Biomedical subjects
Publications and source records attributed to H Narchi.
The concentration of bicarbonate was measured in serum samples from 106 children with gastroenteritis and dehydration. A concentration less than 22 mmol/l was more common in children with severe dehydration, but the magnitude of bicarbonate reduction was not significantly different with increasing degrees of dehydration. Doctors should not rely on the serum bicarbonate concentration when assessing fluid deficit.
OBJECTIVE: Analysis of factors influencing voiding after neonatal circumcision. DESIGN: Prospective study of the following factors in 200 circumcised infants: birth weight, gestational and postnatal age, type and timing of feeding before the procedure, and timing of last voiding before circumcision. RESULTS: There was no significant difference in the age when circumcision was performed between breastfed infants (6 and 60 hours) and in those formula-fed (8 and 130 hours). All infants voided after circumcision, with 75% of breastfed infants and 100% of formula-fed infants voiding within 8 hours of the procedure. Breastfed infants voided up to 8 hours after the procedure, compared with up to 6 hours in formula-fed infants, but without a significant difference. The interval between last feed before the procedure and the time of voiding after circumcision was significantly shorter in formula-fed infants (1 to 9 hours) than in breastfed infants (2 to 21 hours). The interval between precircumcision and postcircumcision voiding was also significantly shorter in formula-fed infants (3 to 12 hours) than in breastfed infants (1 to 23 hours). Ninety percent of formula-fed and 64% of breastfed infants voided within 10 hours of the last voiding before circumcision. No infants aspirated during the procedure, regardless of the time of the last feed. No hemorrhagic, infectious, or surgical complications of circumcision were observed. CONCLUSION: Postoperative voiding time is predictable. Healthy infants who undergo an uncomplicated circumcision can be discharged before voiding occurs.
OBJECTIVE: To determine the incidence of antenatal and intrapartum maternal and fetal complications of gestational diabetes mellitus (GDM) and compare them with pre-gestational diabetes mellitus (pre-GDM) and non-diabetic pregnancies in our population. STUDY DESIGN: Nine-hundred and seventy-two women with gestational diabetes mellitus and 71 women with pre-gestational diabetes mellitus, and their offspring (delivered in our hospital between January 1991 and April 1994) were studied. Maternal and fetal prenatal and intrapartum complications were analyzed. RESULTS: The incidence of GDM was 9.8%. The maternal complications included higher incidences of cesarean section and perineal lacerations in GDM and pre-GDM patients than in the non-diabetic pregnancies, and higher rates of macrosomia and hypoglycemic episodes in their offspring. CONCLUSION: The incidence of maternal, fetal and neonatal complications in GDM is similar to pre-GDM patients and their offspring. Both GDM and pre-GDM pregnancies and the offspring should, therefore, be monitored and managed identically.
The incidence of Down's syndrome was studied in 1870 infants of diabetic mothers out of 22,300 neonates born between January 1987 and April 1994 in our institution. All pregnancies were screened for diabetes and all cases of Down's syndrome were confirmed by chromosome analysis. Down's syndrome (all trisomy 21) was diagnosed in 35 infants: seven were born to mothers with gestational diabetes and 28 to non-diabetic mothers. The incidence of Down's syndrome was higher in infants of diabetic mothers (3.75 per 1000 v 1.36 per 1000) (p = 0.02) with a relative risk of 2.75. No significant difference was found in maternal age between both groups (p = 0.67) and the rate of Down's syndrome was higher in infants of diabetic mothers when compared with infants of non-diabetic mothers of similar age. Down's syndrome should be added to the congenital malformations already known to occur more frequently in infants of diabetic mothers.
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Six children with shunt nephritis are reported of whom two did not show complete recovery of renal function. Follow up and outcome in relation to the delay in diagnosis and renal biopsy appearances are discussed.
We describe the occurrence of antibiotic-associated pseudomembranous colitis in two cases of Henoch Schonlein purpura. We discuss the potential diagnostic difficulties and suggest that Henoch Schonlein purpura may predispose to the development of antibiotic-associated pseudomembranous colitis.
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