Comparison of effectiveness and safety of different concentration of sucrose analgesia in newborn infants undergoing minor painful procedures

Background: Sick preterm and term neonates experience many daily painful procedures during stay in neonatal intensive care units. Recognition and treatment of pain in these babies remains a challenge. Oral sucrose is the most studied pain intervention in newborn

Aim: This study attempted to compare the efficacy and safety of the analgesic effect of different concentrations of sucrose in minor painful neonatal procedures such as heel pricks, intravenous insertion, and wound care, suctioning and bladder catheterization

Methods: A total of 90 newborn babies admitted to El Shatby neonatal intensive care unit were included in this study [gestational age above 34 weeks] undergoing minor painful procedures such as arterial puncture, heel pricks, venous puncture and intravenous insertion

Results: The newborn infants included in this study were divided into 3 groups according to the method of sucrose administration each group subdivided equally into full term and late preterm. The overall pain score was significantly lower among newborn who received sucrose in either concentrations than placebo. However no statistical significant difference was found between sucrose 12% and 24% concentrations [p=0.734], Also no significant difference was found in behavioral and physiologic responses in both full term and later preterm babies

Conclusion: Sucrose is safe and effective for reducing procedural pain from single events. Further investigation on repeated administration of sucrose in neonates and the use of sucrose in combination with other non-pharmacological and pharmacological interventions is needed. Sucrose use in extremely preterm, unstable and ventilated [or a combination of these] neonates needs to be addressed

Dietary habits and physical activity levels in Jordanian adolescents attending private versus public schools

The present study examined differences in dietary habits and physical activity levels between students attending private and public high schools in Jordan. A total of 386 secondary-school males and 349 females aged 14–18 years were randomly recruited using a multistage, stratified, cluster sampling technique. Dietary habits and physical activity level were self-reported in a validated questionnaire. The prevalence of obesity was significantly higher among adolescents in private [26.0%] than in public schools [16.7%]. The frequency of breakfast intake was significantly higher among adolescents in private schools, whereas French fries and sweets intake was significantly higher in public schools. Television viewing showed a significant interaction with school type by sex. A higher rate of inactivity was found among students attending private schools. Despite a slightly better overall dietary profile for students in private schools, they had a higher rate of overweight and obesity compared with those in public schools.

Indicators of outcome after internal fixation of complex acetabular fractures

Complex acetabular fractures are not uncommon injuries in Egypt. The aim of surgical treatment is to preserve hip mobility and to avoid post-traumatic arthritis. The aim of this study was to evaluate the clinical results of patients presented by displaced complex acetabular fractures and treated by open reduction and internal fixation. Factors affecting these results were to be determined. Displaced acetabular fractures involving the both columns were included. Initial assessment and treatment were directed towards the patient's general condition. Posterior hip dislocation was reduced as fast as possible. Standard X-ray views and CT cuts were done for every patient. The definite surgery was done through an ilio-inguinal, a Kocher-Langenbeck or combined approaches. Postoperatively, the residual displacement was recorded together with the head roof relationship. Using Matta radiological and modified clinical grading, a correlation between radiological and clinical results was made. Factors affecting the outcome were defined. The study involved 55 patients between May 2007 and December 2010. The mean follow-up period was 29.62 +/- 7.19 months with a minimum of 12 months and a maximum of 43 months. Excellent to good results were achieved in 38 cases, 69.1%, while fair to poor results were obtained in 17 cases, 30.9%. Anatomical reduction and/or restoration of perfect head/roof congruency were strongly associated with better outcome. Beside this there was significant relation between good clinical outcome and the utilisation of the anterior approach. On the other hand bad outcome was associated with these factors: [1] associated pelvic ring injury, [2] fracture of the posterior wall, [3] articular surface comminution and [4] the presence of intra-articular fragments. Fracture personality and not the fracture type is the main determinant of its complexity. Surgical experience is required to achieve the best reduction while avoiding complications

Epidemiology of diarrhoeal diseases among children under age 5 years in Dakahlia, Egypt

