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The frequency of death among hospitalized neonates with hyaline membrane disease (HMD) in AL-DIWANAH maternity and children teaching hospital from (2005-2007)

Author: Deia.K.kalaf ضياء كاظم خلف
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2008 Volume: 4 Issue: 6 Pages: 50-59
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Assessment the frequency of death among hospitalized neonates with HMD in AL-DIWANAH, maternity and children teaching hospital, and to analyze risk factors associated with poor outcome.Patients and methods: all the neonates with HMD who were admitted to neonatal intensive care unit (NICU) and expired, during a period of three years ( 2005 -2007 ),the patients were divided according to different parameters (sex, B,W, gestational age, mode of delivery, days of death, cause of death,) A total live births of 25463, and a total of 356 case of HMD were admitted during the period of the study, and 112 neonate were died with a frequency of 30%.,with sex ratio of male to female (1.4:1 ) respectively, and most of death was due to apnea in 87%, so the causes of death and risk factors for death were presented and compared with results of other studies in other parts of the world. Major risk factor associated with HMD in the city were apnea, prenatal diagnosis facilities are not available, but post natal diagnosis depend mainly on clinical picture as no lab- test available in regard to L/S ratio by chromatography or shake test for amniotic fluid to assess maturity can be performed, mortality can be reduced by improving the ante-natal, obstetric, post-natal care levels.

تردد الوفيات بين المرضى الداخلين الى مستشفى النسائية والاطفال التعليمي والمصابين بمرض الغشاء المشف .تقييم تردد الوفيات بين الاطفال الخدج وحديثي الولادة المصابين بمرض الغشاء المشف الداخلين في مستشفى النسائية والاطفال في الديوانية مع دراسة العوامل التي تؤدي الى نتائج سلبية دراسة استرجاعية لكل الاطفال المصابين بمرض الغشاء المشف والداخلين في وحدة الخدج وحديثي الولادة واللذين توفوا خلال مدة البحث ثلاث سنوات وتم تصنيفهم اعتمادا على عوامل مختلفة (الجنس, الوزن عند الولادة, اسابيع الحمل ,ايام الرقود في المستشفى سبب الوفاة) كان عدد الولادات الحية خلال مدة البحث 25463 وكان عدد المرضى المصابين بالمرض 356 وكان عدد المتوفين 112(30%), وكانت نسبة الذكور للاناث (2/1 :1),وكان لسبب الرئيسي للوفاة هو توقف التنفس87% , وتم مقارنة العوامل المؤديه للوفاة مع دراسات اخرى.امكانية التشخيص قبل الولادة غير متوفرة حاليا , واماالتشخيص بعد الولادة فيعتمد على العلامات السريرية والشعاعية , ونسبة الوفيات ممكن تقليصها بتحسين مستوى الرعاية قبل , اثناء , وبعد الولادة وتجهيز وحدات الخدج بأجهزة التنفس الاصطناعي ورفع مستوى كفاءة منتسبيها من اطباء وكادر تمريضي .

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Article
The response to Growth Hormone Therapy in Isolated Growth Hormone Deficiency

Authors: Dr. Sura Y. Noory, --- Deia K. Kalaf, --- Refaat M. Abdul Hussain
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2009 Volume: 2 no.6, 7 Issue: 4 Pages: 409-419
Publisher: Kerbala University جامعة كربلاء

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Abstract

objective: to study the response of Growth hormone therapy in children with short staturedue to isolated growth hormone deficiency.Sample: six hundred forty eight patient with short stature were enrolled in this study.Method: six hundred forty eight patient with short stature attending Central Teaching Hospitalfor children Baghdad/ Iraq, were recorded and all patients were investigated to exclude otherdisease like diabetes, hypothyroidism, celiac disease, turner syndrome, renal failure,achondroplasia,..etc. with a total of 48 patients due to these causes were excluded from the study.So the remaining patients were 600 only those exposed to our study. All children investigated forgrowth hormone basal level and after provocation by clonidine done for one time .Results: We found that the basal level of growth hormone was less 0.5 microgram (μg)/liter (L),0.5 -1 μg/liter and more than 1 μg /liter in 25%, 38% and 37% respectively in our sample, whilethe results after provocation were less than 5, 5-10 and more than 10 μg /liter in 60%, 28% and12% respectively in our sample. The effect of growth hormone in one year therapy theincrement in height was less than 4 cm in 22% of our patients, from 4-8 cm in 50%, and morethan 8 cm in 28 % and we found that the male patients were 384(64%), and the female patientswere 216(36%),with peak difference between bone age and chronological age was more than 2year for both sex and most of the patientsُ age was more than 15 years.Conclusion: Most patients with isolated growth hormone deficiency had basal growth hormonelevel 0.5 – 1μg/L, while the provocation level was less than 5μg/L and the effect of growthhormone therapy on height maximally 4-8 cm in proximately 50% of the patients and more than8 cm in 28% after one year treatment. Patients with isolated Gh deficiency showed goodresponse to therapy with growth hormone recombinant in a dose 0.1 mg /kg /day

Keywords

Gh --- Growth hormone

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