Radiological imaging of disorders of sex development (DSD).

The birth of a child with ambiguous genitalia is a matter of a medical and social emergency to decide the appropriate sex rearing and eventually to prevent the associated metabolic disturbances. It must be taken with immediacy and great sensitivity. The pediatric endocrinologist should share the care with a team consists of a pediatric urologist, or surgeon, a pediatric radiologist, geneticist and a child psychiatrist or psychologist who should work closely with the family. Ultrasonograpy is the primary modality for demonstrating internal organs while genitography is used to assess the uterus, vagina, and any fistulas or complex tracts. Magnetic resonance imaging (MRI) is used as an adjunct modality to assess the internal gonads and genitalia. Early and appropriate gender assignment is necessary for healthy physical and psychological development of children with ambiguous genitalia.

The pattern of anthropometric measurements among term newborn infants in Khartoum state in relation to maternal factors.

Anthropometric measurements of neonates are an important clinical tool for diagnosis of abnormally small or large neonates. This study aimed at finding the means of the anthropometric measurements among newborn babies in Khartoum state and to relate the tendency of the anthropometric parameters to maternal and paternal factors. This observational hospital-based study was carried out in 3 hospitals in Khartoum. Birth weights, crown-heel length and head circumference were taken from term neonates and questionnaire-based interviews were conducted with the mothers. Means of the sample and their associations with maternal and paternal factors were calculated using SPSS. In addition, the means were compared to WHO- MGRS (World health organization-multi growth reference standards). It was found that the average male newborn weighed 3.16kg with a range of 2.4kg to 4.1kg, measured 48.91cm in length with a range of 46.1cm to 51.4cm and measured 34.74cm in head circumference with a range of 32.3cm to 36.9cm. As for the females, the average newborn weighed 3.11kg with a range of 2.1kg to 4.2kg, measured 48.49cm in length with a range of 45.1cm to 51.7cm and measured 34.16cm in head circumference with a range of 32.3 to 36.4. These values were found to be statistically significant when compared with the WHO- MGR. We conclude that there was a difference observed in relation to Sudanese neonate's anthropometric parameters compared to WHO-MGR standards. Growth charts specific for Sudanese neonates are urgently needed.

Short stature in children: Pattern and frequency in a pediatric clinic, Riyadh, Saudi Arabia.

Longitudinal growth assessment is essential in child care. Short stature can be promptly recognized only with accurate measurements of growth and critical analysis of growth data. The objective of this study was to determine the pattern of short stature among patients referred to an endocrine pediatric clinic, King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia and to ascertain the aetiological profile of short stature. This is a retrospective review of patients referred to a pediatric endocrine clinic with short stature during the period January 1990 and December 2009. After a proper detailed medical history, growth analysis and physical examination, followed by a radiological (bone age) and laboratory screening (complete blood count and thyroid function). Growth hormone stimulation tests were performed when indicated. Magnetic resonance imaging (MRI) of the pituitary was performed when necessary. As well, celiac screening and small bowel biopsy were performed when appropriate. During the period under review, hundred and ten patients were evaluated for short stature. Their age ranged from 2 years and six months to 4 years. The male to female ratio was 1.3:1. The commonest etiology was genetic short stature found in 57 (51.8%) patients, while in the other 53 (48.2%) patients, variable endocrine and nutritional causes were noted. Short stature was a common referral. A wide variety of etiological diagnosis was noticed with genetic short stature being the commonest. A wide variety of endocrine causes were evident, with growth hormone deficiency, as a results of different etiologies, being the commonest.

Overview of diagnosis, management and outcome of congenital hypothyroidism: A call for a national screening programme in Sudan.

Congenital hypothyroidism (CH) is the commonest preventable cause of mental retardation in children worldwide. It continued to be a major health problem amongst Sudanese children. The lack of a screening programme in Sudan may be the major factor of missing the diagnosis in newborns with such a condition that can present very subtle clinically, yet with poor neurodevelopmental consequences. The outcome is very good when the condition is noticed early (in the first 2 - 3 weeks of life). However, the prognosis is guarded when the diagnosis is delayed, with a squeal of different degrees of developmental delay depending on the severity of the condition. In this overview, we tried to highlight the important issues of screening, diagnosis and outcome with and without early management, worldwide. We thereby send a call out for all paediatricians and endocrine clinicians who work locally or outside Sudan to collaborate with the Sudanese Society of Paediatrician as well as other stakeholders in Sudan to help establishing a national screening programme for all common and preventable causes of childhood illnesses which has devastating consequences such as CH.