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THE ASSOCIATION BETWEEN IRON DEFICIENCY ANEMIA AND FIRST FEBRILE SEIZURE: A CASE-CONTROL STUDY
العلاقة بين فقر الدم الناتج عن نقص الحديد والاختلاجات الحرارية

Authors: AKREM M. AL-ATRUSHI اكرم الاتروشي --- KHALID N. ABDURRAHMAN خالد نواف عبدالرحمن
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2010 Volume: 4 Issue: 1 Pages: 60-66
Publisher: University of Dohuk جامعة دهوك

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Abstract

Background Febrile seizures (FS) are the most common type of seizures in children. Therelationship between iron deficiency anemia (IDA) and first FS has been examined in severalstudies with conflicting results.Purpose The purpose of this study was to determine the association between IDA and firstFS.Patients and Methods In this prospective case-control study we assessed 112 children with adiagnosis of first FS, aged between 5 months and 4 years who were admitted to theemergency unit of Hevi Children’s Hospital in Duhok/Kurdistan region/Iraq, or who visitedprivate office of the authors, during January 2006 to July 2009. The control group consistedof 120 febrile children without convulsion; controls were matched to the cases by gender andage. Patients and controls were reviewed to determine iron status using the hemoglobinconcentration (Hb), mean corpuscular volume, S. iron, and total iron binding capacity.Results A total of 35 (31.2%) of cases had IDA, compared to 14 (11.6%) of controls, whichis statistically significant, P = 0.003.Conclusion IDA was more frequent among children with FS than those with febrile illnessalone. The results suggest that IDA may be a risk factor for FS and screening for IDA shouldbe considered in children presenting with the first FS.

الخلفية: الاخخلاسبح امحرار جٍ ه وى الذر ايواػ امضرػ ش وٍؽب مدى الاعفبل. اسر حٍ ؽدد وى امتحود مخفش رٍ امؾلاقج ت ىٍ فقر امده اميبخز ؽى يقص امحد دٍ والاخخلاسبح امحرار جٍ الاومي وؼ يخبئز وخيبقظج.الاهداف: امغرط وى هذا امتحد هو موؾرفج امؾلاقج ت ىٍ فقر امده والاخخلاسبح امحرار جٍ الاومي.الطرق: خه ق بٍس يشتج امه وٍولنوت ىٍ وحسه املر بٍح امحورو يشتج امحد دٍ ف امده ل) 112 ( ورطٍ وضبة تبخخلارحرار اول‚ووى خراوحح اؽوبرهه ت ىٍ خوشج اشهر وارتؼ شيواح منفخرث وى لبيوى امذبي 2006 ومغب جٍ خووز 2002 . وف يفس اموقح خوح دراشج 120 عفلا وضبتب تحوي تدوى اخخلاسبح لوسووؽج ش عٍرث.النثبئج: غهر فقر امده اميبخز ؽى يقص امحد دٍ ف 35 ور ظٍب وقبريج ة 14 عفلا وى وسووؽج امش عٍرث.الاسثنثبج والارشبدات: فقر امده اميبخز ؽى يقص امحد دٍ الذر ش وٍؽب ت ىٍ الاعفبل اموضبت ىٍ تبلاخخلاسبح امحرار جٍ , مذمك سٍة امخحر ؽى ذمك.


