Biomedical subjects

M O Rawashdeh

Publications and source records attributed to M O Rawashdeh.

12 recordsLinked to original sources

PubMed1998

Respiratory syncytial virus infection in infants hospitalized with respiratory illness in northern Jordan.

During the winter seasons of 1993 and 1994, a total of 256 nasopharyngeal aspirates (NPA) from infants aged less than 1 year old admitted to the pediatric ward of Princess Rahma Hospital, northern Jordan, with bronchiolitis and/or pneumonia, were tested for the presence of respiratory syncytial virus (RSV) using direct immunofluorescence assay (DFA) and cell culture (CC). Of the 256 specimens, 129 (50 per cent) were found positive by both DFA and CC, whereas 24 specimens (9 per cent) and 16 specimens (6 per cent) were found positive by DFA and CC, respectively. In an evaluation of the collected NPA specimens detected by DFA, a sensitivity of 89 per cent and a specificity of 78 per cent were demonstrated. These data suggest that virus isolation in CC is still important for the diagnosis of RSV, although DFA is a valuable, rapid diagnostic assay.

Cells, Cultured↗

PubMed1997

Viral gastroenteritis among young children in northern Jordan.

During the summer months of 1992 and 1993, a total of 439 diarrhoeatic fecal specimens from infants and young children less than 3 years of age admitted to the pediatric ward of Princess Basma Teaching Hospital, northern Jordan were tested for the presence of viruses using direct electron microscopy (EM) and enzyme-linked immunosorbent assay (ELISA) for rotavirus. EM revealed rotaviruses in 83 (18.9 per cent) of cases, adenoviruses in five (1.1 per cent) cases, and small round viruses in three (0.68 per cent) cases. In contrast, the ELISA assay detected rotaviruses in 174 (39.6 per cent) of cases. In an evaluation of the collected diarrhoeatic fecal samples for rotavirus detected by ELISA, a sensitivity of 95.2 per cent and a specificity of 73.3 per cent was demonstrated.

Acute Disease↗

PubMed1997

Non-seasonal viral and bacterial episode of diarrhoea in the Jordan Valley, West of Jordan.

A non-seasonal diarrhoeal episode in the Jordan Valley occurred over a 2-month period, during which no traditional enteropathogens were detected by the health authority laboratories. A total of 17 diarrhoeal stool specimens from infants, young children and adults were randomly collected and delivered to our laboratories to investigate the presence of unusual aetiological agents. Stools were examined for parasites, ova, viruses and cultured for bacterial pathogens. A multiplex polymerase chain reaction was developed to investigate the involvement of diarrhoeagenic Escherichia coli in this episode. Recognised pathogenic organisms were detected in 8 out of 17 of the diarrhoeatic patients, one patient of whom had a mixed infection with two agents. Rotavirus, enteroinvasive E. coli (EIEC), enteropathogenic E. coli (EPEC), and enterotoxigenic E. coli (ETEC) were found to be associated with the diarrhoea. EIEC was the most common enteropathogen detected (4 out of 17) followed by rotavirus (3 out of 17). One of the EIEC isolates detected in one patient was associated with rotavirus. The clinical features of the diarrhoeatic patients were remarkably similar, regardless of aetiology. This study reveals the identity of pathogenic agents that are not detected by traditional methods employed by the health authority laboratories, which emphasise the urgent need for developing the current diagnostic techniques.

Adult↗

PubMed1996

Familial Mediterranean fever in Arab children: the high prevalence and gene frequency.

UNLABELLED: Over a period of 3 years, 192 children with familial Mediterranean fever were prospectively studied. Of these, 106 (55%) were girls and 86 (45%) were boys. The prevalence was 1:2600 children with a gene frequency of 1:50. The age at onset ranged between 4 months and 16 years. Of these patients 24% started their illness below the age of 2 years and 88% were symptomatic before the age of 10 years: 82% had recurrent abdominal pain, 43% had pleurisy, 37% had arthritis, 15% had cutaneous manifestations, 12% had splenomegaly and 4% had hepatomegaly. The presenting symptoms were abdominal pain in 51%, unilateral chest pain in 23% and arthritis in 26%. The family history was positive in 62%. Of 12 affected families 19 members had/have renal failure and amyloidosis was confirmed in 7 patients. CONCLUSIONS: Our data show a high prevalence of familial Mediterranean fever and a high gene frequency in Arab children similar to that reported in Jews and Americans.

