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Biomedical subjects

M Zaki

Publications and source records attributed to M Zaki.

At least 73 records · Page 4Linked to original sources
PubMed1991

Clinical presentation of enteric fever: its changing pattern in Kuwait.

The clinical experience with enteric fever (1985-89) at a general hospital in Kuwait is presented. There were 90 cases of typhoid and 10 cases of paratyphoid fever, with a mortality rate of 2%. Typhoid complications of bowel perforation, haemorrhage or septic shock were present in 5% and abortion in 2%. Neurological or psychiatric manifestations were a feature in 15%. Most infections were imported (78%). Despite rapid economic development, enteric fever may still be acquired locally but less frequently with time. This contributed to initial diagnostic uncertainty in 18% of cases, and especially in children. Another changing pattern emerged with the recent finding of five drug-resistant Salmonella typhi isolates, two in 1988 and three in 1989. Efforts are clearly needed to diagnose enteric fever more rapidly and to utilize new antibiotics for drug-resistant cases.

Adolescent↗
PubMed1991

Clinical report of Blastocystis hominis infection in children.

During a 9-month hospital-based survey, the intestinal parasite Blastocystis hominis was detected in high numbers (five or more organisms per oil immersion field) in faecal specimens from 39 (2%) of 1960 children under 13 years old. Abdominal pain or discomfort with or without diarrhoea was present in 32 children categorized as acute (14), subacute (7) or chronic (11) cases with respective mean ages of 6.4, 7.3 and 8.7 years. They included three with other enteropathogens (Giardia lamblia, Cryptosporidium sp. or Hymenolepis nana). The remaining seven children had no gastrointestinal symptoms. The 14 acute cases (symptoms duration 1-11 days) were characterized by cramp-like abdominal pain, watery diarrhoea and vomiting. The seven subacute (3-4 weeks) and 11 chronic (3-12 months) cases presented with abdominal discomfort and/or loose non-watery stools. Four complained of flatus and eosinophilia was noted in six. All symptoms resolved with eradication of B. hominis or reduction to low numbers after metronidazole chemotherapy (28 cases) or with no treatment (four cases). This study would appear to support the role of the parasite as an enteropathogen in some children. A case control study is clearly needed to clarify the status of B. hominis as a pathogen.

Animals↗
PubMed1990

A boy with the Rett syndrome?

A 13-year-old Kuwaiti boy met all necessary and almost all supportive criteria for the Rett syndrome. Electron microscopy of muscle biopsy specimen revealed abnormal mitochondria, a finding that has recently been reported for girls with the Rett syndrome. The results of other laboratory investigations were normal, besides a blood ammonia level of 100 microM/L. The mitochondrial changes observed in girls may be the consequence of an X-borne gene mutation, in which case only the female zygote survives because of the normal allele on the second X-chromosome. However, another genetic possibility discussed is inheritance according to "metabolic interference" of an X-borne allele, which does not rule out the possibility of a male being affected. We assume that the case reported might be a male variant of the Rett syndrome.

Adolescent↗
PubMed1990

Childhood idiopathic thrombocytopenic purpura: report of 60 cases from Kuwait.

Sixty children with idiopathic thrombocytopenic purpura (ITP) were admitted to a regional hospital in Kuwait over a 6-year period. A high annual incidence of ITP (12.5/10(5] was noted, probably related to viral infections during the period of the study. Forty-one were patients with acute ITP and 19 with chronic ITP. The initial treatment varied: corticosteroids were given in 33 cases, no therapy in 23 cases, and intravenous gamma globulin (IVGG) in four cases. Splenectomy was carried out in two children, of whom one died 2 years later as a result of septicaemia. This study showed that conservative management can be adopted in mild cases of ITP and active measurements should be reserved for patients presenting with moderate-severe mucocutaneous bleeding and significant thrombocytopenia.

Adolescent↗
PubMed1990

Bacterial meningitis in the newborn: a Kuwaiti experience.

Forty-five neonates with bacterial meningitis admitted to a regional hospital in Kuwait over a 5-year period are reported. The attack rate was 6.7/10,000 live births. Listeria monocytogenes was the most common bacteria isolated (31 per cent), followed by Streptococcus agalactiae (15 per cent), and Escherichia coli (11 per cent). Gram negative pathogens constituted 38 per cent of the total. Ten patients died (22 per cent) and 10 (28 per cent of the survivors) developed severe neurological sequelae.

Bacterial Infections↗
PubMed1990

Rett syndrome: a mitochondrial disease?

