Keywords : Children


Thymic Cyst: An Unusual Cause of Cervical Mass in Children: A Case Report

Aws Amjad Al-Hamdany; Ammar Abdulsalaam Al-Sultan; Abdulhakeem Abdulkadir Al-Dabbagh

Iraqi Postgraduate Medical Journal, 2020, Volume 19, Issue 4, Pages 356-360
DOI: 10.52573/ipmj.2020.167331

INTRODUCTION: Cervical thymic cyst is uncommon cause of neck cysts in children, more common in boys and on the left side of the neck, congenital typemore prevalent than the rare acquired types.
CASE PRESENTATION: We report a case of three years old boy who presented with soft, mobile, non tender cystic mass on left side of the neck. The cystic nature of the lesion was detected clinically and confirmed by CT-scan and MRI .Successful surgical excision through mid line sternetomy was done. The diagnosis was established by histopathological study
CONCLUSION: Congenital cervical thymic cyst is rare condition with an excellent prognosis especially if diagnosed early followed by prompt surgical excision by a surgeon who is familiar with anatomy and embryology of the thymic cyst
 

Prevalence of Viral Hepatitis (B and C) in Pediatric Hemodialysis Centers in Baghdad

Iraqi Postgraduate Medical Journal, 2018, Volume 17, Issue 4, Pages 366-372

ABSTRACT:
BACK GROUND:
Viral infection (hepatitis B and C) is a public health problem, especially in high risk patients,
including the patients with chronic kidney disease on hemodialysis.
OBJECTIVE:
To find out the prevalence of hepatitis B virus and hepatitis C in children on haemodialysis unit in
three paediatric haemodialysis centers in Baghdad.
PATIENTS AND METHODS:
This is a retrospective study which was carried out for six months data collection from (Jan. 2017 to
December 2017) in three haemodialysis centres (children welfare hospital, Ibn al-Baladi Hospital for
pediatric and central teaching hospital of pediatric) in Baghdad; all patients from (April 2013 to
December 2017) at least six months on haemodialysis were included in study records, reviewed and
analysed. Information's including demographic characteristics, history of blood transfusion, history of
hepatitis B vaccination, serological investigations before starting of haemodialysis and serial monthly
investigations of virology. The positive ELISA test for hepatitis B surface antigen (HBsAg) and
hepatitis C antibody (HCV Ab) was recorded. The real time polymerase chain reaction (RT_PCR) had
been done to confirm positive cases, follow up of antibody titer and in suspicious cases also done.
RESULTS:
Total number 178 of patients; 87 (49%) male and 91(51%) female. The overall prevalence of hepatitis
C antibody (HCV Ab) positive patients were 24 (13.4%), while prevalence of hepatitis B surface
antigen (HBsAg) positive patients were 2(1.1%); seroconversion to hepatitis C antibody positive after
hemodialysis were 14 (7.9%), while seroconversion to hepatitis B was 0 (0.0%) .
CONCLUSION AND RECOMMENDATION:
Hepatitis C viruses' infection are not uncommon among hemodialysis patients in Baghdad. Blood
transfusion and hemodialysis are risk factors for Hepatitis C viruses' infections. Infection control
within dialysis units is of paramount importance.

Hepatitis Screen in Children with Malignancy at Al-Emamain Al-Kadimain Medical City

Sawsan Sati Abbas; Ali Saadi Salih

Iraqi Postgraduate Medical Journal, 2018, Volume 17, Issue 1, Pages 64-71

ABSTRACT:
BACKGROUND:
Transfusion-transmitted infections continue to be a threat to the safety of the blood supply, in particular the risk is high for parent rally transmitted viral hepatitis in pediatric malignancy.
OBJECTIVE:
The aim is to estimate the prevalence of hepatitis in children with malignancy, identify some variables that could affect the prevalence of hepatitis in these patients, and to have an idea about the effect of vaccination in controlling hepatitis infection.
PATIENTS AND METHODS:
A cross sectional study was done over ten months period between December 1st, 2013 to September 30th, 2014 at the Pediatric Oncology Unit in Al- Emamain Al -Kadimain Medical City, A total of (54) children between the age of [1-15] years with malignancy who were diagnosed and treated at the pediatric oncology department before 6 months and more were studied. Information regarding age, gender ,residence, hepatitis vaccine received ,number of blood transfusion ,any surgical intervention for solid tumors and lymphoma was done, history of hepatitis screen at diagnosis were taken from hospital record and pediatric oncology consultation clinic files ,re- evaluation of hepatitis screen were done through with screen for HBs Ag , Anti HCV. Among those children with malignancy, testing for HBV and HCV were done through blood samples taken from the patients and sent to lab. of the hospital.
RESULTS:
From (54) patients with malignancy, 46 patients were with hematological malignancy(85%) and 8 cases(15%) with solid malignancy, from them 8 (14.8%) cases were HBV positive and 4 (7.4%) cases with HCV positive. Most of the patient were from Baghdad 37 cases (68.5%), male to female ration(1.7:1) and also most dominant age group was from (4-9 year).The number of blood transfusion had significant positive impact on prevalence of hepatitis virus infection , and also the vaccine status had significant positive influence.
CONCLUSION: There is a low frequency of HBV &HCV infection in patients with malignancy treated in Al-Emamain Al- Kadimain Medical City with lower incidence of HCV infections than HBV.
Blood transfusions (more than 3 times) is significantly increasing the incidence of HBV infection and HBV vaccine is significantly reducing the incidence of HBV infection.

