We report the case of a five-year-old girl with plastic bronchitis after repaired complex congenital heart disease, who became asymptomatic after a short course of Augmentin. We report the disease regression as response either to antibiotic or as coincidental with spontaneous resolution.
We aimed to identify the variation in the clinical background of children diagnosed with type 1 diabetes mellitus (T1DM) at King Salman Military Hospital (KSMH), Tabuk City, Kingdom of Saudi Arabia, from 2000 to 2010. Methods: This retrospective observational study was based on the clinical records of pediatric diabetes outpatients at KSMH. All children aged <12 years who were diagnosed with T1DM and were followed up at the diabetes clinic from 2000 to 2010, were enrolled. The local variables associated with the clinical presentation in these patients, including age, sex, body mass index (BMI), and season of onset, were evaluated. Results: Of 313 patients recruited, female patients were predominant (p = 0.002). The mean age of onset was 6.46 years (standard deviation, 3.02). One-third of the newly diagnosed patients were overweight (35.5%). Diabetic ketoacidosis (DKA) was the presenting feature in 38.0% of patients, wherein female patients and those aged 0 -3 years exhibited the highest likelihood of developing DKA (odds ratio, 1.7 and 2.9, respectively). Moreover, underweight children had a greater DKA incidence than healthy, overweight, or obese children (p = 0.02). Conclusion: This study provides additional data on T1DM in the population of the Kingdom of Saudi Arabia. In particular, we found a female predominance at presentation as well as 2 peaks for age at onset. Moreover, the BMI was lower in younger age groups overall, but was greater in older boys. Furthermore, the DKA rates were high in younger children. Thus, our data confirm the presence of variable clinical patterns in the Kingdom of Saudi Arabia, which requires further epidemiological analysis using national registry data.How to cite this paper: Albishi, L.A., Altoonisi, M.M., Alblewi, S.M., Osman, R.H., Ahmed, N
Objectives We aimed to evaluate the levels of serum lipoprotein a, LP (a), in Jordanian patients with type 2 diabetes mellitus (DM); and to examine its relation to glycemic control, metabolic syndrome (MS) and duration of DM. The LP (a) is considered one of the independent risk factors for coronary artery disease (CAD) in the general population. Methods Fasting blood samples were drawn from 51 diabetic patients with type 2 DM and 31 non-diabetic age and sex control subjects. Serum LP (a) was measured along with other parameters, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c) and glycosylated haemoglobin (HbA1c). Correlation analyses were performed between LP (a) and the various variables measured. Results LP (a) measurement showed a skewed distribution towards the lower levels in both groups. Mean LP (a) levels showed a statistically insignificant difference between the two groups. No correlations of LP (a) were observed with age, sex or body mass index (BMI). No correlations of LP (a) with LDL-c, HDL-c, TG, TC, MS, DM duration or HbA1c were observed. The LP (a) serum levels were significantly higher in type 2 diabetic patients with retinopathy. Conclusions LP (a) serum levels are not increased in type 2 diabetic patients; so, LP (a) may not be a reliable marker for early therapeutic interventions in DM patients, even in high-risk for thrombosis groups.
Background Systemic to pulmonary shunt (Shunt) is offered for children with duct dependent pulmonary circulation to augment pulmonary flow. Recently patent ductus arteriosus (PDA) stent (Stent) is widely used as an alternative method. We aimed to compare post intervention outcomes in children underwent either procedure. Methods Infants under 3 months who had an initial palliation by Shunt or Stent were retrospectively reviewed between 2008 and 2016, then followed till the second intervention or 1 year whichever earlier. Results 187 patients (110 Shunt and 77 Stent) were included. Initial weight and pulmonary artery (PA) branches size were similar between the groups. Shunt patients had more shock preoperatively and required more emergency intervention. Stent group showed less ICU stay 4 (1–8) vs 13 (7–23) days, p < 0.0001 and less positive pressure ventilation days 1 (0–2) vs 5.5 (3–11), p < 0.0001. However, Stent group had more symptomatic arterial and deep venous thromboses. In Stent patients the branch PAs growth was better and more homogeneous. At follow-up, no difference between groups regarding cumulative readmission days to hospital, hemoglobin levels and the weight percentile for age. Mortality was not different with a tendency to be higher in the Shunt group (13%) compared to the Stent group (5%), p 0.1. Conclusions The implantation of PDA stent in patients with duct dependent pulmonary circulation results in a smoother ICU course and a shorter hospital stay, with higher risk of vascular injury. Shunt and Stent procedures have a good outcome for PA growth, somatic growth and survival.
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