Prevalence and type of anaemia in young Egyptian patients with type 1 diabetes mellitus

Over a 2-month period, 200 type 1 diabetic patients attending a paediatric diabetic clinic in Cairo, Egypt were screened for anaemia and other complications of diabetes. The mean age was 11.2 years and the mean duration of diabetes was 4.0 years. Anaemia was diagnosed in 75 patients [37.5%] overall: 45 had microcytic hypochromic anaemia, 18 normocytic normochromic and 12 macrocytic hyperchromic. Of the 75, 41 patients [54.7%] had iron deficiency, 14 [18.7%] had folate deficiency and 14 [18.7%] had thalassaemia minor. Three patients [4%] had coeliac disease, and 18 patients [24%] had parasitic infections. None of the patients had hypothyroidism, renal failure or vitamin B12 deficiency

Microalbuminuria in type 1 diabetes: relation to duration, glycemic control and other microvascular coplications: a crosssectional and longitudinal study

Without early detection and specific intervention, about 80% of patients with type 1 diabetes who develop sustained microalbuminuria enter into overt nephropathy over a period of 10-15 years. With the aim of studying the prevalence of microalbuminuria and its risk factors and the role of angiotensin converting enzyme inhibitors, this retrospective and prospective study was done at the Diabetic Endocrine Metabolic Pediatric Unit, Cairo University over period of 5 years A total of 500 patients with duration of 3 years or more were included in the study. Their mean age was 13.95 +/- 4.96 years and mean duration of diabetes 6.99 +/- 4.21 years. Longitudinal study included only 100 patients of them who were-compliant and accepted to be followed up for 5 years. Albumin excretion rate [AER] by radioimmunoassay was estimated at the start of the study while albumin/creatinine ratio by nephelometry was later on, assessed. Microalbuminuria was considered positive f in two of three samples in 6 months time: AER is >30 mg/d or>20 ug/min, or album in/creatinine >30 mg/mg. Patients were also screened for other diabetic complications as neuropathy, retinopathy and cardiovascular autonomic neuropathy. Prevalence of microalbuminuria in this study varied between 13.7% at the start of the study to 9.8% at the end. Twenty-five patients, had positive microalbuminuria, all were pubertal. They showed significantly higher mean systolic and diastolic blood pressure, higher incidence of neuropathy as well as cardiovascular autonomic neuropathy [p=0.03, 0.03, 0.01 and 0.01 respectively] than patients with microalbuminuria. In the longitudinal study, 9 patients with positive microalbuminuria were followed up on caplopril therapy and strict metabolic control, 7 regressed and 2 persisted. Another five cases developed microalbuminuria during follow up and then regressed later, on the same regimen. Metabolic control was highly correlated to the progression as well as regression of microalbuminuria [r=0.35, p=0.02]. Screening for microalbuminuria is recommended in diabetics with duration more than 3 years. Angiotensin converting enzyme inhibitors together with strict metabolic con trot can cause regression of microalbuminuria

Comparative study between true precocious puberty and premature thelarche

Sexual precocolty in girls is the development of sexual characteristics earlier than 8 years. The aim of the present study is to differentiate between premature thelarche [PT] and true precocious puberty [TPP] for proper diagnosis and accurate management. The study included 52 girls presenting with precocious puberty divided into 2 subgroups. The first group consisted of 32 girls with PT with a mean age at presentation 2.97 +/- 2.44 years. The second group consisted of 20 girls with TPP with a mean age at presentation 5.9 +/- 2.7 years. Etiological class fication of girls with T.P.P revealed that 17 girls [85%] had idiopathic TPP and 3 [15%] had TPP secondary to CNS lesions. The studied auxological data between the two groups as regard Height/CA weight/CA, Height/BA, BA [19 were statistically in significant except BA/CA which was markedly advanced in cases of TPP. Comparison of the hormonal values between the 2 groups showed the following: In cases of TPP the basal LH, stimulated peak LH, peak LH/peak FSH mean LH/mean FSH, B2 were as following 3.77 +/- 5 [mIU/ml], 46.4 +/- 55 [mIU/mI], 2.55 +/- 1.58, 2.34 +/- 1.63 and 27.24 +/- 18.1 pg/ml and were significantly higher than in PT. While in PT stimulated peak FSH, stimulated mean FSH, were 32.35 +/- 22.4 mIU/ml, 22.08 +/- 14.84 m JU/ml respectively and were significantly higher in comparison to TPP. In the initial diagnosis uterine length, fundus/cervix ratio, ovarian volume in TPP were statistically sign4flcant in comparison to PT. We concluded that different diagnostic tools are mandatory for proper evaluation of girls with precocious puberty. Auxiological data in comparison to bone age is considered a cornerstone in initiation of medical treatment in girls with precocious puberty