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Article
Complications of High Serum Ferritin Level after Splenectomy in β Thalassemic Patients

Author: Zuhair Omran Easa
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2009 Volume: 12 Issue: 1 Pages: 243-250
Publisher: University of Kufa جامعة الكوفة

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Abstract

Objectives: Compare between splenectomized and non splenectomized β -thalassemic patients regarding clinical, biochemical and therapeutic characteristics. Methods: This study was conducted on 140 patients with beta thalassemia major and thalassemia intermedia, expressed as two groups (group I) splenectomized patients and (group II) non splenectomized patients, who were attending Thalassemia Center in Karbala Teaching Hospital for Children from the first of November 2007 through 30th of April 2008. Both groups were studied by physical examination, biochemical analysis, hemoglobin level, serum ferritin, hepatitis C virus antibodies, and hepatitis B surface antigen. Echocardiography was done for most of patients. Results: In group I patients, 82.9% were under transfused and 80% were underchelated, whereas 91.4% of group II patients were under transfused and 74.3% of them were underchelated. Complications including, cardiac complications, diabetes mellitus, bone deformities, and gall stone were higher in group I than group II patients, moreover, only bone deformities was detected in β- thalassemia intermedia patients of both groups. Splenectomy was beneficial in reducing frequency of blood transfusion in 77.1% of group I patients. Conclusions: There is an aggravating effect of splenectomy on hemosiderosis. High serum ferritin level in splenectomized patients is associated with higher incidence of complications.


Article
Early- and Late-Onset Neonatal Sepsis: Risk Factors and Outcome Study

Author: Dr. Zuhair Omran Easa
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2012 Volume: 5 no 1 Issue: 11 Pages: 1314-1322
Publisher: Kerbala University جامعة كربلاء

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Abstract

Background: Early-onset neonatal infections are acquired before or during delivery (vertical mother-to-child transmission). Late-onset infections develop after delivery from organisms acquired in the hospital or the community. The age at onset depends on the timing of exposure and virulence of the infecting organism. Very-late-onset infections (onset after 1 mo of life) may also occur, particularly in VLBW preterm infants or term infants requiring prolonged neonatal intensive care.Aims of the study: To study the effect of some risk factors, laboratory investigations and outcome on early and late onset neonatal sepsis and their relation with early and late onset neonatal sepsis.Patients and methods: A prospective study was carried out in Karbala teaching hospital from the first of January 2011 through the first of January 2012 for a group of 150 neonates who were subgrouped into 86 (57.3%) with early onset neonatal sepsis and 64 (42.7%) with late onset neonatal sepsis. Information were taken about the patients regarding the age in days, gender, perinatal and maternal history and blood samples were aspirated for complete blood count, blood culture, and C-reactive protein.Results: We found that the neonate is more susceptible to early onset neonatal sepsis in comparison to late onset neonatal sepsis. Premature neonates were more liable for late onset neonatal sepsis than full termB 1341[Early- and Late-Onset Neonatal Sepsis…] Dr. Zuhair Omran Easakerbala J. Med. Vol.5, No.1, Dec, 2012Pageones, 93 vs. 57 neonates (62% vs. 38%). Neonates of mothers with prolonged rupture of membranes were more liable for early onset neonatal sepsis than late onset neonatal sepsis, 27 neonates vs. 11 neonates (31.3 vs.17.2) respectively. Also we found that the blood culture result highly affecting by antibiotics used before culture. The number of neonates with history of maternal fever during pregnancy or shortly before labor was associated with higher number of early onset neonatal sepsis than late onset sepsis, 20 vs. 16 neonates (13.3% vs. 10.7%) respectively. The mortality rate is more in ENS in comparison to late type.Conclusion: Prematurity and prolonged rupture of membranes had significant association with early onset neonatal sepsis while gender, antenatal care and maternal fever had no difference between early onset and late onset neonatal sepsis. Incidence and mortality of early onset neonatal sepsis was higher than late onset neonatal sepsis. Immature: total neutrophils count, and platelets count had high sensitivity to the diagnosis of neonatal sepsis

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Article
Therapeutic and Biochemical Effects of Zinc Sulfate in Acute Diarrhea among Young Children

Author: Zuhair Omran Easa
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2012 Volume: 5 no 2 Issue: 12 Pages: 1464-1472
Publisher: Kerbala University جامعة كربلاء

