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Biomedical subjects

Y A al-Eissa

Publications and source records attributed to Y A al-Eissa.

At least 19 recordsLinked to original sources

Home management of fever in children: rational or ritual?

Fever is extremely common in childhood. Parents have been shown to have unrealistic fears, resulting in inappropriate management of fever in their children. This study was conducted to survey parents about their knowledge concerning home management of fever in children in their care. Parents of 560 febrile children were randomly recruited and interviewed in the waiting areas of the outpatient clinics or emergency room in four hospitals in Riyadh city using a standard questionnaire. Most of the interviewees were mothers, aged within 20-39 years. Although more than one-half of fathers and one-third of mothers in the study were well educated, most were misinformed about recognition and definition of fever. Most parents had poor knowledge regarding minimum temperatures for administering correct doses of antipyretic drugs or for sponging/bathing with water of the correct temperature. Most parents demonstrated a poor understanding of the appropriate frequency for checking the child's temperature and administering antipyretics. Only one-third of parents indicated a reasonable educational imprint by health-care providers. Considerable efforts will be required to educate parents about fever and its management.

Adult↗

Non-group A streptococci: are they pathogens in the throat?

A total of 3,184 paediatric patients with sporadic pharyngitis was studied at King Khalid University Hospital in Riyadh, Saudi Arabia. In addition, 478 children without pharyngitis who were matched for age and sex were included as controls. Group A beta-haemolytic streptococci (beta HS) were detected significantly more often among the children with pharyngitis than among the controls (8.4% vs 2.3%; p < 0.0001). In contrast, total non-group A and group C beta HS were isolated at lower frequency from the sick than control children (0.9% vs 2.5% and 0.2% vs 1.2% respectively; p < 0.01) while other non-group A beta HS such as groups B, G and F were each isolated in similar frequency from both the sick and control children. We conclude that non-group A beta HS appear not to be as important as aetiological agents of sporadic pharyngitis in these children.

Adolescent↗

The impact of the Gulf armed conflict on the health and behaviour of Kuwaiti children.

This study deals with the psychological reactions of Kuwaiti children to war-related stresses in the early period of the Gulf crisis following the summer 1990 Iraqi invasion of Kuwait. A sample of 106 children was drawn from Kuwaiti displaced families and a comparable control sample was obtained from Saudi families in Riyadh, Saudi Arabia. An interview checklist of symptoms of physical and psychological distress was administered to the index child and a female key informant in each household of cases and controls. Most Kuwaiti children were exposed to unpleasant war experiences. It was found that Kuwaiti children exhibited a substantially greater degree of dysfunctional social and emotional behaviour. The types of adverse behaviours were a function of the child's age, sex and experience of aggression. The findings support the notion that a negative relationship exists between armed conflict and the health and behaviour of the children. The complex needs of children exposed to violence require professionals to seek ways of combining psychodynamic interventions and relief programmes.

Adolescent↗

Determinants of term intrauterine growth retardation: the Saudi experience.

In a clinical study from an unselected Saudi obstetric population, the incidence of and risk factors for intrauterine growth retardation among live births were investigated. From a total study group of 4578 consecutive live births, 76 (1.7%) infants were found to be growth retarded. These infants were then compared with a randomly selected control group of 76 term newborns with appropriate birthweight for their gestational ages. Delivery at term of a growth-retarded infant was significantly associated with maternal age under 20 years, maternal body mass index less than 23, first degree consanguinity, poor housing, primiparity, and inadequate prenatal care in univariate analysis. When considered jointly in multivariate logistic regression analysis, the significant determinants were reduced to primiparity, first degree consanguinity, and poor housing. These risk factors correctly predicted 63% and 71% of the intrauterine growth-retarded infants or normal birthweight infants, respectively.

Adult↗

Prevalence of intestinal parasites in Saudi children: a community-based study.

A community-based study was undertaken to determine the prevalence and types of intestinal parasites in the pediatric population of Al-Baha region, Saudi Arabia. Stool samples were randomly collected from 19,939 children of whom 4208 (21.1%) were found to harbour intestinal parasites. The most affected age group was 5-9 years and the sex distribution was almost equal in all age groups. Specific prevalence rates were Giardia lamblia 9 per cent, entamoeba histolytica 5 per cent, Hymenolepis nana 2 per cent, and Enterobius vermicularis 2 per cent. The findings of this survey confirm the extremely complex nature of parasitic profile in developing communities, and indicate that relationships exist between cultural and ecological factors, sanitation, and observed pattern of intestinal parasites.

Adolescent↗

Febrile seizures: rate and risk factors of recurrence.