Six girls between 2 years 9 months and 15 years of age with Rett syndrome were thoroughly investigated. Blood ammonia levels varied between 42 and 123 mumol/L, and serum lactate concentration was slightly elevated in two girls. Electroencephalograms showed a dysrhythmic pattern during wakefulness; during drowsiness and light sleep, bilateral bursts of spike or multispike-and-wave activity were seen in all but the oldest girl. In one of the younger girls, slight cortical atrophy was found on computed tomographic scan. Muscle biopsy was performed on all girls, and electron microscopy revealed abnormal mitochondria. Physical signs such as somatic hypotrophy with extremely small muscle mass, and unsatisfactory weight gain in spite of good appetite are found in Rett syndrome. These attributes, as well as reports of ornithine carbamoyltransferase deficiency, may support a mitochondrial dysfunction. The mitochondrial changes indicate either a mitochondrial mutation or more probably an X-borne modulator gene mutation. Another genetic possibility discussed is the "metabolic interference" of an X-borne allele. Further delineation of such mitochondrial changes may clarify the causal metabolic defect in Rett syndrome.

Adolescent↗
PubMed1990

Effectiveness of sodium valproate in the treatment of Sydenham's chorea.

We treated 15 children with Sydenham's chorea with sodium valproate at a dose of 15 to 20 mg/kg/d. In 13 of them the chorieform movements disappeared within 1 week of therapy. The remaining 2 had incomplete response. Two patients relapsed; 1 of them responded to the reintroduction of valproate. The mean duration of treatment was 6.7 weeks. We observed no major side effects. This study strongly suggests that valproate is an effective drug in the treatment of Sydenham's chorea.

Acute Disease↗
PubMed1990

Mosaicism 45,X/46,X, t dic(Xp:Xp) in a girl with short stature.

An eight-year-old girl with marked short stature and no apparent stigmata of Turner syndrome was investigated. Clinical features include bilateral epicanthic folds, frontal bossing, prominent ears and normal intelligence. Ultrasound scanning revealed an apparently normal vagina, streak ovaries and no uterus. Bone age was normal. Karyotype analysis of peripheral blood lymphocytes showed mos 45,X/46,X tdic(Xp:Xp) in the ratio 66:34, respectively. In addition, three cells with different abnormal X chromosomes were present which possibly originated from a 46,XX clone. Replication of the duplicated X chromosome was consistently late and symmetrical. Buccal smear confirmation of the karyotype showed Barr body negative in 90% and large or bipartite in 10% of the cells. Karyotypes of the parents were normal. The clinical manifestations in cases of Xp deletion due to terminal rearrangement associated with or without a 45,X cell line are discussed.

Body Height↗
PubMed1990

Childhood shigellosis: clinical and bacteriological study.

Ninety-three children with shigellosis were hospitalized in a regional hospital in Kuwait during the year 1988. S. flexneri was the most common isolate (54%) followed by S. sonnei (39%) and S. boydii (7%). In addition to the gastrointestinal manifestations, 14 patients (15%) developed generalized convulsions. The benign and self-limiting nature of the convulsions associated with shigellosis means that neither diagnostic procedure nor drug therapy are usually necessary. The disease was self-limiting in 41% and antimicrobial usage did not seem to shorten the duration of symptoms or hospital stay. All shigellae isolated were sensitive to gentamicin and amikacin, 56% were resistant to three or more antimicrobial agents, 32 were resistant to five or more. These findings may indicate the need for better control of antibiotic use, particularly in developing countries.

Amikacin↗
PubMed1990

Cryptosporidium gastroenteritis in immunocompetent children from Kuwait.

During an 18 months' survey of children admitted to hospital with gastroenteritis, oocysts of the protozoan Cryptosporidium were detected in 35 cases (1.6% of the total 2205 surveyed). The affected children (age range 5 months to 8 years; mean 34.2 months) were immunocompetent, and had green and offensive watery diarrhoea. Vomiting (94%) with dehydration (80%), fever (66%) and abdominal pain (26%) were major clinical features of the diarrhoeal illness which lasted a mean 8.2 (range 3-14) days. Five children were infected with other enteropathogens. The illness was self-limiting in all cases and none were excreting oocysts 2 weeks after cessation of diarrhoea. Peak incidence occurred during the months of March and April, with no cases during the hottest months of July and August. There was no known contact with animals or pets; 4 children had other siblings affected and 2 conformed to cases of travellers' diarrhoea. The significance of cryptosporidiosis in Kuwait and the need for epidemiological studies are discussed.

Animals↗
PubMed1990

Childhood bacterial meningitis in Kuwait.

