Amegakaryocytic thrombocytopenic purpura responded to methyl prednisilone.

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Trends in pediatric casualties in a regional hospital of Kuwait.

The purpose of this study was to statistically analyze the emergency care services of the Paediatric Department of Farwania Hospital, Kuwait. The study was conducted from 1 July 1987 until 30 June 1988, during which a total of 77,497 cases were recorded (41,594 [53.7%] males; 35,903 [46.3%] females). Kuwaiti children represented 40,738 (52.5%) of the total. Children aged 2 to 5 years constituted 22,805 (29.4%) of the cases, and the age group 1 month to 1 year comprised the second largest group (15,475; 19.9%). Admissions peaked in February (8,425 [10.8%]) and Friday was the busiest day (13,561 [17.5%]). There were 61,242 (79.02%) self-referrals. Respiratory diseases were the most common reason for emergency room visits, and totaled 51,583 (66.5%), followed by gastroenteritis with 19,898 (25.7%). This study points up an alarming increase in the number of visits to the casualty clinics of Farwania Hospital. If this increase continues, this will not only markedly increase the burden to staff but will also adversely affect the quality of services.

Vitamin-D-deficiency rickets in Kuwait: the prevalence of a preventable disease.

Two hundred and fifty children with clinical, biochemical and radiological evidence of vitamin-D-deficiency rickets were studied over a period of 5 years. Their ages ranged from 1 month to 2 years. Breastfed infants formed 63% of total cases. Intramuscular therapy with vitamin D in a dose of 600,000 IU, deep intramuscular, proved to be safe and effective. In contrast, oral vitamin D did not provide such satisfactory results, presumably owing to poor patient/parental compliance. This report reveals that vitamin-D-deficieny rickets is common in Kuwait in spite of abundant sunlight all through the year because children are wrapped up and kept indoors. Insufficient intake of vitamin D is another important factor in the pathogenesis of vitamin-D-deficiency rickets in Kuwait.

Congenital chloride diarrhoea in Kuwaiti children.

Congenital chloride diarrhoea was diagnosed in 16 Kuwaiti children over a 7 year period (1980-1986) with an estimated incidence of 7.6 per 100,000 live births. The mean age at diagnosis was 3.2 months (range 1 week to 5 months). There were 9 boys and 7 girls with a mean age of 3 years 10 months (range 10 months to 7 years). All children had a shortened gestational period, abdominal distension and chronic diarrhoea. The serum electrolytes in all patients prior to treatment showed hyponatraemia, hypokalaemia, hypochloraemia and metabolic alkalosis. The diagnosis was confirmed by a stool chloride content that exceeded the sum of faecal sodium and potassium. Fifteen patients survived and showed catch-up growth with adequate replacement therapy and 1 died with renal failure.

Neonatal brucellosis.

Three Arab children with neonatal brucellosis are described. The first presented with late neonatal hyperbilirubinaemia, the second with a septicoemia-like picture and the third was born prematurely and presented with respiratory distress. The diagnosis of brucellosis was based on a positive blood culture and on a high or rising titre of antibodies to the Brucella organism. All the three neonates responded well to antibiotic therapy as monitored by a Brucella titre of less than 1:40 and a negative blood culture 10 weeks after the onset of therapy. The three mothers had Brucella infections during pregnancy and the Brucella agglutination titre of the breast milk was high. No Brucella microorganism was isolated from the breast milk. The mode of transmission of brucellosis in neonates is discussed.

Congenital hypoplastic anaemia in Arab children (Diamond-Blackfan syndrome).

Three Arab children with congenital hypoplastic anaemia are reported. The three children presented with pallor in the first 3 months of life. All were given corticosteroids at different times. The first child is on high doses of prednisone and also needs blood transfusion every 6 weeks. The second child is on 5 mg prednisone every other day and is in remission. The third has been in complete remission for the last 5 years and is on no treatment. None of these children has associated congenital or chromosomal abnormalities.

Neonatal listeriosis: a report of seven cases.

Seven neonates with listeriosis admitted to Farwaniya Hospital, Kuwait, are reported. Six had the meningitic type and one the septicaemic type. Serotyping showed 1/4b in all neonates. The response to 2 weeks ampicillin and amikacin was excellent with no mortality or morbidity.