Clinical Profiles and Outcome of Children Admitted with Measles During 2009 Outbreak

Hadeel Ali Aziz; Muhi Kadhem Al-Janabi; Abbas Oweid Oleiwe; Nadia Aziz Nasir

Iraqi Postgraduate Medical Journal, 2017, Volume 16, Issue 2, Pages 191-197

ABSTRACT:
BACKGROUND:
Measles is a highly contagious acute viral infection. It is a common cause of morbidity and mortality constituting half of vaccine preventable diseases.
OBJECTIVE:
The study was designed to describe the demographic, vaccination status, clinical profiles, and outcome of children admitted with measles during outbreak.
PATIENTS AND METHODS:
A cross sectional hospital based study was conducted on 137 children admitted with measles in Children Welfare Teaching Hospital/Medical City /Baghdad during the outbreak of measles in the period from 1st January- 31st May 2009. Patients below the age of 14 years who were clinically diagnosed as cases of measles were treated and followed.
RESULTS:
The median age was 17 months with a range of 3 months-14 years. Male /female ratio of 1.14:1. 86.86 % patients were admitted in March. Sixty eight (49.63%) children were not vaccinated. Twenty four (55.81%) children of vaccinated group had one dose of measles vaccine only and 19(44.19%) children had two doses. Complications of measles were detected in 120(87.59%) of patients. The most frequent complication of measles was pneumonia which was encountered in 72(52.55%) cases. Gastroenteritis was recorded in 44(32.12%) of patients. Six patients (4.38%) died after developing complications in the form of pneumonia in five and encephalitis in one. Forty four (32.12%) cases were malnourished and majority of them 26 (59 %) cases were in the >15 months age group. Two thirds of deaths were among malnourished children. The case fatality was 4.38%.
CONCLUSION:
One third of measles infections occurred before the age of 9 months. Half of measles cases were not vaccinated. The majority of the complicated cases had occurred in the unvaccinated children. Pneumonia was found to be the most frequent complication of measles that necessitated admission. Young age, pneumonia, malnutrition, immune deficiency and non-vaccination status were significant factors related to mortality.
.

Lupus Nephritis in Children Hospital Based Multicentre Study

Alyaa Hameed; Nariman Fahmi; Wissam Fliah

Iraqi Postgraduate Medical Journal, 2017, Volume 16, Issue 2, Pages 198-203

ABSTRACT:
BACK GROUND:
Lupus nephritis is a common and serious feature of a chronic autoimmune disease characterized by multisystem inflammation (systemic lupus erythematosus).
OBJECTIVE:
Study he demographic, renal manifestations, laboratory findings and histopathological findings of patients with lupus nephritis.
PATIENTS AND METHOD:
This study was descriptive cross sectional study, conducted on 71 patients with lupus nephritis who were diagnosed and treated in four major pediatrics nephrology units in Baghdad, Children Welfare Teaching hospital, Central Teaching hospital, Al-karama Teaching Hospital and Ibn Albalady hospital. The collected data included: gender, age at diagnosis, renal and extra renal manifestations, laboratory findings, renal biopsy findings.
RESULTS:
Seventy one patients enrolled in this study with a mean age of 11.9 ± 2.7 years, the mean age at diagnosis was 9.6 ± 2.3years. Female to male ratio was 4:1.Nephrotic syndrome was the most common renal manifestation, it was found in 51 (71.8%), and reduced renal function was found in only in 17patients (23.9%). Antinuclear antibody was positive in majority of patients 66 (92.9%), followed by low C3, C4 in 58 (81.6%), positive Anti double stranded DNA in 58 (81.6%).Renal biopsy was done for 58(81.6%) patients and class II lupus nephritis was the most common histopathological class which was found in 25 patients (35.2%), the least common was Class V which was found in only 4 patient (5.6%).On the other hand, none of the patients had class VI.
CONCLUSION:
Nephrotic syndrome is the most common renal manifestation in lupus nephritis in children; class II lupus nephritis was the most common histopathological class and Positive ANA was found in majority of patients. early referral of the diagnosed patients to the nephrologist is important to ensure better management of those patients.

Amyand's Hernia in a 9-Month-Old Infant: Case Report & Review of the Literature

Ali Egab Joda; Nawzat Hussein

Iraqi Postgraduate Medical Journal, 2017, Volume 16, Issue 2, Pages 218-223

ABSTRACT:

Amyand’s hernia is defined as the presence of an appendix inside the sac of inguinal hernia whether inflamed or not, it is very rare occurring in less than 1% of patients of inguinal hernia surgery. Although it was first described three centuries ago in an 11-year-old boy by Claudius Amyand, it still continues to possess some fuzziness regarding its diagnosis & treatment because of the scarcity of its occurrence. It has variable clinical presentation according to the extent of appendix inflammation & related complications. The diagnosis of an Amyand's hernia is difficult to settled clinically. However, imaging studies are beneficial for both diagnosis and recognition of the associated complications. Here, we report a case of Amyand's hernia in a 9-month-old male infant discovered incidentally during surgery for right sided inguinal hernia in the department of pediatric surgery in the Central Child Teaching Hospital in Baghdad in which we did reduction of a normal appendix into abdominal cavity & herniotomy with high up transfixation of hernia sac.
The purpose of presenting this case report is the rare occurrence of Amyand's hernia & the possibility of encountering an unusual content of hernia sac during the repair of inguinal hernia, that is why Amyand's hernia should be taken in consideration while operating on obstructed or strangulated inguinal hernia. The surgeon need to be aware of all clinical presentations with which the Amyand's hernia may present and the suitable, individualized option of surgical treatment applied. In this paper we review the
literature on presentation of Amyand's hernia and discuss the diagnostic modalities with the current options of its surgical treatment.

Patterns and Prognosis of Epileptic seizures in Children with Cerebral Palsy

Kawes O.Zangana; Muhi Kadhem Al-Janabi; Abdulla F. Ahmad; Zaher T. Gardi

Iraqi Postgraduate Medical Journal, 2017, Volume 16, Issue 1, Pages 64-71

ABSTRACT:
BACKGROUND:
Cerebral palsy (CP) is the result of non-progressive damage to the developing brain and consists of a number of clinical neurological syndromes of heterogeneous etiology. Epilepsy is known to have a higher association with cerebral palsy; 15–60% of children with cerebral palsy have been reported to have epilepsy.
OBJECTIVE:
This study was performed to determine and assess the characteristics of cerebral palsy and explore the relationship between type of cerebral palsy and patterns of epileptic seizures and to determine the associated factors, nature and prognosis of epilepsy in children with cerebral palsy.
PATIENTS AND METHODS:
Design:A prospective, hospital-based, case-control study.
Setting: RaparinPediatric Teaching Hospital, Rizgary Teaching Hospital-Neurology Department and Helina Handicap Care Centre during the period of January 2013- July 2015, Erbil, KRG, Iraq.
PATIENTS:
One hundred and twelve children had CP and seizures were studied (group1). Two control groups included 70 children had CP without seizures (group2), and 50 children had seizures without CP (group3).
The following data were ascertained: Type of CP, pattern of seizures, age, gender, age at onset of seizures, mode of delivery, history of hypoxic ischemic encephalopathy in the neonatal period, neonatal seizures, history of status epilepticus, family history of seizures, developmental delay, EEG data, image findings, use of anti-epileptic drugs, seizures control and seizures outcome. Children with febrile convulsion were excluded from this study.
RESULTS:
Spastic tetraplegia wasthe most common type of CP (29.46%, 35.71%) in group 1 and 2 respectively.Generalized tonic, clonic or tonic clonic seizures were the most common types of seizures in both groups. Unlike those who had epilepsy without CP,themajority; 57(50.89%) of patients who had epilepsy and CPdeveloped seizures in the first year of life. Twenty eight percent of caseswith epilepsy and cerebral palsy, and 88% of cases with epilepsies alone showed good seizure control by antiepileptic therapy. Children who had epilepsy and CPhad a higher frequency of; neonatal seizures44 (39.28%), developmental delay98 (87.5), abnormal brain CT scan 91(81.25%) and family history of seizures47 (41.69%). Large number of patients who had epilepsy and CP 81(72.32%) needed poly therapy while majority ofthose who had epilepsy without CP needed single therapy 60(90%).
CONCLUSION:
Cerebral palsy is associated with a higher incidence of seizure disorders, whichin a majority has its onset in the first year life.Brain imaging showed abnormal pathology in most affected children and needed poly therapy and even difficult to control.