Article
The Association between Hyponatremia and Recurrent Febrile Convulsions

Authors: Hadeel Rashied --- Shamel sharba --- Jasim Mohammed Hashim
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2017 Volume: 10 Issue: 1 Pages: 2613-2619
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Febrile seizures are common pediatric problem, yet there is a great deal of disagreement about the appropriate diagnostic evaluation of a child with this disorder. Different predisposing factors have been suggested to enhance the susceptibility to febrile seizure and its recurrence. Fever play an important role in causing disturbances in fluid and electrolytes balance, hyponatremia has been thought to enhance the susceptibility to seizures.Objective: To determine the effect of hyponatremia in recurrent febrile convulsions.Patients And Methods: A case-control study which carried out in Al- Zahraa teaching hospital in Al-Najaf city during the period between 1st of January to end of October 2015. One hundred fifty children were included in this study. We classified the patients into three groups; group (A) included (50) children presented with fever without seizure, group (B); (50) children presented with simple febrile convulsion, group (C); (50) children presented with recurrent febrile convulsions. Group A conceder as control group. The serum level of Na were estimated in these 3 groups by Na kits.Results: One hundred fifty children were studied with age range between (6months-6years) old. We compare the S. Na among the three groups;It is found that male in group A represented 26 (52%) and 24 (48%), 28(56%) in group B and C respectively, while female represented by 24 (48%), 26 (52%), 22 (44%) in groups A, B, C respectively, with p value of 0.726.There were no significant difference between male and female, in all age groups.Also it is shown that family history of febrile convulsion represented 20%, 50%, 50% in group A, B, C respectively, in family history of recurrent febrile convulsion, represented 4%, 4%, 10%, in group A, B, C respectively, and with family history of epilepsy show group A (0%), group B (4%), group C (0%).While p value in family history of febrile convulsion (0.002), in family history of recurrent febrile convulsion (0.345), in family history of epilepsy (0.132).So there were no significant difference in all parameters except family history of febrile convulsion which is significant in all three groups, P value=0.002.Also the study will show no significant difference in age, white blood cell count, and random blood surge while there is significant difference in temperature.A significant difference in serum sodium level which is lowest in group C. Regarding Calcium level, there is significant difference between group A and B.Conclusion:-There is a significant association between recurrent febrile convulsion and lower level of serum sodium, in which serum sodium concentration is lowest in those patient with recurrent febrile convulsion


Article
Association of febrile convulsion with serum sodium and hematological indices among Iraqi children in Diyala province
علاقة التشنجات الحموية بمستوى الصوديوم وبعض مؤشرات الدم عند الأطفال في محافظة ديالى - العراق

Authors: Suadad M. Abdulalameer سؤدد مصطفى --- Jalil I. Kadhim جليل ابراهيم --- Nameer F. Gaeb نمير فاضل
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2019 Volume: 32 Issue: 1 Pages: 28-32
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

AbstractBackground: Several studies had documented the relationship between iron deficiency and low serum sodium levels with the risk of developing recurrent seizure among children within the same febrile illness.Objectives: To figure out the association between serum sodium levels and iron deficiency with occurrence of febrile convulsion in children between 6 months to 6 years old in Diyala province.Patients and Methods: A case control study was conducted in Al-Batool Teaching Hospital for Maternity and Children, Diyala-Iraq during a period from September 2017 to March 2018. 200 patients aged between 6 months to 6 years were enrolled, 100 of them were diagnosed with febrile convulsion and the other 100 were age and sex matched apparently health children as controls. Patients aged < 6 months or > 6 years, cerebral palsy, meningitis, epilepsy, severe gastroenteritis and dehydration, history of chronic drug use, and history of developmental delay were excluded from this study. Diagnosis of febrile convulsion was based on initial evaluation focusing on the source of the fever and thorough physical examination for the presence of meningeal signs and the child's level of consciousness. All patients were subjected to detailed history, complete physical and neurological examination, laboratory investigations and lumbar puncture which proceeded by fundoscopy examination. Human privacy was respected by taken child's parents consent. Accumulated data were analyzed using the SPSS version 25. The independent t-test (two tailed) was used and P value less than 0.05 were considered significant.Results: There was a significant lower means in patients regarding total red blood cells (4.61 vs 4.76, P= 0.032), hemoglobin concentration (11.38 vs 11.85, P= 0.003), packed cell volume (34.07 vs 37.67, P= 0.001), mean corpuscles volume (74.06 vs 78.01, P= 0.001), and higher red distribution width mean (14.73 vs 13.51, P= 0.001). Furthermore, a significantly lowered means in serum iron (mg/dl) (4.02 vs 4.74, P= 0.008), serum ferritin (ng/mL) (46 vs 58.58, P= 0.001), serum sodium (mEq/L) (131.11 vs 139.89, P= 0.001) and higher total iron binding capacity (μg/dL) (80.84 vs 66.12, P= 0.001) among patients compared to controls. Conclusion: Children with febrile convulsion are more likely to have iron deficiency anemia and hyponatremia.

