Clinical evaluation of children with heart murmurs by pediatricians and primary care physicians in an academic centre

To determine the ability of the generalist to evaluate children with a heart murmur and evaluation of the need for further investigations in a large teaching hospital All echocardiograms performed on 100 consecutive children [aged 1 month -13 years] who were referred by pediatricians or primary physicians to the pediatric cardiology services for evaluation of cardiac murmur in a 12-month period [July 2005 to June 2006] at King Abdul Aziz University Hospital, Saudi Arabia were reviewed. One pediatric cardiologist [RSB] who was blinded to the indication of referral and clinical outcomes later reviewed the patient records and echocardiograms. According to the echocardiogram result, classification of the findings into normal or abnormal results was made. The prevalence of congenital heart disease was calculated. Forty-one percent of the children were correctly freed from having heart disease [sensitivity 96.8%] except for 1 child with patent ductus arteriosus. Out of the 100 of the children, 59% were referred for an echocardiographic study, and no clinically significant heart disease was missed. Of these 59 children echocardiogram confirmed the presence of clinically non-significant structural heart defects in 30 children [50.8%]. A thorough clinical evaluation performed by pediatricians or primary physicians without any special training in pediatric cardiology could correctly free 41% of the neonates and children from congenital disease, with no need for further cardiac consultation. The detection of a murmur should prompt early referral to a pediatric cardiologist for diagnosis or appropriate reassurance

Evaluation of several substrates for mass multiplication of Arbuscular mycorrhizal [AM] fungi grown on onion

Sand, clay soil, vermiculite, perlite, peat and their combinations in various proportions were compared to select a suitable substrate for mass multiplication of Glomus spp inoculums. On the basis of root colonization, spore production and infection propagule, peat: vermiculite: perlite mix [1:1:1 by volume] was found to be the best substrate for the production of arbuscular mycorrhizal inoculums. It was also proved to be the best substrate of onion growth