revealed that the mean birth weight was 3.164 and that low birth weight was detected in 18.8% of newborns. Maternal mid upper arm circumference, post partum weight hemoglobin level antenatal care, parity and maternal empolyment were signficant predictors of birth weight. In additon to that maternal anthropometry and hemoglobin level were positively correlated with low birth weight. Maternal nutritional status is the signle most important risk factor for low birth weight

Rotavirus infection among hospitalized children with acute watery diarrhea in Basrah - Iraq

To estimate the frequency and describe the clinical profile of rotavirus infection in children under five years admitted with acute watery diarrhea. A prospective study done on 268 patients. All were investigated for the detection of rotavirus antigen in their stool by ELISA test. The report focuses on 116 [43.3%] patients in whom rotavirus was detected. The percentage of rotavirus infection among children with acute watery diarrhea was 43.3%. The percentage was higher in the first year of life and males were more affected than females. Malnourished children were at higher risk of having prolonged diarrhea and prolonged shedding of the virus from the intestine. Rotavirus infection should be suspected in any patient with acute watery diarrhea, as there is no specific clinical pattern. Malnourished children are at a higher risk of developing prolonged diarrhea after rotavirus infection that may aggravate their nutritional status

value of signs and symptoms of acute respiratory tract infection in requesting chest radiography

Chest radiography of 244 febrile children with respiratory sings and symptoms were reviewed. 219 [90%] patients had a combination of respiratory sings and symptoms, [cough, difficulty in breathing, tachypnea and crepitation]. 223 [91%] patients had abnormal findings on chest radiography. 204 [93%] patients of those who had a combination of respiratory sings and symptoms had abnormal radiographic findings. The positive predictive value was 91%