A total of 110 cases of bacterial meningitis were studied over a 7-year period. The attack rate was 3.2/100,000 overall and 13/100,000 in children under 12 years. Haemophilus influenzae was the most common pathogen (44.3%), followed by Streptococcus pneumoniae (20.9%) and Neisseria meningitidis (12.7%). The mean patient age was 2.7 years, but 44/49 cases of H. influenzae meningitis were in children under 2 years, an attack rate of 31/100,000. The mortality was 22.4% for neonates and 6.5% for other children, and was associated with coma at presentation and unusual microorganisms. Neurological sequelae were detected in 19% of surviving children.

Age Factors↗
PubMed1989

Primary nephrotic syndrome in Arab children in Kuwait.

Fifty-five Arab children with primary nephrotic syndrome (PNS) were seen at two regional hospitals in Kuwait over a 5-year period. There were 35 boys and 20 girls with a mean age of 5.3 years. The annual incidence was 7.2 and 6.0 per 100,000 children below 10 and 12 years of age, respectively. An initial response to steroids was noted in 84% with almost 50% responding within 1 week of therapy. Nine patients did not respond to steroids; histopathological classification of their renal biopsies showed 5 cases of membranoproliferative nephritis, 3 cases of focal segmental glomerulosclerosis and 1 case of membranous nephropathy. Microscopic haematuria was noted at presentation in 7 of 46 steroid responders, in all 5 patients with membranoproliferative disease and in 1 of 3 with focal segmental glomerulosclerosis. We conclude that the incidence of PNS seems to be higher among Arab children than in Western countries. With regard to initial biochemical abnormalities, steroid response and subsequent relapses, the pattern is the same as elsewhere.

Child↗
PubMed1989

Interaction between diazepam and oral antidiabetic agents on serum glucose, insulin and chromium levels in rats.

This study was undertaken to investigate the effect of diazepam in the presence and absence of glibenclamide, metformin or their combination on serum levels of glucose, insulin and chromium in rats. Results indicated that diazepam (10 mg/kg i.p.) induced marked hyperglycaemic effects in hyperglycaemic rats. This effect was associated with significant reductions in serum chromium levels and insignificant reduction in serum insulin levels. Diazepam-induced hyperglycaemia was counteracted by concurrent administration of glibenclamide (5 mg/kg orally), metformin (500 mg/kg orally) or their combination. The effect of diazepam on serum chromium level was counteracted partially by administration of glibenclamide and augmented in the presence of metformin or its combination with glibenclamide. It is concluded that the diazepam-induced hyperglycaemia, as well as the hypoglycaemic effect of glibenclamide, might be related to changes in serum chromium levels.

Animals↗
PubMed1989

Prolonged and secondary fever in childhood bacterial meningitis.

In order to study the causes of prolonged and secondary fever in bacterial meningitis, a group of 102 infants and children with proven bacterial meningitis were studied. The causative agent was Haemophilus influenzae in 58% of patients, Streptococcus pneumoniae in 25% and Neisseria meningitidis in 17%. Prolonged fever was observed in 12% of the patients. The established causes include, in order of frequency, subdural effusion, drug fever, otitis media, gastroenteritis and urinary tract infection. Secondary fever was noted in 18% of the patients. The causes, in order of frequency, were urinary tract infection, subdural effusion, otitis media, phlebitis, pneumonia and drug fever. Neither relapse of the meningitis nor inadequate response to antibiotic therapy was the cause for prolonged or secondary fever. Neurological sequalae were observed in 21 patients. There was no correlation between prolonged or secondary fever and neurological sequalae. We conclude that prolonged and secondary fever in patients with treated bacterial meningitis is rarely caused by the primary infection.

Anti-Bacterial Agents↗
PubMed1989

Intervertebral discitis in childhood.

Many paediatricians are unaware of the disease entity of discitis, which must be included in the differential diagnosis of several acute and subacute diseases of infancy and childhood. In order to draw attention to this disorder, three Swedish and two Arabic children, aged from 9 months to 3 years, are jointly presented. The onset of symptoms was 2-4 weeks prior to admission. The clinical diagnosis was verified by plain X-ray of the spine and bone scanning. Two of the children had low grade fevers. The erythrocyte sedimentation rates were moderately elevated, while white blood cell counts were normal or slightly increased. Blood cultures were negative. The children were treated with immobilization, and three of them received antibiotics. Full recovery was achieved in all children after 1-2 months. The diagnostic procedure and the rationale of using or not using antibiotic treatment is discussed.

Child, Preschool↗