Urinary tract infection in infants and children in Al-Jahra area, Kuwait: an overview

To find the prevalence of urinary tract infections [UTI] in Al-Jahra area, Kuwait and to evaluate the clinical data and laboratory tests that help in the diagnosis of UTI in children. Patients and One hundred and forty-eight patients with proven UTI were included in this study. They were subjected to detailed history and thorough clinical examination. Urine was collected for analysis and culture, and imaging studies necessary for evaluation of the urinary tract were done. Our patients commonly presented with fever and lower urinary symptoms. The majority had no physical signs. Urinalysis was positive in almost all patients, and the organism most commonly isolated was E. coli. Ultrasound examination was useful in the identification of urinary tract anomalies and abnormalities of renal growth. Renal scars were found in 21% of patients. UTI are common in infants and children in A l - Jahra area; 5.5% are affected. They usually present with fever and lower urinary tract symptoms. The disease has to be suspected in febrile patients even in the presence of an equivocal cause of the fever; urinalysis can help in such decision. Furthermore, it is important to treat patients p romptly and effectively because of the potential sequelae

Bardet-biedl syndrome: clinical, endocrinological and imaging evaluation of three unrelated Bedouin children

Bardet-Biedl syndrome [BBS] is a heterogeneous disorder; clinical dissimilarities do exist among patients. Cases of BBS have been reported with hypertension, diabetes mellitus and renal disease, while others were reported with hepatic disease. Here, we are reporting 3 newly diagnosed unrelated Bedouin children, evaluated for the presence of an endocrine disorder. Our patients were 2 males and 1 female. These patients are obese with a voracious appetite, postaxial polydactyly and mentally retarded. Pigmentary retinopathy was found in the older children and hypogenitalism is apparent in the older male child who is also hypertensive. The clinical, endocrinological and imaging evaluation data are compared with previously published cases. Also, phenotypic variability and genetic heterogeneity of BBS pleiotropic gene are briefly discussed. The results of hormonal studies in our cases showed no endocrinological dysfunction, except for the presence of hypogonadism. Although no specific treatment is available, an early evaluation of BBS cases can be the first step in initiating symptomatic management and preventive measures for the patient and the family

Congenital chloride diarrhea: Emphasis an antenatal diagnosis and management

Congenital chloride diarrhea, a rare autosomal recessive disorder, is characterised by sustained watery diarrhea [due to a primary defect of absence of active Cl/ HCO[3] exchange in the ileum and colon], high fecal chloride [>90mmol/L], abdominal distention and failure to thrive. We report here from the Al-Jahra area our experience with clinical and laboratory findings in 11 cases of congenital chloride diarrhea from July 1991 to July 1996, based on which an estimate of the incidence in the Al-Jahra area alone is 1 in 2200, which is much higher than the estimated incidence of 1 in 14000 in other areas of Kuwait reported in 1989. The perinatal factors that helped in early recognition included; consanguineous marriage, maternal polyhydramnios, intrauterine growth retardation, preterm labour, low birth weight and abdominal distention. Fetal ultrasound after 28 weeks showed fetal abdominal distention with dilated intestinal loops and was a significant characteristic finding in all our cases. A high index of suspicion, awareness that the gene for this disorder is present in this population, and especially perinatal ultrasound helps in instituting early management which prevents developmental delay and failure to thrive - the morbidity that is associated with this disorder