Serum zinc level in children with nephrotic syndrome

Abnormalities of zinc metabolism are well documented in patients with chronic renal disease. We aim to study changes in serum zinc level in children with nephrotic syndrome [NS]. A hospital based case control study conducted in pediatric nephrology clinic inAl-Kadhymia Teaching Hospital for the period between I January 2010 to 31 October 2010. Forty children with NS were studied. Patients were divided into two groups: 24 patients with relapse [with proteinuria] constitute group A, and 16 patients with remission [without proteinuria] were in group B. Both groups were further subdivided into subgroups according to treatment with or without corticosteroid. Control group consisted of 40 healthy children. Serum and urine albumin was measured for all children. Serum zinc level was estimated by atomic absorption spectrophotometry. Patients aged 2-14 years, girls were 23 and boys were 17. Patients maintained a significant low serum albumin level in group A which was normalized in group B. The mean serum zinc level in group A 57.2 +/- 15.286 microg/dl, was significantly lower than that of controls 96.2 +/- 7.501 microg/dl. An increase in the level was observed in group B, however still significantly lower from that of controls. Low serum zinc level was noted in all treatment groups with or without steroid therapy. The serum zinc-albumin ratio in group B, 1.6260 +/- 0.28864 microg/g was significantly lower than controls. These changes reflect actual lower zinc level in spite of normal serum albumin. Zinc deficiency is present in children with NS, both during relapse and remission. Both serum albumin and corticosteroid had no effect on low serum zinc levels in children with NS. Other probable factors for hypozincemia need to be highlighted in further studies

Treatment of pediatric urolithiasis in Iraq: five-year study

To report our experience with the management of childhood urolithiasis during a 5 year period. Between April 1999 and April 2004, 204 children with urolithiasis were prospectively evaluated, treated, and followed up in a university hospital in Baghdad. There were 150 males [73.5%] and 54 females [26.5%]. There was a history of previous stones in 73 [35.8%]. Stones were located in multiple sites in 80 children. Metabolic disorders were present in 58 [72.5%] of those with multiple sites. Etiology for stone formation was established in 89.7% of cases; 10.3% were idiopathic. Metabolic disorders were detected in 147 patients [72.1%]. Recurrent urinary tract infection was present in 87 patients [42.6%]. Anatomical defects of the renal system were present in 25 patients [12.3%]. The follow up of 156 patients [76.5%] ranged from one month to 5 years [mean= 36 months]. of those 156 patients, surgery was performed on 51. Extracorporeal shock wave lithotripsy [ESWL] was performed in 26, medical therapy was used in 111, and 19 patients were kept on observation. The ultimate stone free rates were 78.7%, 38.5% and 24.3% following surgery, ESWL and medical therapy respectively. Recurrence of stone disease was 19.7% following surgery. Respectively, 46.9% and 11.5% of patients receiving medical therapy, ESWL had no change in stone size. A combined approach with one or more techniques was applied to our patients. Our results indicate that a comprehensive approach to the care of pediatric urolithiasis requires attention to metabolic disorders

Clinical and epidemiological study of visceral leishmaniasis in a group of hospitalized children in Baghdad

To study some of the clinical, epidemiological and diagnostic characteristics of visceral leishmaniasis cases and evaluate response to therapy and compare the present series with previous Iraqi studies and some other endemic regions in the world. Prospective study undertaken in the University Hospital Saddam College of Medicine for the period between December 1998 to March 2000. Patients were 43 children admitted to the pediatric ward with visceral leishmaniasis. Males were more than females with ratio of 1.15:1. Age range was between 4 months to 5 years, 46.5% of cases were below one year of age Duration of illness ranged from 10 days to 3 months. Fever spleenomegaly and hepatomegaly were detected in all cases [100%]. Anemia was present in all children [100%] with the majority [79%] in moderate to sever range. Diagnosis was done by positive Bone Marrow smears for Leishmania donovani bodies [73%], and / or positive Indirect Fluorescent Antibody Test [IFAT] [90.7%], 41 children had been treated with Pentostam with excellent response, 56.1% of them had response [subsidence of fever] in Day 3 and Day 4 of therapy. Mortality rate was 4.6%. The clinical profile of the disease in our study is similar to previous Iraqi studies with some differences: more infants are affected now, with shorter duration of illness and higher percentage of leg edema, jaundice and bleeding tendency. Visceral leishmaniasis in Iraq is a major childhood illness, the clinical profile in the present series is similar to previous Iraqi studies with few differences, and similar to Mediterranean regions and Brazil