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Biomedical subjects

Z Bittar

Publications and source records attributed to Z Bittar.

7 recordsLinked to original sources
PubMed1995

Major anomalies in consecutive births in south of Beirut. A preliminary report about incidence and pattern.

A prospective study of major congenital anomalies (MCA) in the newborn is planned for 3 years. This preliminary report included 2161 consecutive newborns who were examined in one year for the presence of MCA in one center whose population is mostly of unfavourable living conditions. Major anomalies were found in 32 infants at incidence of 14.8/1000 (B). 29 infants with full description included 21 with a single and 8 with multiple MCA, 5 of whom were non syndromal and 3 of sequence type Skeletal anomalies were leading among the group followed by neural tube fusion defects (NTFD) forming 21.05% and 18.42% of total anomalies respectively. Incidence of NTFD (3.23%) and of esophageal atresia (1.38%) was higher than in many other western and middle eastern reports. No cases of mongolism were observed among the group putting its incidence below the usually reported figures. Incidence of low birth weight (LBW) was 5.7% among the studied population and 25% among the group of patients. Incidence of MCA among the group of LBW was 6.5%. Perinatal death was 2.82% among the whole group of newborns, 50% among malformed infants who formed 26.22% of perinatal death. 62.5% of cases were amerable to surgery.

Congenital Abnormalities↗
PubMedDate not supplied

Significance of atypical pathogens among community-acquired pneumonia adult patients admitted to hospital in Kuwait.

OBJECTIVES: The aim of this study is to determine the microbial etiology and severity of community-acquired pneumonia (CAP) in Kuwait. SUBJECTS AND METHODS: The severity of consecutive adult CAP cases admitted to 3 hospitals over a 1-year period was classified according to the Pneumonia Outcome Research Team (PORT) severity index. The microbial etiology was determined using standard methods for bacteria and serological tests for atypical and viral pathogens. RESULTS: The study population was 124 of the 135 admissions; 63 female, 61 male; mean age 41.3+/-18 years. The severity class distribution was: class I 31%, class II 37%, class III 17%, class IV 13%, and class V 2%. Etiological agents were identified from 44 patients (35%), with one pathogen in 31 (25%), two in 9 (7%), and three or more in 4 (3%). The most common pathogens identified were: Mycoplasma pneumoniae in 14 patients (11%), Legionella pneumophila in 10 (8%), Chlamydia pneumoniae in 8 (6%), influenza B virus in 8 (6%), influenza A virus in 5 (4%), Haemophilus influenzae in 4 (3%), Streptococcus pneumoniae in 3 (2%), Staphylococcus aureus in 3 (2%), gram-negative enterobacteria in 5 (4%), Moraxellacatarrhalis in 2 (2%), and viruses in 4 (3%). The yields from laboratory tests were 48% for paired serology, 20% from adequate sputum sample, and 3% from blood culture. CONCLUSION: Our study shows that a large percentage of mild CAP cases are admitted to hospitals in Kuwait. Atypical pathogens have a significant role in the etiology of CAP. There is overtreatment of CAP with a combination treatment consisting mainly of third-generation chephalosporins and macrolides.

Adolescent↗
PubMedDate not supplied

Rates of perinatal mortality and low birth weight among 3367 consecutive births in south of Beirut.

3367 consecutive births were reviewed prospectively. Population belongs mainly to a community with relatively underprivileged living conditions. Perinatal mortality was found at a rate of 22.4/1000 B. Early neonatal mortality formed 6.66/1000 B and stillbirth formed 15.83/1000 B. Low birth weight rate was 5.43% of live birth. Analysis of our findings suggests the need to improve follow-up during gestation to avoid complications resulting in macerated stillbirths, and to review the routine of follow-up and care in the immediate period before delivery, during delivery, in the immediate post partum period including resuscitation procedures, and care in the ICN. The aim is to prevent and appropriately treat intrauterine asphyxia, fetal distress, obstetric complications, and in the post partum period to appropriately resuscitate the newborn and improve ICN procedures. These measures are expected to reduce fresh stillbirth and early neonatal mortality and consequently infant mortality. Lowering rate of low birth weight is of less urgent nature in this population as it is relatively not high, but because a larger portion of early neonatal mortality is among low birth weight infants, with weights below 2000 gms, improving ICN care provided to these neonates is expected to sharply reduce neonatal mortality. In Lebanon we have a growing number of ICN units with wide variability of the quality of medical supervision and facilities. Insufficient number of neonatologists and nurses who are specialized in neonatal intensive care is leaving the chance for sick neonates to be attended by general pediatricians and insufficiently trained nurses. Our medical schools are called to encourage pediatricians to specialize in neonatal intensive care and to create more opportunities for this specialty to meet the national requirement. It is suggested, too, to subject ICN units in Lebanon to standardized requirements concerning attendance and facilities before obtaining official recognition. Centralization of care given to severely sick neonates and to women with high risk pregnancy in optimal conditions is most needed.

Female↗
PubMedDate not supplied

Major congenital malformations presenting in the first 24 hours of life in 3865 consecutive births in south of Beirut. Incidence and pattern.

3865 consecutive newborns delivered between 2/1/91 and 7/31/93 were prospectively studied. All the neonates received a physical examination during the first 24 hours of life. Major congenital anomalies (MCA) were found in 64 newborns at incidence of 16.5/1000 births. 61 patients with full description included 40 with single and 21 with multiple MCA. Out of the latter 2 had syndromal (Osteogenesis Imperfecta and Achondroplasia), 16 nonsyndromal and 3 sequence multiple (Pierre Robin, diaphragmatic hernia with dextrocardia and breech presentation sequence) malformations. Skeletal anomalies were leading among the group (46.29%), followed by genitourinary (GU) defects (12.14%) and neural tube fusion defects (NTFD) (11.21%). Incidence of low birth weight (LBW) was 6% among the studied group of newborns and 26.56% among the group with MCA. Incidence of MCA among the group of LBW was 7.32%. While 65.62% of cases were amenable to surgery the malformed infants formed 24.34% of all perinatal death suggesting that improved care given to these patients will appreciably participate in reducing perinatal mortality. Incidence of NTFD (3.10/1000 births) was higher than in many western and middle eastern reports suggesting the need for further testing for incidence and etiology. Among the malformed infants, the rate of low birth weight and the rate of parental first cousin consanguinity were significantly higher than corresponding rates among normal infants in a control group.

Congenital Abnormalities↗