Adolescent↗

PubMed1996

Paediatric upper gastro-intestinal endoscopy in developing countries.

A retrospective study of 200 endoscopies performed on 168 children (90 girls and 78 boys) aged 3 months to 18 years (median 6 years) is reported. All procedures were completed successfully in an adult endoscopy unit in a comprehensive health centre. Most children of less than 6 months and above 12 years of age needed no intravenous sedation. One child developed respiratory depression and was successfully resuscitated. Indications for endoscopy were: small intestinal biopsy, 78 (46%); recurrent abdominal pain, 40 (24%); acute epigastric pain, 13 (8%); persistent vomiting, 12 (7%); haemorrhage, 10 (6%); caustic substance ingestion, six (4%); and dysphagia, four (2%) children. Positive diagnoses were obtained in 123 (62%) procedures. Coeliac disease (26 cases) was the most common histological diagnosis, followed by gastritis (19 cases), oesophagitis (18 cases), duodenitis (16 cases), duodenal ulcer (11 cases), hiatus hernia (six cases), gastric ulcer (three cases) and oesophageal stricture (two cases). Where specialized paediatric endoscopy units are not feasible, e.g. in developing countries, endoscopic services for children can be safely provided by paediatric endoscopists as part of an adult endoscopy service, provided that suitable resuscitation equipment is available and the necessary modifications to meet the medical and psychological needs of children and their parents are taken into consideration.

Adolescent↗

PubMed1996

Celiac disease in Arabs.

A systematic study of celiac disease in a defined population of Arab children has not been previously reported. We therefore performed a prospective study to determine the incidence and clinical presentation of celiac disease in Jordanian children. A total of 34 (12 boys and 22 girls) cases were diagnosed over a period of 36 months. Nine cases were clustered in three families. The incidence was calculated to be 1:2,800 live births. The mean age at presentation was 4.6 years (range 0.3-13), but it was 8.4 years at the time of diagnosis. Diarrhea was the main initial symptom in 15 (44%) patients. Other signs and symptoms included recurrent abdominal pain in five patients (14%), short stature in four (12%), abdominal distension in three (9%), constipation in three (9%), pallor and recurrent mouth ulcers in two patients each. At the time of diagnosis, 24 (71%) had hypochromic microcytic anemia, and nine (26%) had rickets. The relatively high incidence of celiac disease may be related to the large wheat consumption in this population (135 kg/head/year), and the late onset could be related to the widespread prevalence of prolonged breast-feeding in Jordan (12 months) and late introduction of cereals (6.2 months) in children with late presentation. The delay in diagnosis might be due to the presence of other diseases clinically resembling celiac disease in our community.

Adolescent↗

PubMed1995

Pneumatic reduction of intussusception in children.

The use of an air enema in the diagnosis and reduction of intussusception, using a simple home-made device, was prospectively studied in 36 children with the tentative diagnosis of intussusception. Plain abdominal films were inconclusive in 19 patients (53%). Using an air enema, the diagnosis of intussusception was easily reached or excluded in all suspected cases. Twenty-nine patients had intussusception. Their ages ranged from 3 to 20 months (mean: 7 months), and all had ileo-colic involvement. Pneumatic reduction was successful in 23 cases (79%), and reduction was completed within 2-3 minutes in all successfully reduced cases. At operation, three children had a tear of the sero-muscular layer of the transverse colon, but there were no perforations or recurrences of the intussusception in the immediate post-reduction or follow-up period (1-25 months). An air enema is a safe, cheap, clean and reliable procedure for the diagnosis and reduction of intussusception, and can now be considered as the treatment of choice in uncomplicated intussusception.

Child, Preschool↗

PubMed1995

Bacterial meningitis: still a cause of high mortality and severe neurological morbidity in childhood.

