A critical review of B.C.G. vaccination programme in Egypt.
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Biomedical subjects
Publications and source records attributed to A S Khalifa.
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CNS infarction is a devastating complication in sickle cell anemia. Episodes are frequently repetitive and often result in permanent neurologic abnormalities. In an attempt to prevent such recurrences a periodic transfusion program was begun at the Children's Hospital of Michigan in 1969. Twenty-one children currently on the program receive buffy-coat poor transfusions on an out-patient basis every 3 weeks. Of 15 who have been on the program for periods of from 9 months to 5 3/4 years, none have had progression of neurologic abnormalities, and several have had definite improvement in neurologic function. One child who was not brought in regularly had recurrent CNS infarction. The only recognized complication has been one instance of serum hepatitis. While such a transfusion program is not without risk, it seems an effective way of preventing progression of neurologic abnormalities resulting from recurrent CNS infarction in sickle cell anemia.
Levels of immunoglobulins G, A and M were determined in 55 children with idiopathic thrombocytopenic purpura (ITP) (32 acute, 18 chronic and 5 recurrent). Mean IgG levels tended to be low in acute ITP and returned to normal with recovery. In contrast, chronic and recurrent ITP had persistently low IgG and IgA levels. C3 complement levels in 10 cases of acute ITP were normal. Seven patients with chronic ITP had their spleens removed, and IgG and IgA levels tended to rise, while IgM levels decreased in 4 patients after the operation. Low IgA levels observed at the onset of purpura in a child might favor the diagnosis of chronic or recurrent ITP.
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Progesterone was the principal therapeutic agent used in 40 cases of pre-eclamptic toxaemia. It was also given to 10 normal pregnant women who served as a control group. A significant fall in both the systolic and diastolic blood pressures was observed in 80% of the toxaemic patients. In all cases there was a marked increase in the 24-hour urinary output with an apparent loss of weight. Serum uric acid showed a significant drop and the urea clearance values also improved. The serum sodium showed an apparent decline while the serum potassium did not show any marked variation. The serum uric acid, urea clearance, blood urea, serum sodium and serum potassium remained unchanged in the control group.
Adenosine deaminase has been measured in the lymphocytes of children with acute lymphocytic leukemia and in those of their parents. The activity was found to be significantly lower in both acute lymphocytic leukemia children in remission and relapse and in the parents of acute lymphocytic leukemia children when compared with normal adults and children of similar ages.
A field survey in a village was carried out to study child health in a rural area. The vaccination scheme was found to be inadequate and the value of health education is stressed. Parasitic infestation was found to be higher than urban areas but significantly lower than 1959 and the latter is attributed to a safer water supply. Growth and development lagged behing the whole national standards particularly during the 1 - 6 years age period. Health care for the pre-school age, taking advantage of co-operation from medical faculties and local health authorities, is recommended.
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