Wilson’s Disease in Children (Clinical Presentations & Diagnostic Difficulties) (Three years experience in Children Welfare Teaching Hospital- Baghdad

Sawsan I.I. Al-Azzawi; Dheia Hassan Al-Baldawi; Auday Yasin Abbas

Iraqi Postgraduate Medical Journal, 2012, Volume 11, Issue 4, Pages 437-442

ABSTRACT:
BACKGROUND:
Wilson’s disease (WD) is rare but curable hereditary metabolic disease presents in childhood in different ways which make the diagnosis difficult and delayed.
OBJECTIVE:
To evaluate all cases of WD, modes of presentations, available diagnostic methods, treatment and follow up in a sample of Iraqi children.
PATIENTS AND METHODS:
Clinical presentations and management of 24 patients with WD were studied after the exclusion of other chronic liver diseases by thorough investigation. Low ceruloplasmin level and high copper excretion in urine pre and post challenge with penicillamine, in addition to the presence of Kayser Fleischer rings were the main stay of the diagnosis. The diversity of the results with the response to treatment and side effects of drugs used were registered over 3 years period in the GIT & Hepatology unit and consultation clinic at the Children Welfare Teaching Hospital, Medical city, Baghdad in the period from the 1st of May 2003 till the 1st of may 2006.
RESULTS:
From the twenty four patients with WD included in the study, we had 17 patients (70.8%) with hepatic manifestations (4 with acute hepatitis, 3 with fulminant hepatic failure and 10 as chronic liver diseases). Only two patients (8.3%) had neurological symptoms. One patient had hepatic manifestation + evidence of hemolysis (4.1%) and 4 (16.7%) asymptomatic siblings. The mean age of presentation was less in hepatic than the neurologic presentation (7.5 and 9.2 years respectively). The time interval between the symptoms and the diagnosis was more in the neurological than hepatic cases (95 vs. 42 days). Low ceruloplasmin found in 70.1% & Kayser-Fleischer ring present in 47.1% of hepatic cases and in all neurological cases. Family history was positive in 3 patients of the index cases. On follow up after treatment one child had bone marrow depression and two patients had thrombocytopenia. One patient died (4.2%) with fulminant hepatic failure, ascites and encephalopathy.
CONCLUSION:
Acute hepatitis, chronic liver affection, fulminant hepatic encephalopathy acute hemolytic anemia may be the presentation of Wilson disease in children. They also may exhibit a neurological manifestation as tremor and ataxia. At least two of the three diagnostic criterion plus index of suspicion, family history of affected sibling or death in the family of a jaundiced child raises the possibility of WD after exclusion of other chronic liver diseases by investigations.

Natural History of Symptomatically Treated Children with Cystinosis

Nariman Fahmi A.Azat

Iraqi Postgraduate Medical Journal, 2012, Volume 11, Issue 2, Pages 254-257

ABSTRACT:
BACKGROUND:
Cystinosis is an autosomal recessive disorder of lysosomal transport of cystine . Nephropathic (infantile) cystinosis is the most common and the most severe clinical expression of the disease .
OBJECTIVE:
To highlight the natural history of symptomatically treated children with cystinosis
PATIENTS AND METHODS :
A retrospective study was done on cystinotic patients who were diagnosed and treated symptomatically in children welfare teaching hospital in Baghdad from period Jun 2002 –July 2011.
RESULTS:
Twenty nine patients ,19 (66%)males and 10(34%) females who were diagnosed as cystinosis and treated symptomatically were included in the study; their ages ranged between (0.6 -12 ) years median 4 years . the age of onset of symptoms of tubular dysfunction ranged from (0.3-3.5 yrs) median (1.1 yrs.), positive family history of cystinosis was found in 11(37.9 %) cases and parents were consanguineous in 25 (86.2%) families.
All patients presented with history of polyuria, polydypsia, anorexia, vomiting, constipation and failure to thrive.
Rickets was found in 22(75%)and photophobia was found in 19 (65.5%) patients.
Follow up data showed renal insufficiency in eighteen patients(62%) at a median age of 9(4-12) years ,hypothyroidism diagnosed in one patient(3.44%)at the age of 11 years , six (20.68%) patients died , three (10.3%)patients secondary to renal failure .
CONCLUSION AND RECOMMENDATIONS:
Cystinosis causes extensive morbidity and death in childhood and because of high rates of consanguineous marriages in our society ,
we encourage a high index of suspicion in infants presenting with fluid and electrolyte loss aiming at early diagnosis and treatment of cystinosis . leukocyte cystine levels is still needed to be available to confirm diagnosis in infants who have negative ocular examination .and to win in the fight against this terrible disease cysteamine treatment need to be available for these patients

Incidence of Bronchiolitis in Breast Fed Infants Below 2

Haider Nadhim Abd

Iraqi Postgraduate Medical Journal, 2012, Volume 11, Issue 1, Pages 1-5

ABSTRACT:
BACKGROUND:
Acute viral bronchiolitis is a common respiratory infectious disease of children.
OBJECTIVE:
To study the relationship between bronchiolitis and breastfeeding in children below 2 years of age.
MATERIAL AND METHODS:
A prospective study was carried out with100 child aged up to 24 months to evaluate their
breastfeeding status as possible risk factors for unfavourable evolution in department of pediatric
in AL-Kahdimiya Teaching Hospital during the period from first of October 2008 to the end of
March 2009.
RESULTS:
Hundred cases of bronchiolitis were included in this study. Most of them ( 78 %) were below one
year. Male children were 70%, female children were 30%. Fifty-four of the children were
exclusively breastfeeding. Eighty of the children were admitted to the hospital because of severe
attack. The median length of hospital stay was four days and of oxygen-use was three days.
CONCLUSION:
The duration of exclusive breastfeeding was inversely related to the length of oxygen-use and the
length of hospital stay. Shorter exclusive breastfeeding was observed in children who were
assigned to a pediatric ward or to an intensive care unit. Longer duration of breastfeeding was
associated with better clinical outcomes.

