BACKGROUND AND OBJECTIVESAlthough the prevention of the neuropsychological consequences of congenital hypothyroidism (CH) through the use of replacement therapy represents an important public health success, knowledge about the modifiable risk factors could reduce the number of infants affected by this disease. This study was carried out to identify risk factors for CH at Fayoum Governorate, Egypt.DESIGN AND SETTINGSThis was a population-based case-control study, which started in 2003 and was carried out for 8 years through Fayoum center of the Egyptian Ministry of Health and Population screening program for CH.METHODSThis study was a population-based case-control study carried out by using national project for CH. One control was enrolled for each new CH infant; 320 cases and 320 controls were enrolled in 8 years. Maternal and neonatal influences were investigated.RESULTSA statistically significant association of CH was observed with birth defects, female gender, gestational age >40 weeks, and gestational diabetes. An increased risk for CH was detected in twins by a multivariate analysis.CONCLUSIONOur results suggest a multifactorial origin of CH in which genetic (high frequency of additional malformations) and environmental factors (especially maternal diabetes) play a role in the development of the disease.
BackgroundBreaking bad news to mothers whose children has disability is an important role of physicians. There has been considerable speculation about the inevitability of parental dissatisfaction with how they are informed of their child’s disability. Egyptian mothers’ preferences for how to be told the bad news about their child’s disability has not been investigated adequately. The objective of this study was to elicit Egyptian mothers’ preferences for how to be told the bad news about their child’s disability.MethodsMothers of 100 infants recently diagnosed with Down syndrome were interviewed regarding their preferences for how to be told bad news. Mothers were recruited through outpatient clinics of the Pediatric Genetics Department at Fayoum University Hospital (located 90 km southwest of Cairo, Egypt) from January to June 2011.Results and discussionQuestionnaire analyses revealed nine themes of parental preferences for how to be told information difficult to hear. Mothers affirmed previously reported recommendations for conveying bad medical news to parents, including being told early, being told of others with a similar condition, and being informed of the prognosis.ConclusionsMothers affirmed communication themes previously discussed in the literature, such as being told early, and being informed of the prognosis. Although more research is needed in this important area, we hope that our findings will stimulate future search and help health care providers in different societies establish guidelines for effectively communicating bad news.
This study showed that patients with beta-thalassemia major and normal conventional echo doppler parameters had statistically significant changes detected by pulsed wave tissue doppler imaging.
Background: Neonatal sepsis remains a challenge for neonatal care providers. The accurate and timely diagnosis of neonatal sepsis remains a challenging issue due to its non-specific clinical presentation. Patients and Methods:This descriptive cross sectional study was carried out at neonatal intensive care unit in Fayoum University Hospital from February to December 2019. Samples were obtained from 100 neonates that were met the inclusion criteria as having EONS. Neonates were subjected to: History taking, through clinical examination for manifestations of sepsis. Complete blood count, differential leucocytic count, Creactive protein and Blood culture were done to all neonates. Results: of 100 neonates who met the inclusion criteria, (61%) were males and (39%) were females.71 (71%) subjects were included in confirmed sepsis group and 29 (29%) were in non-confirmed sepsis group. Mean eosinophil count in confirmed EONS and non-confirmed EONS group were 250 ± 170 cells/mm3 and 670 ± 470 cells/mm3 , respectively, considered as significant (p<0.001).Result from diagnostic test of eosinopenia from the EONS group (cut-off point 280 cells/mm3 ) obtained 56.3% sensitivity and 93.1% specificity. Mean NLR in EONS and non-confirmed EONS group were 3.08 ± 1.9 and 1.29 ± 0.76, respectively, also considered as significant (p<0.001).Result for diagnostic test of NLR in EONS group (cut-off point 1.75) obtained 70.4% sensitivity and 75.9% specificity. Conclusion: Eosinopenia and increasedin NLR both have a high specificity value as a diagnostic marker of EONS.
Background: Neonatal sepsis remains a challenge for neonatal care providers.Aim: This work was aiming to measure red cell distribution width percent (RDW %) as a marker for neonatal sepsis and to correlate it with other indicators and with a simple clinical scoring system for neonatal sepsis (Griffin score).Methods: This case control study was carried out at neonatal intensive care unit at Fayoum University Hospital and Abshawai central hospital . Ethical Research Committee Approval and written consents were obtained from parents of the neonates30 neonatal sepsis cases and 30 normal controls. Neonates were subjected to: History taking, clinical examination for manifestations of sepsis. Complete blood count, differential leucocytic count, C-reactive protein, Blood culture, RBS, and determination of RDW % were done to all neonates.Results: Our study showed that I/T ratio and RBS was significantly higher in cases than controls (p<0.001), but WBCs show no statistically significant difference among cases and controls. Moreover, blood culture was positive in 63.3% of cases only. Also, CRP was high in 76.7% of cases and 30% of controls (P=0.01) , and that the mean RDW % was higher among cases than controls (16.4 ± 3.8 and 13.7± 1.6 respectively) (P = 0.001), with further increase in preterm neonates . Also, there was a significant positive correlation between RDW level Griffin score (p=0.001). However, there was insignificant difference between RDW and WBCs or I/T ratio but high RDW level associated with raised RBS level of study group. Conclusion:RDW can serve as a marker and prognostic indicator in neonatal sepsis especially when used together with Griffin score.
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