Interstitial pneumonitis: is it a major hidden criteria of rheumatic fever

Rheumatic heart disease still a major cause of acquired heart disease in developing countries. Dyspnea and palpitation are two major symptoms that disabling cardiac patients. However, these symptoms could not be attributed to the severity of cardiac affection. So, the aim of this work was to study the effect of rheumatic fever disease on children regarding the cardiac chambers and valvular lesions as well as pulmonary functions. Also, to study the relation between symptoms, cardiac structural changes and pulmonary functions in diseased patients and control children. The study included three groups of children: group I comprised 24 patients with rheumatic valvular lesions. Group II comprised 15 patients with MVP and past history of rheumatic fever and group III included 15 patients with normal heart as control. All of them were subjected to clinical examination, ECG recording, pulmonary function tests and doppler echocardiographic study. Their age ranged from 7 to 16 years old in the three groups. There was no significant difference between the three groups regarding their age, gender, height, weight, blood pressure and heart rate. Echocardiographic study revealed significant increase of LVIDs, LVIDd and left atrial dimension in group I than both group II and control group [p < 0.01, 0.01 and 0.00001 respectively]. Doppler parameters revealed increase of mitral flow "E" and "A" velocities only in group I. The pulmonary function tests revealed small airway obstruction with significant decrease of FEF[25-75], FEF[50], FEF[75] in both group I and group II than the control group [P<0.0001, <0.002, P<0.0001 respectively]. These changes occurred without changes of pulmonary vein velocities during doppler study. The prime cause of abnormal pulmonary function tests is due to the rheumatic fever pathology affection of parenchymal connective tissue that is beyond the cardiac hemodynamic changes. This raises several questions including; is interstitial pneumonitis a major hidden criteria of rheumatic fever?. Rheumatic fever still requires to be studied again thoroughly

Study on microbial infections in children suffering from upper respiratory tract infection

The study was done on 354 patients attending the outpatient clinic of AI-Mattarya Teaching Hospital complaining of upper respiratory tract infection, from February 1988 to January 1989. Patients were divided into two groups according to age. Group I from 6 months to 2 years and group II from 2 to 6 years. Pharyngeal and nasal swabs were taken for bacteriological studies. S. pneumoniae was isolated from 62.5 percent in group I and 50 percent in group II. The second commonest organism was H. influenza, [10.4 percent and 23 percent] in group I and group II respectively. Combined S. pneumoniae and H. influenza were positive in [10.4 percent and 19.2 percent] in group I and II respectively. Pharyngeal bacteria were common in early age, 62 percent in group I and 38 percent In group II. The commonest organisms were N. meningitides G.A. in both age groups [25.8 percent, 26.3 percent], then S. pneumoniae and Gram [+ve] cocci. In 48 control we found that 16.6 percent were positive. Virus study was done on 205 cases from the previous cases, 13.2 percent were positive. The commonest viruses were respiratory syncytial virus [R.S.V.] and adenovirus. Three cases showed combined bacterial and viral infections

Evaluation of infants suffering from gastroenteritis as a high risk factor for infection by hepatitis B. virus

Gastroenteritis is the commonest disorder affecting egyptian infants and the major cause of morbidity and mortality among them. In the management of gastroenteritis, parenteral injections may be used. This study proved the possible role of gastroenteritis as a high risk factor for infection by hepatitis B-Virus. Ninety-two infants were the subject of this study. They were classified into four groups: group I [30 infants with gastroenteritis and history of injections], group II [22 infants with gastroenteritis without history of injections], group III [24 normal control infants with history of injections], and group IV [16 normal control infants without history of injections]. Their sera were analysed for HBsAg and anti-HBs by ELISA method. The incidence of HBsAg was 22.8% as these samples reflect only the local situation and were not representative of the whole country. The age, sex, weight and clinical aspects of the patients were not significant in relation to the prevalence of HBsAg [P> 0.05]. On the other hand significant correlation between the incidence of HBsAg and gastroenteritis was obtained

Autoimmune reactions in Egyptian children with hepatomegaly

Our study included 52 children having hepatomegaly along with 20 controls, their ages ranged from 1-18 years. The aim of this work is to search for autoantibodies in the different liver diseases. The correlation between their presence and the clinical and biochemical data is 'evaluated. Cases and controls were submitted to full sheet, general laboratory tests and special investigations to determine the aetiology as far as possible. Special investigations included, liver function tests, detection of anti-specific liver antigen [ALSP] by double diffusion on agar, non-specific liver antibodies [ANA, AMA, ASA] by indirect immunofluorescent test, HBsAg by hemagglutination test and serum immunoglobulins [IgG, IgM, IgA] by immunodiffusion. Liver antigen was prepared by gel filtration chromatography from rabbit liver. Autoantibodies, ALSP, AMA, ASA and ANA were present in 44.23%, 44.23%, 30.77% and 7.69% in all cases with hepatomegaly respectively. HBs Ag could not be detected except in 1.92% of all cases. Liver function tests were significantly increased in all groups for most of them. lgG and IgM were raised in all groups above the normal values. IgA was within normal limits. No correlation was present between liver specific autoantibodies [ALSP] and the non-organ specific autoantibodies. ALSP is present more in chronic cases, but it could also be detected in acute cases. ALSP could be used for diagnosis of certain types of liver disease. Also to detect pathological cases of hepatomegaly in children