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Biomedical subjects

A Y Elzouki

Publications and source records attributed to A Y Elzouki.

At least 19 recordsLinked to original sources

Peritonitis in continuous ambulatory peritoneal dialysis in children living in Saudi Arabia.

The clinical aspects of peritonitis and catheter infections were reviewed in 64 children on continuous ambulatory peritoneal dialysis living in Saudi Arabia over a period of 6 years. Peritonitis occurred in 41 children (64%). The mean time from starting dialysis to the first episode of peritonitis was 7.2 months. The incidence of peritonitis was 1 episode in 9 treatment months. Gram-negative organisms were responsible for the majority of episodes (42%), followed by Gram-positive organisms (20%), and Candida albicans (6%); 32% were culture negative. Recurrent peritonitis was present in 20 cases. Catheter was replaced in 24 patients: 44% due to recurrent peritonitis. Peritoneal membrane loss occurred in 7 patients, 3 had Candida peritonitis and 3 had recurrent peritonitis due to Pseudomonas. The mortality rate was 4.6% but none of the deaths were related to peritonitis or dialysis.

Candidiasis↗

Brucella endocarditis associated with glomerulonephritis and renal vasculitis.

We report a patient with a peculiar association of brucella endocarditis, glomerulonephritis, and renal vasculitis, with immunopathological features different from those of endocarditis glomerulonephritis. Renal biopsy revealed moderate diffuse hypercellularity involving the mesangium as well as capillary loops, immunoflurescence revealed no staining for IgG, IgM, IgA, C3, and fibrinogen. The clinical and biochemical evidence of glomerulonephritis disappeared after antibiotic treatment combined with steroid therapy. No similar case has been previously reported in the literature.

Brucellosis↗

Thin-section computed tomography scans detect medullary cysts in patients believed to have juvenile nephronophthisis.

Juvenile nephronophthisis (NPH) and medullary cystic kidney disease are an important cause of chronic renal failure in children and young adults. Medullary cysts are regarded as the hallmark of this condition. The diagnostic techniques that were used previously were not conclusive in most cases to demonstrate medullary cysts. We studied the role of thin-section (1.5-mm) computed tomography (CT) scan as an optimal imaging diagnostic technique. Three children who were admitted to our hospital consecutive with a clinical diagnosis of NPH were included. We found that the thin-section CT scan demonstrates the medullary cysts in all patients. We recommend CT scan as the investigation of choice in patients with clinical features suggestive of nephronophthisis-cystic renal medulla complex.

Child↗

Sister chromatid exchange analysis in monitoring chlorambucil therapy in primary nephrotic syndrome of childhood.

Sister chromatid exchange (SCE) analysis is the most sensitive method for assessing chromosome damage induced by chemical mutagens. We report the SCE of peripheral blood lymphocytes in children with primary nephrotic syndrome (NS) treated with chlorambucil. Group I consisted of 20 normal children, group 2 of 14 children with primary NS who had never received a cytotoxic drug and group III of 7 children with primary NS who had received chlorambucil, which was discontinued 6-36 months prior to the study. Group IV consisted of 4 nephrotic children who were receiving chlorambucil therapy during the study. There was no significant increase in SCE in group III compared with group I or group II (P much greater than 0.05). A significant rise in SCE (P less than 0.05) was seen in all patients in group IV.

Child↗

Evaluation of chlorambucil therapy in steroid-dependent and cyclophosphamide-resistant children with nephrosis.

A prospective study was performed to evaluate the efficacy of chlorambucil in inducing long-term remission in children with steroid-dependent or cyclophosphamide-resistant primary nephrotic syndrome (NS). The 16 steroid-dependent children had a relapse rate of 5.3/patient per year (range 4-8) and a mean age of 8.4 years (range 2-13). The chlorambucil dosage was 0.2 mg/kg per day for a total of 8 weeks. Nine patients (56%) remained in complete remission for an average of 39.2 months (range 16-70). The interval to the first relapse in the remaining 7 ranged from 4 to 41 months and the relapse rate decreased significantly to 0.6 relapses/patient per year (P less than 0.05). Five children had steroid- and cyclophosphamide-resistant NS, 4 with focal segmental glomerulosclerosis and 1 with mesangiol proliferative glomerulonephritis. Chlorambucil was given in a dose of 0.2 mg/kg per day for 8-16 weeks. Complete remission was obtained in 4 patients; 2 patients relapsed. No serious long-term complications were observed in our patients.