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Abstract

Background Zinc deficiency is prevalent in children in developing countries. Supplemental zinc provides therapeutic benefits in diarrhea.Objectives: To evaluate the role of zinc supplementation in the recovery of hospitalized children on intravenous fluid for acute diarrhea.Patients & Methods: A randomized control trial of 116 cases who were admitted to Karbala teaching hospital for children from October 2007 toAugust 2008 were enrolled in our study, the children aged 3 to 60 months old were divided into 2 groups, zinc group (57 cases) who received zinc for 14 days and control group (51 cases) who did not receive zinc. Zinc was given according to WHO guideline, 10 mg daily for infants up to 6 months of age, and 20 mg daily for older infants and children. General stool examination, serum k+, Na+, blood urea, and serum alkaline phosphates were done for all patients.Results: Our study showed improvement in 16 patients (28.07% )of cases versus 5 (9.8%)in the control group ( p value of 0.013) within the1st three days of treatment with zinc and52 patients (91.23% )versus 36 (70. 58% ) [ p value 0.017] 6 days after the treatment .Conclusions: Zinc supplementation reduces the severity and duration of acute diarrhea in hospitalized children on intravenous fluid.Abbreviations: IVF: intravenous fluid; ALP: alkaline phosphatase; ORS: oral rehydration solution.Key words: Acute diarrhea, zinc, alkaline phosphatase, oral rehydration solution

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Article
Effect of intravenous fluid supplementation on serum bilirubin level during conventional phototherapy of term infants with severe hyperbilirubinemia

Author: Zuhair Omran Easa زهير عمران عيسى
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2013 Volume: 9 Issue: 15 Pages: 36-45
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Background: Adequate hydration (hence good urine output ) improve the efficacy of phototherapy. The aim of this study was to evaluate the effect of intravenous fluid supplementation on decrease of serum bilirubin levels in jaundiced healthy term infants during conventional phototherapy.Patients and Methods: this study conducted in Karbala teaching hospital for children during the period from January 2, 2010 through December 31, 2010. Sixty four healthy breast-fed neonates with non-hemolytic hyperbilirubinemia (total serum bilirubin > 18 mg/dL [308 μmol/L] to < 22 mg/dL [375 μmol/L ] ) were assigned randomly to receive either breast milk or bottle formula exclusively (non-supplemented group; n=32) or intravenous fluid in addition to breast milk or formula (supplemented group; n=32) during conventional phototherapy.Results: The mean total serum bilirubin (TSB) levels at the time of enrollment and within 84 hours after phototherapy were not statistically different between two groups. Similarly, the duration of phototherapy required in both supplemented and non supplemented groups was 48hr.Conclusion: These data show that administration of extra intravenous fluid in jaundiced healthy, term, breastfed neonates have no beneficial effect on the rate of serum bilirubin reduction during conventional phototherapy.

بيان فعالية إعطاء السائل الوريدي في تقليل نسبه البليروبين الكلي في مصل الدم في الأطفال حديثي الولادة كاملي النمو والمصابين بداء اليرقان الولادي الغير انحلالي .أجريت هذه الدراسة في مستشفى كربلاء التعليمي للأطفال من الاول من كانون الثاني ٢٠١٠ الى الأول من كانون الثاني٢٠١١ على ٦٤ طفل حديثي الولادة كاملي النمو عراقي الأصل والمصابين بداء اليرقان الولا دي الغير انحلالي ادخلوا إلى وحدة العناية بالأطفال حديثي الولادة وجرى تعينهم عشوائيا إلى مجموعتان.المجموعة الأولى :لم يتم إعطاؤهم أي سوائل اضافيه وعددهم ٣٢ طفل حديث الولادة.المجموعة الثانية: تم إعطاؤهم سوائل وريديه بالاظافه إلى الرضاعة وعددهم ٣٢ طفل حديث الولادة. وجرى متابعة نسبة البليروبين الكلي في مصل الدم كل ١٢ ساعة خلال فترة علاجهم بالعلاج الضوئي العادي .لم يكن للمحلول الوريدي المعطى خلال عملية العلاج الضوئي العادي دور فعال في تقليل نسبه البليروبين الكلي في مصل الدم.

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