Homocysteine ,Folic acid ,Vitamin B12 and Pyridoxine : Effects on Vaso-Occlusive Crisis in Sickle Cell Anemia and Sickle –Thalassemia

Sawsan Sati; Abbas; Najat Abul; Razak; Noor Mustafa; Razeqa Abd Ali

Iraqi Postgraduate Medical Journal, 2011, Volume 10, Issue 4, Pages 473-479

ABSTRACT:
BACKGROUND:
Hemoglubiopathies include sickle cell anemia and the Thalassemia . S/ β0- Thalassemia have a clinical course similar to HbSS. Elevated concentration of Homocysteine contribute to thrombosis , a frequent event in sickle cell anemia . Vitamin B12, Pyridoxine , and folic acid deficiencies lead to dangerous increase in plasma Homocysteine.
OBJECTIVE:
1- To test whether children with sickle cell anemia and Sickle cell – Thalassemia have elevated concentration of serum Homocysteine with diminished level of folate, B6, B12.
2- To determine whether hyperomocysteinaemia has a correlation with the frequency of Vaso-occlusive crisis.
PATIENTS AND METHOD:
A case- control study was carried over a period of one year from Jan.- Dec. 2010 inclusive, 30 patients were collected from the Thalassemia centre in Ibn –AL-Baldy Hospital together with healthy 30 cases, age and sex matched ,were taken from AL- Kadhimiyia Teaching Hospital. Venous blood sample were aspirated from both groups to estimate serum Homocysteine, Folic acid, B12 and B6 level. Statistical analysis was done, using the student T-test ( P. value < 0.05 is considered as statistically significant) . Pearson correlation analysis was performed.
RESULTS :
The age of the patients range between (5-29) years, the majority of the patients were between ( 10 -19 ) years , 10 cases ( 38 .46 %). More than one half were male ,16 cases ( 61.54 %) . Sickle cell – Thalassemia constitute 20 cases (76.93%). Vaso-occlusive crisis was mainly involving the large joints, 15 cases (57.69 %). Mild attacks constitute more than half of the patients, 16 cases (61.54 %).Homocysteine level was higher in the patients group compared with control group with a mean and standard deviation of (44.52 ± 23.008) and (18.65 ± 4.56)μmol/L respectively . Folic acid level was lower, B12 level was higher, B6 level was lower in the patients group compared with control group with a mean and standard deviation of (11.32± 3.23) and (14.71 ± 3.39)ng /ml, (172.57± 61.34) and (103.45 ± 30.45)pg /ml, (4.43± 3.93) and (10.23 ± 2.30) ng/ml respectively, the results were statistically not significant, P. value > 0.05. Significant inverse correlation was found between Homocysteine level and B6 level. A strong positive correlation between Homocysteine level and the frequency of Vaso-occlusive crisis was found.
CONCLUSION:
Patients with sickle cell disease have high serum level of Homocysteine with low level of folic acid and pyridoxine. This Hyperomocysteinaemia is significantly inversely correlated with pyridoxine deficiency , but positively correlated with the frequency of Vaso-occlusive crisis.

Correlation of Angiographic Findings and Clinical Presentations in Unstable Angina

Ali Abdulamir Mohammad AL.Mossawi; Kasim Abbas Ismail; Azher Sabih Zubaidy; Adil Siwan Aqabi; Majid Hameed AL Maini; Jawad K. Mnuti; Fadhil A. AL- Abbudi; Amira H. Shubbar; Layth Rafea Taqa; Sawsan Sati; Abbas; Najat Abul; Razak; Noor Mustafa; Razeqa Abd Ali; Nassir Enssief Mohsun; Raji H AL-Hadithi; Suhaila Saadallah; Darya Akram Faqe Mahmood; Ari R. Qader; Kurdo A. Mohmmad; Dawood Salman Hameed Alazzawi; s Central Teaching Hospital in Baghdad; a Descreptive Study; Autism Among Children Attending Pediatric Psychiatric Department in Child; Jaafar Muhamed Hassan; AL- Ghabban; Haider Abdul Muhsin; Huda Adnan Habib; Maysaloun Muhammed Abdulla; Selwa Elias Yacoub; Abdulrazak H. Alnakash; Shaema Jafar; Yousef Abdul-Raheem; Alaa Hussein Ali; Montadhar Hameed Nima; Rasha Abbas Azeez; Jassim Mohammad Alkhazraji; Hussein Mahmood Gazi; Mohammed Shafik Tawfeek; Nabeel Ghazi Hashim; Hayder Hadi Lazim; Maysoon Mohammad Najeeb Mohammad Saleem; Arieg Abdul Wahab Mohammad; Majid Syki Jabir; Kareem Al-Tameemi; Malak A. Al-Yawer; Adel Rabea Alsaadawi; Mohammed S. Saeed; Thukaa T. Yahya; Osama E. Hudder; Issraa A. Hussein

Iraqi Postgraduate Medical Journal, 2011, Volume 10, Issue 4, Pages 449-455

ABSTRACT: BACKGROUND: Unstable angina is usually related to acute thrombosis superimposed on a disrupted plaque. The highest; level of Braunwald classification of unstable angina can be used to assess the severity of clinical presentation. However the highest classes have not been directly correlated with thrombotic and complex lesions. OBJECTIVE: The study was done to clarify the correlation between angiographic findings and the most acute and / or severe clinical presentation in unstable angina. PATIENTS AND METHOD: We conducted a prospective study of 110 patients of unstable angina at Ibn-Albitar Center for Cardiac Surgery. All of these patients underwent cardiac catheterization, culprit lesion was identified in 80 patients and in 30 patients there was no an identifiable culprit lesion .Complex lesions including complex morphology, intracoronary thrombus, or total occlusion were also quantitatively analyzed and Thrombolysis in Myocardial Infarction (TIMI) flow grade was assessed. Patients were classified according to Braunwald classification in instable angina .We compared patients with and those with no culprit lesions in regarding Braunwald classification. We sequentially compared the highest Braunwald classes II, C, 3 with classes