Using multistage cluster sampling, we conducted a household survey of diarrhoea among 4458 children under age 5 years in Dakahlia governorate from June 2002 to May 2003 to determine the prevalence and determinants of diarrhoeal diseases. Frequency of diarrhoea in the previous 2 weeks and last 24 hours were 23.6% and 8.7% respectively. Oral rehydration solution use rate was 24.3% among children with diarrhoea in the past 2 weeks. The frequency of diarrhoea was significantly higher among children in rural areas, those aged 6-24 months and of higher birth order, in the summer, when mothers were younger, had lower education or were not working, and when fathers had lower education or were farmers or manual labourers. Overcrowding, improper refuse disposal and non-flush toilets were also significantly correlated with diarrhoea incidence

Trace elements in rhinoscleroma

The aim of this study is directed towards demonstration of the possible changes present in the levels of three important trace elements affecting state of cell mediated immunity in the course of rhinoscleroma.50 rhinoscleroma patients were picked up from the outpatient clinic of ENT department in EL-Minia University Hospital, allover 18 months, 15 pathological contols as contols for the tissue levels of trace elements [the pathological controls were suffering from allergic nasal polypi].15 healthy controls as controls for the serum levels of trace elements The 3 trace elements [zinc, copper and iron] were estimated in serum and tissues of the scleroma patients and controls [healthy and pathological controls]. Results of this study -revealed that there were decrease in zinc level both in serum and tissues of patients more than in the controls. Also, we found hypercupraemia in the patients group than controls. Iron was found to be decreased in the patients than controls. From the above results we conclude that all scleroma patients better to be investigated for the trace elements as these elements play a very important role in cell mediated immunity. Also, may be there is a role of the nutritional aspect regarding to zinc and iron in the routine treatment of scleroma and in the prophylaxis from any immune deficiency in their contacts

Autogenous fibrin glue versus gel foam in myringoplasty

The purpose of this study to compare the use of Autogenous Fibrin Glue [A.F.G.] with the use of Gelfoam in myringoplasty.50 patients with dry central perforations were selected from ENT outpatient clinic in El-Minia University Hospital. In 25 patients we used the prepared autogenous fibrin glue [A.F.G.] in myringoplasty while the gelfoam balls were used in the another 25 cases. The results of autogenous fibrin glue [A.F.G.] group were better than the results of gelfoam group. We concluded that the results of this study recommend the use of autogenous fibrin glue [A.F.G.] in myringoplasty as it improves grafts take, does not transmit any infectious diseases and does not impose any change in technique

Growth markers in macrosomic infants of diabetic mothers

Growth markers [birth weight, crown-heal length, head circumference [HC], midarm circumference [MAC], triceps skin fold thickness, ponderal index, MAC/HC ratio] of 40 symptomatic macrosomic infants born to diabetic mothers [IDM] and 40 macrosomic infants delivered to non diabetic mothers [INDM] were studied. Body weight, ponderal index, triceps skin fold thickness and MAC/HC were significantly higher among IDMS. The positive predictive value for the ponderal index and MAC/HC ratio could successfully discriminate the symptomatic IDM infant from the macrosomic infant born to non-diabetic mother with a predictive value of 66.6% and 86.4%, respectively

Fetal glycosylated hemoglobin as an index of fetal glucose supply

Few studies have considered HbF1C in newborn infants. It has been reported as normal or elevated in infants with accelerated intrauterine growth [LDMs]. No reports described its level in infants with slowed intrauterine growth [SGA]. The results of the present study have shown that HbF1C level is significantly different in LGA [IDMs] and SGA infant groups when compared to its value in the appropriate-for-gestational age group. Moreover, it has demonstrated the value of HbF1C as an indirect index of fetal glucose supply, which is important in determining fetal growth rate and birth weight

Bacterial causes of neonatal septicemia in Alexandria [intensive care nursery] El-Shatby Hospital

Blood cultures were done for 55 infants presenting with clinical manifestations suggestive of septicemia in the intensive care nursery, at the El-Shatby Hospital, during the year 1982. Klebsiella pneumoniae was the most frequently isolated organism [645] followed by S. wien and E. coli [9.7% each]. Biotypting, klebecin production and antibiogram of K. pneumoniae strains revealed that these strains have different epidemiological markers which indicate that they originated from different sources of infection. While the strains of S. wien were identical as regards antigenic structure, colicin production and antibiogram that indicate a common source for these strains which may be a carrier that has to be traced and eliminated