Among 121 cases of bacterial meningitis (age 2 months to 12 years; mean, 35 months) treated over a 3-year period, Neisseria meningitidis was the most common pathogen (33 per cent), then Haemophilus influenzae (32 per cent) and Streptococcus pneumoniae (15 per cent). In the H. influenzae group, 95 per cent were aged below 2 years. Overall mortality was 12 per cent: higher in the S. pneumoniae (17 per cent) and less common organism (21 per cent) groups. Neurological sequelae in 21 (20 per cent) of the 106 survivors included hearing impairment in 17 and quadriparesis in eight. Meningitis caused by S. pneumoniae contained a significantly higher proportion of children with neurological morbidity (P = 0.0128). The addition of dexamethasone treatment during the third year produced an apparent but not significant trend towards less mortality (P = 0.7568), fewer neurological sequelae (P = 0.3401) and less hearing impairment (P = 0.3903). Despite the availability of effective chemotherapy, bacterial meningitis will remain an important cause of high mortality and considerable morbidity.

Brain Diseases↗

PubMed1995

Remission following an elemental diet or prednisolone in Crohn's disease.

The short- and long-term effects of an elemental diet in children with acute Crohn's disease were compared with those of prednisolone in historical controls. Clinical remission was induced in 25 of 30 and in 18 of 28 episodes treated for six weeks with an elemental diet and prednisolone. Patients with proximal disease had longer remission after treatment with an elemental diet (p < 0.05) than did patients with colonic disease after treatment with prednisolone (p < 0.01). Disease activity index score improved in both groups compared with the pretreatment scores (p < 0.05). However, the improvement in the elemental diet group was significantly better than in the prednisolone group (p < 0.001). Changes in linear growth were better after treatment with an elemental diet compared with steroids (p < 0.001). Serum albumin and haematocrit concentrations all improved significantly in the children treated with an elemental diet (p < 0.001) but not in those treated with steroids. Thus an elemental diet was better than prednisolone in proximal disease and confirmed improved growth and nutritional status.

Adolescent↗

PubMed1994

Shigellosis in Jordanian children: a clinico-epidemiologic prospective study and susceptibility to antibiotics.

During a 2-year prospective study of children hospitalized with gastroenteritis, shigellosis was detected in 66 cases (9 per cent of 726 admissions). The age group for peak shigella incidence was 1-4 years. The incidence increased from 8 per cent in 1991, to 11 per cent in 1992. Shigella flexneri was the most common isolate (65 per cent), followed by Shigella sonnei (17 per cent), Shigella boydi (11 per cent), and Shigella dysenteriae (7 per cent). At presentation, 44 per cent had watery diarrhoea, followed by dysentery during hospitalization in the majority of cases. Seizures occurred in 27 per cent of cases and preceded diarrhoea in 15 per cent. Most Shigella flexneri and dysenteriae strains were resistant to co-trimoxazole, ampicillin, tetracyclin, and chloramphenicol. Nalidixic acid, gentamicin and cefotaxime were the most effective antibacterial agents. Case fatality was 3 per cent associated with strains resistant to the antibiotics used initially in the treatment.

Adolescent↗

PubMed1992

Using the steatocrit to determine optimal fat content in modular feeds.

The steatocrit was measured in infants with protracted diarrhoea who were receiving intragastric modular feeds. Measurements were made when fat intake was constant to determine steatocrit variability and during increases in fat intake to determine fat tolerance limits. Steatocrit variability was expressed as the range between a subject's lowest and highest steatocrit value. The median between-stool and between-day variabilities were 2% and 11% respectively. Variability was also measured in seven healthy breast fed infants. In the five still displaying appreciable physiological steatorrhoea, the between-day variability (median 8%) and between-stool variability (median 9%) were not significantly different from the protracted diarrhoea group. In the fat tolerance investigations in the protracted diarrhoea group, the steatocrit increased with increases in the module fat content. Fat intake and steatocrit were significantly positively related. A significant negative correlation was seen between steatocrit and weight gain, the latter becoming negligible at steatocrit values around 30%.

Breast Feeding↗

PubMed1992

The steatocrit: an improved procedure.

The steatocrit is a simple and easily repeated assay for measuring the fat content of infants' stools. However, we and others have experienced technical difficulties in its use. Three modifications were therefore made to the original procedure: incorporation of a lipid-soluble dye, improved homogenization and a heating step. The modified method was used to measure the stool fat content of young children with and without clinical steatorrhoea. Validation of the modified steatocrit is presented, together with examples of its application to both clinical research and clinical practice.

Celiac Disease↗