Keywords

braunwald classification
---
unstable angina

Children’s Exposure to Mildly Cold Environment

Ahmad Al-Ali; Zayd Al-Nouri; Siham Al-Zubaidy; Luay Al-Nouri

Iraqi Postgraduate Medical Journal, 2011, Volume 10, Issue 3, Pages 278-283

ABSTRACT:
BACKGROUND:
Exposure to mildly cold environment was considered to be the cause of many children illnesses during winter, or even during summer. Understanding these beliefs is essential for improving the care of children.
OBJECTIVE:
To find out in what ways mild exposure to a cold environment was believed to affect children health , and how did mothers respond.
METHODS:
Mothers of 200 children who brought their children to Al-Mansour Children Hospital , Baghdad, in the period Jan.1st to April 30th 2002 were interviewed to fill a questionnaire form about the harmful effect of mild cold exposure.
RESULTS:
The mothers held beliefs regarding mild cold exposure that ranged from causing coryza 96.5%, fever 96%, cough 94% , chest pain 85% , pneumonia 74% , to vomiting 88% , diarrhoea 95.5% and abdominal colic 94% . The sources of exposure described included : giving a bath, inadequate clothing , uncovering during sleep, walking barefooted , crawling on a cold floor , or taking a cold drink or food .
CONCLUSION:
These beliefs lead to improper care of children including over warning or over clothing, while distracting attention from useful measures like avoiding contact with infected persons or consumption of contaminated food or drink

Homocysteine ,Folic acid ,Vitamin B12 and Pyridoxine : Effects on Vaso-Occlusive Crisis in Sickle Cell Anemia and Sickle –Thalassemia

Sawsan Sati; Najat Abul; Razak; Noor Mustafa; Razeqa Abd Ali

Iraqi Postgraduate Medical Journal, 2010, Volume 9, Issue 4, Pages 473-479

ABSTRACT:
BACKGROUND:
Hemoglubiopathies include sickle cell anemia and the Thalassemia . S/ β0- Thalassemia have a
clinical course similar to HbSS. Elevated concentration of Homocysteine contribute to thrombosis , a
frequent event in sickle cell anemia . Vitamin B12, Pyridoxine , and folic acid deficiencies lead to
dangerous increase in plasma Homocysteine.
OBJECTIVE:
1- To test whether children with sickle cell anemia and Sickle cell – Thalassemia have elevated
concentration of serum Homocysteine with diminished level of folate, B6, B12.
2- To determine whether hyperomocysteinaemia has a correlation with the frequency of Vasoocclusive
crisis.
PATIENTS AND METHOD:
A case- control study was carried over a period of one year from Jan.- Dec. 2010 inclusive, 30
patients were collected from the Thalassemia centre in Ibn –AL-Baldy Hospital together with
healthy 30 cases, age and sex matched ,were taken from AL- Kadhimiyia Teaching Hospital.
Venous blood sample were aspirated from both groups to estimate serum Homocysteine, Folic acid,
B12 and B6 level. Statistical analysis was done, using the student T-test ( P. value < 0.05 is considered
as statistically significant) . Pearson correlation analysis was performed.
RESULTS :
The age of the patients range between (5-29) years, the majority of the patients were between ( 10 -
19 ) years , 10 cases ( 38 .46 %). More than one half were male ,16 cases ( 61.54 %) . Sickle cell –
Thalassemia constitute 20 cases (76.93%). Vaso-occlusive crisis was mainly involving the large
joints, 15 cases (57.69 %). Mild attacks constitute more than half of the patients, 16 cases (61.54
%).Homocysteine level was higher in the patients group compared with control group with a mean
and standard deviation of (44.52 ± 23.008) and (18.65 ± 4.56)μmol/L respectively . Folic acid level
was lower, B12 level was higher, B6 level was lower in the patients group compared with control
group with a mean and standard deviation of (11.32± 3.23) and (14.71 ± 3.39)ng /ml, (172.57±
61.34) and (103.45 ± 30.45)pg /ml, (4.43± 3.93) and (10.23 ± 2.30) ng/ml respectively, the results
were statistically not significant, P. value > 0.05. Significant inverse correlation was found between
Homocysteine level and B6 level. A strong positive correlation between Homocysteine level and the
frequency of Vaso-occlusive crisis was found.
CONCLUSION:
Patients with sickle cell disease have high serum level of Homocysteine with low level of folic acid
and pyridoxine. This Hyperomocysteinaemia is significantly inversely correlated with pyridoxine
deficiency , but positively correlated with the frequency of Vaso-occlusive crisis

Correlation of Angiographic Findings and Clinical Presentations in Unstable Angina

Ali Abdulamir Mohammad AL.Mossawi; Kasim Abbas Ismail; Majid Hameed AL Maini; Adil Siwan Aqabi; Azher Sabih Zubaidy; Jawad K. mnuti; Fadhil A. AL- Abbudi; Amira H. Shubbar; DEFINITION GERD is described as any symptomatic or histopathological alteration resulting from episodes of gastroesophageal reflux; Layth Rafea Taqa; INTRODUCTION; Reflux esophagitis describes the subset of GERD patient with histopathological changes of; Sawsan Sati; Najat Abul; Razak; Noor Mustafa; Razeqa Abd Ali; Suhaila Saadallah; Raji H AL-Hadithi; Darya Akram Faqe Mahmood; Ari R. Qader; Kurdo A. Mohmmad; Dawood Salman Hameed Alazzawi; Entissar Hadi AL- Shimery; Jaafar Muhamed Hassan; AL- Ghabban; Haider Abdul Muhsin; Huda Adnan Habib; Maysaloun Muhammed Abdulla; Selwa Elias Yacoub; Abdulrazak H. Alnakash; Shaema Jafar; Yousef Abdul-Raheem; Alaa Hussein Ali; Montadhar Hameed Nima; Rasha Abbas Azeez; Jassim Mohammad Alkhazraji; Hussein Mahmood Gazi; Mohammed Shafik Tawfeek; Nabeel Ghazi Hashim; Hayder Hadi Lazim; Maysoon Mohammad Najeeb Mohammad Saleem; Arieg Abdul Wahab Mohammad; Majid Syki Jabir; Kareem Al-Tameemi; Malak A. Al-Yawer; Adel Rabea Alsaadawi; ABSTRACT; Issraa A. Hussein; Osama E. Hudder; Thukaa T. Yahya

