COGNITIVE FUNCTIONS IN CHILDREN WITH TYPE I DIABETES.

OBJECTIVE: The aim: To assess the patterns and severity of cognitive impairment in children with type 1 diabetes as well as its association with disease onset and poor glycemic control. PATIENTS AND METHODS: Materials and methods: We assessed higher mental function and screened for psychosocial functioning in 60 children with type 1 DM and 60 age-matched control using the Modified Mini-Mental State examination and Pediatric Symptoms Checklist and its relation with age, gender, socioeconomic status, age at the onset of disease, duration of disease, HbA1c level, frequency of diabetic ketoacidosis and hypoglycemic attacks and type of treatment. RESULTS: Results: Diabetic patients demonstrated a lower Modified Mini-Mental State examination score than controls (25.12±4.58 versus 30.08±2.95) with a highly significant difference. Furthermore, the mean Pediatric symptoms checklist score in patients was 39.08±8.18 which was much lower than that of controls 54.42±6.0 with a highly significant difference. CONCLUSION: Conclusions: There is neurocognitive impairment in diabetic children compared to non-diabetics, and poor glycemic control whether hyper or hypoglycemia could affect their cognition and mental health.

Nutritional status of children and adolescents with Type 1 Diabetes Mellitus in Baghdad: a case-control study.

Diabetes mellitus (DM) is a major life-long non-communicable illness correlated with obesity and chronic undernutrition. It is particularly important to monitor the nutritional status of children with type 1 diabetes mellitus (T1DM), as they are still growing and may be affected by the disease or associated conditions like celiac disease. This study aimed to evaluate the nutritional status of children and adolescents with T1DM in Baghdad city and identify possible risk factors for undernutrition. A single-center, case-control study was conducted in Central Child's Teaching Hospital, Baghdad, Iraq, over 9 months from November 2021 to July 2022. The study included patients with T1DM and healthy controls. Detailed history, clinical examination, and anthropometric measures were performed for all participants in the study. The mean age of the sample was 10.0 ±3.73 years and 8.68±3.1 years in diabetic patients and controls, respectively. Anthropometric measures in patients with type 1 diabetes were significantly lower than those of controls (P<0.001). All patients within the undernourished group were from large-size families compared with 75.76% of the normally nourished group, with a significant difference. The mean age of disease onset in the normal nourished group was 6.61 ± 2.78 years which was significantly earlier than that of the undernourished group (8.83 ± 2.89). Weight-for-age and BMI z-score had a significant negative correlation with HbA1c (r=-0.312, p=0.004, and r=-0.295, p=0.006, respectively). Patients with T1DM had significantly lower anthropometric measures than the normal population. Older children, female gender, large family size, and disease duration are independent predictors of undernutrition in T1DM. BMI and weight-for-age have a significant negative correlation with metabolic control of diabetes represented by HbA1c.

Clinical and laboratory characteristics of children with neurological presentations of COVID-19: a single-center experience.

The study aimed to assess the frequency of neurological presentations of pediatric COVID-19 patients and compare the clinical and laboratory characteristics and the outcomes of those who presented with neurological complaints and those without complaints. A cross-sectional study enrolled 84 children diagnosed with COVID-19 at the emergency department over 12 months. All previously healthy children with a laboratory-confirmed diagnosis of COVID-19 were included in the study. The diagnosis of COVID-19 was made by positive PCR of a nasopharyngeal swab. Patients were divided into 2 groups: group 1 included COVID-19 patients with neurological complaints, and group 2 included COVID-19 patients with non-neurological complaints. Demographical, clinical, and laboratory characteristics were compared among groups. During the study period, 84 children aged 2 months-15years were diagnosed with COVID-19. Only 17 patients (20.2%) presented with new-onset neurological complaints. Seizure was the most common neurological complaint (58.8%), and febrile convulsion was the most frequent diagnosis of COVID-19 patients with neurological presentation (47.1%). C-reactive protein (CRP) and duration of hospitalization were higher in patients with neurological presentations, with P values of 0.002 and 0.001, respectively. All patients with neurological complaints survived the acute illness. Neurological symptoms were present in 20% of the COVID-19 pediatric patients, having higher CRP than patients with non-neurological presentations. CRP can be used as a reliable indicator for neurological symptoms in COVID-19 pediatric patients.

Risk factors in children with febrile seizures and their iron status.

OBJECTIVE: To determine the risk factors for patients with febrile convulsions and to assess their iron status. METHODS: The case-control study was conducted at the Central Child Teaching Hospital, Baghdad, Iraq, from May 1 to August 31, 2017, and comprised febrile patients aged 6-72 months admitted after presenting with axillary temperature ≥38oC. Those who got fits along with fever were declared the cases, while those with just fever were considered the controls. Venous blood samples were taken for complete blood count, biochemical tests, and for serum ferritin, serum iron and total iron binding capacity. Data was analysed using SPSS 23. RESULTS: Of the 80 patients, 40(50%) were in each of the two groups. Respiratory tract infection was the commonest cause of fever in 29(58%) cases and 21(42%) controls (p>0.05). The cases were significantly younger in age (p<0.05). Also, there was significantly low haemoglobin level, low packed cell volume, low serum iron, higher total iron binding capacity and low serum ferritin in the case group (p<0.05). Iron deficiency anaemia was found in 17(73.9%) of the cases compared to 6(26.1%) among the controls. The mean serum ferritin of the cases was lower compared to the controls (p=0.001). CONCLUSIONS: The risk of febrile seizure in iron-deficient children increased in the presence of risk factors.