The rate of recurrence of febrile seizures and the factors predictive of a recurrence were prospectively examined in a cohort of 98 Saudi children who presented consecutively with their first febrile seizure at the pediatric emergency department of the King Khalid University Hospital, Riyadh, Saudi Arabia. Children with prior afebrile seizures or evidence of a neurodevelopmental deficit were excluded. The median age was 15 months (range, 4 to 60 months). Of the 98 children, 72 had simple and 26 had complex initial febrile seizures. In a follow-up of 3 to 6 years (mean, 49 months), 26% of the 98 untreated children had at least one recurrence and only 8% had more than three recurrent febrile seizures; 30% of first recurrences took place within 3 months, 60% within 6 months, 72% within 12 months, and 96% within 24 months of the onset. Four major risk factors for recurrent febrile seizures were identified: early age at onset (< 12 months), first-degree consanguinity of parents, epilepsy in a first-degree relative, and complex initial febrile seizure. Gender, family history of febrile seizures, and degree of fever were not related to recurrence.

Age Factors↗

Clinical and therapeutic features of childhood neurobrucellosis.

Brucellosis is a multisystem disease with diverse clinical presentations, and involvement of the nervous system is considered to be rare in childhood. Five children with meningitis (n=2), meningoencephalitis (n=1), meningomyelitis (n=1), or cerebellar ataxia (n=1) are described, all of whom had a history of exposure to a possible source of brucellosis. Examination of cerebrospinal fluid (CSF) revealed lymphocytic pleocytosis in 4 patients, high protein concentration in 5 and low glucose concentration in 3. Reciprocal brucella agglutination titers were significantly elevated in serum (> or = 160) and in CSF (> or = 80) of all patients. Brucella melitensis was isolated from blood and CSF in one patient, from blood only in 2, and from bone marrow only in another one. All patients were treated successfully by a three-drug combination of streptomycin (4 patients) or doxycycline (one patient) with trimethoprim-sulfamethoxazole and rifampin, and in one patient dexamethasone was also added. In endemic areas, neurobrucellosis should be suspected in the evaluation of patients with unexplained neurologic symptoms.

Anti-Bacterial Agents↗

Risk factors for spontaneous preterm birth in a Saudi population.

Preterm birth (< 37 weeks completed gestation), the primary predictor of infant morbidity and mortality, can result from diverse biologic and sociodemographic variables. A case-control study was undertaken to determine risk factors that were significantly associated with preterm birth in our population. Pertinent data were collected by structured interviews with eligible subjects and by medical record abstraction. The study population consisted of 118 mothers of singleton, preterm, appropriate for gestational age infants (cases) and 118 mothers of singleton, term, appropriate for gestational age infants (controls). A multiple logistic regression analysis indicated that significant risk factors for preterm birth were first or second trimester vaginal bleeding during current pregnancy, a previous preterm birth, inadequate prenatal care, consanguinity, maternal body mass index of < 23, and short inter-pregnancy interval. Awareness of such risk factors is essential in planning public education programs and in considering appropriate perinatal care options for women at potentially higher risk for preterm delivery.

Adolescent↗

Reactogenicity and safety of meningococcal A and C vaccine in Saudi children.

During an outbreak caused by group A Neisseria meningitidis in March 1992, groups A and C meningococcal polysaccharide vaccine was administered to 1,168 children aged from 2 to 18 years. Parents were surveyed to ascertain reactions of children to the vaccine and development of invasive group A meningococcal disease after immunization. The most common reactions were mild local pain (21.9%), erythema (12.2%), and swelling at the injection site (7.2%). Only 1.7% of the children experienced fever and 3.7% displayed irritability. The vaccine was well tolerated and all adverse reactions disappeared within 24-48 hours of immunization. No cases of meningitis or sepsis caused by group A meningococci were seen in the 1st 12 months of observation among the vaccinated children.

Adolescent↗

Factors influencing linear growth in Saudi Arabian children aged 6-24 months.

This study was carried out to identify possible factors influencing the growth pattern of Saudi children in the first 2 years of life. The body length and weight of 400 healthy babies attending the well-baby care clinic of King Khalid University Hospital, Riyadh, Saudi Arabia, were measured at various determined ages in a cross-sectional study design. Nutritional indicators were calculated and the proportions with low height-for-age, low weight-for-height and low weight-for-age were compared with the reference population. The results showed a prevalence of 2 per cent of wasted children and 18 per cent of children with stunted growth. A univariate and multivariate analysis of personal and nutritional variables with the standard nutritional indicators identified age, sex, bottle feeding, and type of solid foods as significant risk factors for stunted growth. Stunting increases with age and males have poorer growth pattern than females. Genetic factors and poor feeding practices of the children are suggested reasons for the observed faltering growth between 6 and 24 months of age. A public health education programme for good nutrition is highly recommended.