Iraqi Postgraduate Medical Journal, 2010, Volume 9, Issue 4, Pages 449-455

ABSTRACT:
BACKGROUND:
Unstable angina is usually related to acute thrombosis superimposed on a disrupted plaque. The highest;
level of Braunwald classification of unstable angina can be used to assess the severity of clinical
presentation. However the highest classes have not been directly correlated with thrombotic and complex
lesions.
OBJECTIVE:
The study was done to clarify the correlation between angiographic findings and the most acute and / or
severe clinical presentation in unstable angina.
PATIENTS AND METHOD:
We conducted a prospective study of 110 patients of unstable angina at Ibn-Albitar Center for Cardiac
Surgery. All of these patients underwent cardiac catheterization, culprit lesion was identified in 80
patients and in 30 patients there was no an identifiable culprit lesion .Complex lesions including complex
morphology, intracoronary thrombus, or total occlusion were also quantitatively analyzed and
Thrombolysis in Myocardial Infarction (TIMI) flow grade was assessed. Patients were classified
according to Braunwald classification in instable angina .We compared patients with and those with no
culprit lesions in regarding Braunwald classification. We sequentially compared the highest Braunwald
classes II, C, 3 with classes

Keywords

braunwald classification
---
unstable angina

Drug Compliance In Epileptic Children In Sulaymani Governate

Salem Rahma; Ibrihem khasro

Iraqi Postgraduate Medical Journal, 2010, Volume 9, Issue 2, Pages 158-162

ABSTRACT:
BACKGROUND:
Compliance behavior depends on the specific clinical situation, the nature of the illness, and the treatment program.
OBJECTIVE:
Determine the rate of drug compliance in families caring for a child or adolescent with epilepsy and to describe some associated factors.
METHODS:
Two hundred patients with epilepsy under 18 years of age, who were attending the pediatric clinic for a twelve month period (August 2007-August 2008) and their families, were interviewed.
RESULTS:
Drug compliance was satisfactory in 123(62.5%) and was poor in 77(37.5%) of the patients according to their self or parental report. Age of the patient, gender, residence, etiology of epilepsy, and monotherapy versus polytherapy did not significantly influence the drug compliance but duration of the disease, parental education, family size and positive family history of epilepsy were more significantly associated with drug non compliance.
CONCLUSION:
In this study, drug compliance was satisfactory in 62.5% of the patients. There was a significant association between drug non compliance and socioeconomic status (large family size, family history of epilepsy, low parental education

Risk Factors of Bronchial Ahtma in Children … A Hospital Based Study

Nadia A. Nasir; Mahmoud Shebab; Nebal Waill; Sadiq J. Alhammash; Muhi K. Aljanabi

Iraqi Postgraduate Medical Journal, 2010, Volume 9, Issue 1, Pages 6-9

ABSTRACT:
BACKGROUND :
Asthma is characterized by inflammation of the airways with intermittent bronchospasm. Bronchial asthma is an important cause of morbidity and mortality in childhood. There are many identifiable risk factors contributing to both the expression and persistence of asthma .
OBJECTIVE:
This study threw a light on some of the risk factors of bronchial asthma in childhood.
PATIENTS AND METHODS:
This study was performed to determine some of the risk factors of childhood asthma in 62 asthmatic children admitted to Children Welfare Teaching Hospital in Baghdad Medical City in the period from 1st February to 1st July 2007 . The control group was composed of 108 age and sex matched children attending the outpatient clinic with non pulmonary health problems .
RESULTS :
Forty two ( 67.7%) asthmatic children were males and 20(32.2%) were females with a male to female ratio of 2.1:1 . Fifty two(83.8%) suffered from bronchial asthma before the age of 3 years , While 10(16.2%) acquired the disease after this age . A positive family history of asthma was positive in 31(50%) asthmatic children compared to 9 (8.33%) in the control group , scoring a highly significant association. A positive family history of allergic rhinitis (27.41%) in asthmatic children was more often recorded than in the control group (21.29%) but the difference was not statistically significant . A highly significant association between a positive history of smoking at home environment and childhood bronchial asthma was detected , where it was found positive in 50(80.6%)asthmatic children and in 55(50.9%) controls . A low crowding index ( ≤ 3 persons /room) was recorded in 52 (83.9%)asthmatics compared to 72 (66.6%) controls , Scoring a significant association between low home density and childhood bronchial asthma.
CONCLUSION:
The present study concludes certain risk factors being associated with asthma namely positive family history of asthma , passive smoking and low crowding index. The study recommends avoidance of smoking at home where a child with a positive history of these risk factors resides .

Kerosene Poisoning In Children

Mahjoob Al-Naddawi; Mohammad Abdul-Qader Al-Chalabi; Khawla Mohammad Kamil

Iraqi Postgraduate Medical Journal, 2009, Volume 8, Issue 4, Pages 350-355

ABSTRACT:
BACKGROUND:
Accidental kerosene ingestion is the commonest cause of poisoning and its subsequent mortality and morbidity in children less than five year of age in developing countries. Low socio- economic status and frequent use of kerosene for cooking, lighting and heating are the major cause.
OBJECTIVES:
To study the epidemiology, presentations and radiological appearance of kerosene poisoning in children.
METHODS:
A prospective study comprised fifty patients, who were admitted with accidental kerosene poisoning into children welfare hospital in medical city complex /Baghdad. In the period from the 1st of January to the 31st of august 2008. History was taken from the relatives on a specially designed questionnaire. Every patient was examined completely concentrating on symptoms of cough, dyspnea, cyanosis, drowsiness, vomiting, and fever. Chest X-ray was done to every patient after 6-8 hours from the time of ingestion. White blood cell count was done to 39 patients within the 1st 24 hour of admission. Fisher's exact test was considered for the statistical analysis with a significance level of P < 0.05.
RESULTS:
Of the fifty admitted children, 86% of them aged between 1-3 years, 31(62%) were boys, the majority from poor and crowded families, and the kerosene ingested, in the majority, from small containers. The most common presentations were cough (96%), fever (94%) and dyspnea (80%).Vomiting which occurred in 90%, had a significant association with the development of pneumonitis the major radiological abnormality was right lower lobe infiltration in 16 patients (32%). The major complication was pneumothorax, pleural effusion and respiratory failure. Fever appeared in 94% of the patients in the first 24 hours, lasting 2-7 days. Pneumonitis occurred in 42 patients who were diagnosed clinically and radiologically. All patients improved except one who died.
CONCLUSION:
All the kerosene poisoning was accidental, occurred in children under five year of age. Ignorance and poor storage of kerosene played a big role in the kerosene ingestion process. The respiratory system is the main target involved. Vomiting playing a role in the development of pneumonitis.