Adolescent↗

Frequent relapser minimal change nephrosis: an unrecognized X-linked disorder?

We report three brothers who developed nephrosis between the age of 3-10 years. The parents were nonconsanguineous and of Arab descent. The mother's sister had a son with a similar condition. Patients were steroid responders and frequent relapsers. Renal biopsies in the three brothers showed findings of minimal change nephrosis. This family may suggest the existence of an X-linked recessive nephrosis which provides further evidence for genetic heterogeneity of familial nephrosis.

Biopsy↗

Serum concentrations of vitamin D metabolites in rachitic Libyan children.

Twenty-two consecutive patients with rickets were studied in Benghazi, Libya. All were less than 2 years old. Rickets was associated with traditional cultural habits that limited sunshine exposure of the mothers and their infants, and with breast-feeding. Serum concentrations of the vitamin D metabolites 25-hydroxyvitamin D (25-OHD), 1,25-dihydroxyvitamin D, and 24,25-dihydroxyvitamin D, and other parameters of mineral metabolism were typical of vitamin D deficiency disease, as was the biochemical and clinical response to treatment. Minimum safe serum levels of 25-OHD (20 nmol/L), and the serum levels of vitamin D metabolites in response to vitamin D treatment, were identical to previously obtained results from native Norwegian and Norwegian immigrant children with rickets, suggesting lack of racial differences in response to vitamin D. Fifty percent of the patients had adequate levels of vitamin D metabolites at the time of diagnosis, indicating that they had recently received oral vitamin D or cutaneous exposure to sunshine. Many cases of rickets in the area may, therefore, be spontaneously cured when the children's maturity allows adequate mobility and independence to achieve exposure to sunshine.

Breast Feeding↗

Long-term, small dose prednisone therapy in frequently relapsing nephrotic syndrome of childhood. Effect on remission, statural growth, obesity, and infection rate.

A prospective study was performed to evaluate the effect of long-term small-dose prednisone therapy in frequently relapsing nephrotic syndrome (NS); 37 patients were included, with a relapse rate 4.6/patient/year (range, 3-8) (mean age, 6.7 years; range, 2-15 years). Prednisone was started 2 mg/kg/day once remission was induced. Prednisone was progressively reduced over weeks until 10 mg/day was reached, and then the daily dose was changed to 10 mg on alternate days. On follow-up (mean, 25.4 months; range, 10-58 months), only five had subsequent relapses and their relapse rate decreased significantly to 1.2/patient/year (p less than 0.05). Forty-six episodes of infection were associated with exacerbation of NS; 41 of these excerbations remitted spontaneously without an increase in the dose of prednisone. Serial height and weight measurements revealed evidence of improved height velocity and obesity persisted in only two of 13 initially obese children.

Adolescent↗

Mechanical ventilation in newborn infants.

A 20-month experience of mechanical ventilation (MV) in the newborn infants (birth weight greater than or equal to 1500 g) from a developing country is described. A total of 41 neonates (4.1% of total admissions to the Neonatal Intensive Care Unit) were treated with MV. The mode of MV was intermittent positive pressure ventilation and continuous positive airway pressure via nasotracheal intubation. The mean birth weight and gestational age were 2544 g and 36.2 weeks, respectively. The mean age at the start of MV was 141 h and the mean duration was 54 h. The indications for MV were respiratory distress syndrome (18), aspiration pneumonia (8), non-aspiration pneumonia (6), apnoea (8) and tetanus neonatorum (1). The complications encountered during MV were sepsis (26.8%), pulmonary haemorrhage (21.9%), congestive heart failure (17.1%), pneumothorax (14.6%) and intraventricular haemorrhage (7.3%). Post-extubation atelectasis was observed in 29.6% of cases. The overall survival rate was 43.9%. The risk factors for a poor outcome were birth weight less than 2000 g, prematurity and late referrals to the Neonatal Intensive Care Unit.

Apnea↗

Congenital choanal atresia in North African infants.

Eleven cases of congenital choanal atresia seen over a period of 2 years are described. Its incidence in the community was 1 in 3100 births. Twenty-seven per cent of cases were missed at birth, suggesting an even higher incidence. The anomaly was significantly commoner in infants of younger mothers with less than four children (P less than or equal to 0.05). Maternal polyhydramnios was present in three cases (P less than or equal to 0.0001). The sex incidence was equivocal and three infants were of low birthweight. The atresia was bilateral in the majority of the cases, and associated congenital anomalies were present in five of the 11 infants. Five underwent surgery with no complications.

Adult↗