Anthropometry↗

Myelofibrosis in severe combined immunodeficiency due to vitamin D deficiency rickets.

An infant with severe combined immunodeficiency is described in whom a refractory anemia and thrombocytopenia developed after the age of 6 months, associated with poor growth and frequent episodes of upper respiratory tract infections and diarrhea. He required frequent blood and platelet transfusions. Bone marrow biopsy provided evidence that the anemia and thrombocytopenia were the results of myelofibrosis which was secondary to vitamin D deficiency. Therapy with 1,25-dihydroxycholecalciferol resulted in resolution of the hematologic and skeletal abnormalities, but he remained susceptible to recurrent serious infections and died at the age of 13 months.

Biopsy, Needle↗

Management of acute childhood diarrhoea in Saudi Arabia: practices versus the WHO recommendations.

The fluid management of 247 infants and children who were admitted to King Fahad Hospital at Al Baha, Saudi Arabia with acute diarrhoea was reviewed. Half of them were infants and 25% were exclusively breast fed. Although dehydration was mild in 149 (60.3%) patients and 227 (92.7%) were at the most moderately dehydrated, as many as 95.8% were given intravenous (IV) hydration at least initially. This indicates that the WHO recommendation to prescribe oral rehydrating solution (ORS) for the control of diarrhoeal diseases, is still not implemented at some of the regional hospitals in Saudi Arabia, and emphasizes the need for urgent and effective efforts to rectify this situation.

Acute Disease↗

Acute rheumatic fever in Saudi Arabia: mild pattern of initial attack.

Fifty-one children with the initial attack of acute rheumatic fever (ARF) were studied prospectively to verify the sociodemographic and clinical profile and to compare results with those from other countries. Most children belonged to large families who lived in an urban setting with ready access to medical care. Unlike reports from many developing countries, the clinical manifestations in this study paralleled data from the West and included arthritis in 76% of the cases, carditis in 43%, and chorea in 8%. Among the 22 cases with carditis, 18 had mitral regurgitation, three developed combined mitral and aortic regurgitation, and one had aortic regurgitation. This study demonstrates the mild nature of ARF in Saudi Arabia and supports the concept that climate and geography appear to bear little relationship to the incidence and severity of ARF.

Adolescent↗

Unusual suppurative complications of brucellosis in children.

Three cases with suppurative complications of Brucella melitensis infection are presented, demonstrating localized involvement of the brain, bones and lungs, respectively, and the lesions were well defined on radiographic examination. The diagnosis was made on the basis of significant Brucella titres and positive blood culture. Awareness of such complications and performance of the appropriate serological and bacteriological studies will establish the diagnosis and will also differentiate this disease from other infections, especially tuberculosis.

Bone Diseases↗

Pancytopenia in children with brucellosis: clinical manifestations and bone marrow findings.

Among 276 paediatric cases of brucellosis seen over a 7-year period, 16 patients (5.8%) with pancytopenia were identified. The most frequent presentations were fever, malaise, anorexia, weight loss, arthralgia, and hepatosplenomegaly. Fourteen patients (87.5%) had positive blood and/or bone marrow cultures for Brucella melitensis. Bone marrow aspiration specimens showed hypercellularity in 14 patients and normocellularity in 2. Histiocytes, eosinophils and plasma cells were increased in every marrow aspirate, and haemophagocytosis was observed in 14 patients (87.5%). Non-caseating granulomas were present in the bone marrow biopsy of 11 patients (68.8%). The pancytopenia was transient, and resolved on treatment of the Brucella infection.

Adolescent↗

Campylobacter gastroenteritis in children in Riyadh, Saudi Arabia.

Campylobacter jejuni/coli (CJC) was isolated from the stools of 82 (1 per cent) of 7369 children with gastrointestinal symptoms during a 2-year period. Among 1130 control children, CJ was isolated from the stool of one (0.09 per cent). The peak incidence of CJC associated gastroenteritis was in the winter. Seventy-six per cent of the patients were 4 years of age and younger with the highest incidence (56 per cent) in children 2 years old and younger. The most common presenting symptoms and signs were diarrhoea (95 per cent), anorexia (71 per cent), abdominal pain (70 per cent), high fever (57 per cent), and frank blood in stools (48 per cent). In five (6 per cent) patients CJC isolates were resistant to erythromycin. In all patients CJC infection was self-limited and the majority of patients required only supportive therapy.

Age Factors↗