A Clinical Study of Vibriosis During 1999 in Al-Mansour Childrens' Teaching Hospital

Zayir H. Khalid; Mahjoob N AL-Naddawi

Iraqi Postgraduate Medical Journal, 2009, Volume 8, Issue 2, Pages 148-152

ABSTRACT:
BACK GROUND:
Cholera is an acute infectious disease characterized by profuse watery diarrhea and vomiting.It is caused by Vibrio Cholerae O1and O139 sero-group
OBJECTIVE:
To find out clinical variety of the admitted cases of Vibriosis..
METHODS:
Clinical features of the illness were studied , and fresh stool specimens were sent for culture.The stool is taken in seawater containers to the laboratory where further processing of the stool is done on alkaline peptone and TCBS medium.
RESULT:
All patients presented with diarrhea and the majority had vomiting ( 65%) , ( 37.5%) of the patients presented with sever dehydration and no patient died during this study .
The epidemic mainly caused by Ogawa serotype (75%) , and there was different antibiotic resistance recorded especially for trimethoprim (47.5%) and tetracycline (25%) .
CONCLUSION:
Nearly all cases in vitro were susceptible to cefotaxime

Predictors of Hypoxemia in Children with Acute Lower Respiratory Tract Infections

Muhi K.Al-Janabi

Iraqi Postgraduate Medical Journal, 2009, Volume 8, Issue 1, Pages 40-46

ABSTRACT:
BACKGROUND:
Acute lower respiratory tract infections (ALRI) are the leading cause of morbidity and mortality among children in developing countries, causing one – third of all deaths in childhood. Pulse oxymetry is a simple technique to determine the oxygen saturations.
OBJECTIVE:
It is important to accurately identify hypoxemic children by use of clinical signs alone.
METHODS:
A well matched case control study was performed on 104 children from 2 months to 5 years of age admitted with ALRI to the emergency department of Children Welfare Teaching Hospital -Medical City - Baghdad in the period from 15thMarch -15thJune 2006.Clinical symptoms and signs were recorded .Hypoxemia was defined as oxygen saturation less than 95%.The ability of various clinical symptoms and signs to predict the presence of hypoxemia was evaluated.
RESULTS:
Fifty (48.1%) children were hypoxemic. The median O2 saturation was 91.2%with a range of 82-94% Physical signs including tachypnea, intercostal and subcostal retractions, supraclavicular recessions, grunting and nasal flaring were statistically significantly associated with hypoxemiUse of combinations e.g. Tachypnea or head nodding ( P. 0.02 , sensitivity 70% , specificity 48%),tachypnea or suprasternal recessions( P.0.05 ,sensitivity 70% ,specificity 44%)only slightly improved the predictive ability.
CONCLUSION:
None of the clinical features either alone or in combinations have sufficient sensitively and specificity to predict hypoxemia in children with acute lower respiratory tract infections, therefore pulse oxymetry is desirable for identification of hypoxemia.

Central Nervous System Relapse in acute Lymphoblastic Leukemia: Prognostic Factors and the Outcome

Tariq Abadi Al-Shujairi

Iraqi Postgraduate Medical Journal, 2008, Volume 7, Issue 4, Pages 339-346

ABSTRACT:
BACKGROUND:
Despite the advances in treatment of acute lymphoblastic leukemia(ALL), CNS relapse remains an obstacle to successful treatment. This study was performed to determine the frequency of CNS relapse in ALL patients and to study risk factors and outcome after CNS relapse.
PATIENTS AND METHODS:
A retrospective study done on 364 patients diagnosed as ALL in Central Teaching Hospital for Children-Baghdad for the period from 1st Jan 2000 to 31st Mar 2005. ALL patients whom diagnosed after 1st Jan 2004 received CTHC 2004 protocol .The following parameters were studied: gender, age, hepatomegaly, splenomegaly, LAP, mediastinal mass, initial WBC count, platelets count, FAB morphology, initial CNS involvement and if the patient received radiotherapy.
RESULTS:
35 patients were excluded from the study. Out of 329 eligible patients, 76 patients (23.1%) had CNS relapse(isolated or combined), with mean duration before CNS relapse 12.30±8.28 months and median of 11 months. The following factors were significantly associated with development of CNS relapse: male gender, age <2 years, massive hepatomegaly, massive splenomegaly, lymphadenopathy, mediastinal mass, initial WBC count≥50000/mm, initial CNS involvement, and patients who did not receive prophylactic CNS radiation. The study shows that frequency of CNS relapse decreased significantly after addition of three intrathecal doses during induction). Shorter duration between diagnosis of ALL and CNS relapse was associated with higher mortality.
CONCLUSION:
Frequency of CNS relapse and mortality rate still higher than globally-accepted figures. Intensification of systemic and CNS-directed therapy, significantly decreased these figures in our patients.

Iraqi Children with Acute Bacterial Meningitis... Who May Need Ventilatory Support?