الخلاصة:الخلفيــة: اشارت العديد من الدراسات السابقة عن وجود علاقة بين نقص الحديد وانخفاض مستوى الصوديوم مع خطورة تطور نوبات متكررة من التشنجات (convulsions) لدى الاطفال الذين يعانون من الاختلاجات الحموية.الهدف من الدراسة: لتحديد العلاقة بين مستوى الصوديوم والحديد في المصل وبعض مؤشرات قيم الدم مع حدوث التشنجات االحموية المصاحبة للاختلاجات الحرارية في الأطفال بين ستة أشهر - ستة سنوات من العمر.العينات وطرق البحث: اجريت هذه الدراسة في قسم طب الأطفال في مستشفى البتول التعليمي في محافظة ديالى- العراق خلال الفترة من سبتمبر 2017 إلى مارس 2018. شملت الدراسة 200طفل, 100 منهم ادخلوا الى المستشفى بسبب التشنجات الحموية تراوحت أعمارهم بين 6 أشهر و6 سنوات ، و100 طفل اخرين من الاصحاء ظاهريا كمجموعة سيطرة. تم استبعاد المرضى الذين تتراوح أعمارهم اقل من 6 أشهر أواكثرمن 6 سنوات، والشلل الدماغي، والتهاب السحايا،والصرع، والتهاب المعدة والأمعاء الشديد المصحوب بالجفاف، ومن لهم تاريخ باستخدام الادوية المزمنة، ومن لهم تاريخ التأخر التنموي من الدراسة. استند تشخيص التشنج الحموي على التقييم الأولي مع التركيز على سبب الحمى والفحص البدني الدقيق لوجود علامات سحائية ومستوى وعي الطفل. خضع جميع المرضى لتاريخ مفصل ، والفحص البدني والعصبي الكامل ، والفحوص المختبرية والبزل القطني الذي سبقه فحص (fundoscopy). تم احترام الخصوصية البشرية من خلال الحصول على موافقة الوالدين. تم تحليل البيانات المتراكمة باستخدام إصدار SPSS 25. تم استخدام اختبار t المستقل واعتبرت قيمة P أقل من 0.05 ذات دلالة احصائيةالنتائـــــــج: اظهرت النتئج الحالية ان هناك انخفاض كبير لدى المرضىى بإجمالي عدد كريات الدم الحمراء 4.61 مقابل 4.76 (P = 0.032)، وتركيز خضاب الدم 11.38 مقابل 11.85، ( P = 0.003) PCV و 34.07 مقابل 37.67 (P = 0.001) وMCV 74.06 مقابل 78.01 P = 0.001) ) ، و RDW أعلى 14.73 مقابل 13.51 (P = 0.001) و أقل في حالة نسبة الحديد في الدم (ملغم / ديسيلتر) 4,02 مقابل 4.74 P = 0.008)) ، ferritin و (ng / mL) 46.0 مقابل 58.58،P = 0.001)) ، ونسبة الصوديوم (mEq / L) 131.11 مقابل 139.89،P = 0.001) ) و TIBC أعلى (ميكروغرام / ديسيلتر) 80.84 مقابل 66.12 P = 0.001) )0الاستنتاج: الأطفال الذين يعانون من تشنجات حموية أكثر عرضة للإصابة بفقر الدم ونقص الصوديوم في الدم عند مقارنتهم بمجموعة السيطرة 0الكلمات المفتاحية : التشنجات الحموية , مؤشرات الدم، الصوديوم في الدم، محافظة ديالى

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