Muhi Kadhem Al-Janabi

Iraqi Postgraduate Medical Journal, 2008, Volume 7, Issue 2, Pages 100-105

ABSTRACT:
BACKGROUND:
Acute bacterial meningitis (ABM) is one of the most potentially serious infections occurring in infants and older children. Indications for PICU admission are shock, markedly elevated intracranial pressure (ICP), coma, and refractory seizures (1).
METHODS:
This cross sectional study enrolled children 2 months-12 years of age presented with (ABM) who were admitted to Children Welfare Teaching Hospital (CWTH) -Medical City- Baghdad, including those who needed Pediatric Intensive Care Units (PICUs) admission in CWTH Unit and Surgical Specialty Hospital (SSH) Unit in the period from the 1st of Feb 2004 to the 1st of Feb 2006. The diagnostic inclusion criteria of (ABM) were clinical symptoms and signs of meningitis plus a CSF neutrophilic pleocytosis with a CSF cells count of more than 5 cells/mm3 (1). Data included history, clinical examination, investigations, complications, PICU management, and outcome. Statistical analysis was done by using SPSS version 13.0 computer facility, Chi-square test and T test were used when needed and a P.value < 0.05 was considered significant.
RESULTS:
In the present study (ABM) in children 2 months -12 years constituted 7% of cases admitted to PICUs. The majority of cases (77.2%) were below 2 years of age. The mean age of children with (ABM) was 18.3+6.80 months. The PICU cases of (ABM) differed from the neurological ward cases in their more acute onset, higher body temperature, higher peripheral WBCC, lower CSF glucose, and higher CSF cell count, higher CSF protein, lower serum calcium and longer duration of stay and all these characteristics showed highly significant differences The case fatality rate of children with (ABM) is 13.3%.
CONCLUSION:
The study concluded the need for PICU admission in children with (ABM) with acute onset, higher body temperature, higher peripheral WBCC, lower CSF glucose, and higher CSF cell count, higher CSF protein, lower serum calcium, and recommended laboratory and PICU service expansion

Ear, Nose and Throat (E.N.T) Diseases in Children: Patterns and Risk Factors.

Mahmood Dhahir Al-Mendalawi

Iraqi Postgraduate Medical Journal, 2008, Volume 7, Issue 2, Pages 106-111

ABSTRACT:
BACKGROUND:
Ear, nose, and throat (E.N.T) diseases are common in children. Early diagnosis and proper management are essential to ensure adequate growth and development.
OBJECTIVE:
To determine patterns of E.N.T diseases in children and define risk factors affecting them.
METHODS:
A Cross- sectional study of 264 children under the age of 12 years attended E.N.T clinic/ Al-Kindy Teaching Hospital/ Baghdad from the period of 1/10/2006 to 28/2/2007. We analyzed the following data: age, gender, residence, family size, socio-economic status, parental educational level, family history of atopy, presence of smoking, state of vaccination, presence of anemia or any concomitant chronic illness, and final diagnosis. Statistical analysis was done through Chi-Square.
RESULTS:
Males outnumbered females (48.1% vs. 51.9%) (P>0.05).The encountered prevalent E.N.T problems included those of pharynx and tonsils (41.7%), nose (18.6%), ear (16.3%), larynx (6.8%), adenoids (6.0%), sinuses (5.3%), and miscellaneous disorders (5.3%). Overall, infections were the predominant (57.9%) followed by foreign bodies impaction (11.7%) and allergy (6.0%). Statistical analysis revealed that crowding, low socio-economic status, poor parental educational level, smoking, and anemia were statistically significant risk factors (P<0.05).
CONCLUSION:
Pediatricians and E.N.T specialists share a combined responsibility in managing properly the commonest pediatric E.N.T problems. Enhancement of educational and preventive programs targeting the relevant risk factors is suggested.

Chronic Renal Failure in Children Admitted to Children Welfare Teaching Hospital

Nariman Fahmi Ahmed

Iraqi Postgraduate Medical Journal, 2008, Volume 7, Issue 1, Pages 12-17

ABSTRACT:
BACKGROUND:
Chroic renal failure (CRF) is a devastating medical, psychological, social and economic problem for
patients and their families.
AIM OF THE STUDY:
The aim of the present study was to determine the etiology, clinical presentations and highlight
treatment modalities used for patients with CRF admitted to children welfare teaching hospital.
PATIENTS' AND METHODS:
A Retrospective study of all children with CRF admitted to children welfare teaching hospital during
the period from 1stof jan.2002 to 1st of jan.2007 were included in the study .CRF was defined as
having glomerular filtration rate less than 80m1 /min/1.73m2.
RESULTS:
The study group included 50 patients with CRF below 17 years of age,29(58%) males and 21(42%)
females. Male: female ratio 1.38:1
Their age ranged between (1m -17 year).Twenty (40%) patients were above 10 years of age. In this
study the mean glomerular
Filtration rate was (29.5 + 18.5m1 /min/1.73m2).
Congenital abnormalities were the major cause of CRF, it was found in 18 patients (36%), followed
by hereditary conditions in 14 (28%) patients and glomerular diseases in 13 (26%) patients.
The most common presenting symptom was anemia. It was found in 16(32%) patients followed by
hypertension in 12 patients (24%) and failure to thrive in 12(24%) patients.
Twenty-one patients (42%) received peritoneal dialysis, four (8%) received hemodialysis. Renal
transplant was done to 3 patients (6%).
CONCLUSION:
Congenital abnormalities was to the most common cause of CRF in our patients. Establishing registry
system that provide detailed information concerning the incidence, causes, and overall outcomes of
mild to severe renal functional impairment acquired during developmental age can clarify further the
natural history of the disease and the factors that influence its course.

Clinical Profile and OutComeOf Respiratory Failure In Iraqi Children

Muhi Al-Janabi

Iraqi Postgraduate Medical Journal, 2006, Volume 5, Issue 2, Pages 132-137

ABSTRACT:
BACKGROUND:
The frequency of acute respiratory failure is higher in infants and young children than in adults.Acute
respiratory failure remains a significant cause of morbidity and mortality for children .
PATIENTS AND METHODS:
One hundred and twenty children under the age of 15 years presented with respiratory failure and
admitted to RICU in Children Welfare Teaching Hospital and Surgical Specialty Hospital in Medical
City - Baghdad in the period from the 1st of May -2003 to the 30th of June 2005 were enrolled in a
descriptive study.
RESULTS:
Seventy nine (65.83%) cases were males and 41 (34.17%) were females. Male / female ratio was
1.93:1.The mean age was 30.21 months, 35 (29.16%) cases were neonates. Sixty eight (56.7%) cases
were from urban areas and 52 (43.3%) were from rural areas. Seventy eight (65%) children were
admitted for medical diseases and 42 (35%) were admitted for surgical problems. The most common
medical causes were respiratory (50%) followed by neurological (37. 17%).The most common
respiratory cases were bronchiolitis (28.2%) and most common neurological cases were Guillain- Barre
Syndrome (58.6%).The majority (90.47%) of surgical cases were admitted post-operatively. The
average duration of stay in RICU was 9.71 days. Fifty three patients (44.17%) survived and 67
(55.83%) died.
CONCLUSIONS:
The most common age group admitted to RICU is infancy, medical cases are more commonly admitted
than surgical cases, the most common medical causes of admission are respiratory followed by
neurological causes, the most common respiratory cause of admission is acute bronchiolitis.