Department of Paediatrics

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    Assessment of Respiratory Status with Elevated Prone Position on Children (One Year to Less Than 5 years of Age) With Acute Respiratory Tract Infection in Ibrahim Malik Hospital
    (University of Khartoum, 2015-12-22) Mariam Yousif Omer Elhussain ; Ilham Mohammed Omer ; Department of Paediatrics
    Acute RTI is one of the common causes of death in under 5 years children. The management of ARI needs both medical and nursing staff, so this study supported the clinical nursing practice with an aims to assess the respiratory status with elevated prone position compared with semi- fowler position. Methods: - A comparative, prospective - hospital based study was conducted in the paediatrics department (short stay wards), in Ibrahim Malik hospital during the period (2013 -2015).The target population were children one to less than 5 years of age admitted to the short stay ward. The sample size was 401 children. Data was collected by standard observation checklist and the researcher used the semi-fowler position and compared it with elevated prone position. The child respiratory status (respiratory rate, pulse rate and O2saturation) was assessed, and then compared with standard values. Result: -According to SPSS versions 20 analysis, the mean respiratory ratesemi- fowler position was 32cycle per minute and for elevated prone position was 24cycle per minute. The mean for pulse was 135beat per minute for old position and 109beat per minute for new one. The mean oxygen saturation (O2) was93% for semi-fowler and 98% for elevated prone position. TheCorrelationwas 0.917,P =(0.000). Conclusion: -The elevated prone position was better than semi- fowler and preferable for younger children than old one.
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    Accounting for Growth in Sudan1982-2005
    (University of Khartoum, 2015-06-16) Al-Siddiq Ahmed AbdulRahman, Shamboul ; El-Tayeb Ahmed Shumo ; Economics
    The present study seeks to examine sources of economic growth and to evaluate quantitatively their relative contributions in actual growth rate using time series data series for Sudan during the period 1982-2005. The neoclassical growth theory postulates that, growth in factor inputs (labor and capital) and productivity are the chief sources of long-run economic growth. To test such hypothesis, we use a growth accounting methodology, due to Solow (1957), to decompose the actual rate of growth in output into the contributions from growth rates in physical capital and labor and a residual measure of the change in total factor productivity (TFP). The latter is a comprehensive productivity measure that includes, among other things, new technologies, economic efficiency, organizational improvements, measurement errors, etc. Over the entire period (1982-2005), the estimated rate of growth in real GDP was 4.43%. The share of TFP was 2.41% in the estimated rate; labor share was 1.70% and capital share was 0.32%. Hence, the combined share of inputs was 2.02%. In relative terms, the contribution of TFP in observed growth was 58% that of labor was 35% and that of capital was 7%. The main findings, thus, indicate that the actual growth in real GDP over the period under study was driven by both TFP and factor accumulation; however, the contribution of the TFP was slightly much higher than the combined contribution of the latter. It follows that growth experience in Sudan during the study period was a mixture of both intensive and extensive growth. The poor contribution of capital is attributable to low saving and investment levels due to factors such as civil war and economic distortion especially during the pre-oil discovery era. Despite the drain of skilled labor due to expatriation, the role of labor in growth, however, is substantial. T 6 It should be noted that these findings are sensitive to the model specification and assumptions especially the assumptions of constant returns to scale and competitive factor prices. During this period, several factors have contributed to this pattern of growth. Prominent among them are the civil war, natural disasters, budget deficit and hyperinflation. Owing to the importance of sustained growth and its relation to welfare and the role of TFP in sustained growth, the researcher believes that the government and the private sector as well should pay heed to factors that boost productivity such as R&D and education, on job training etc
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    Acute, Urinary, Tract, Infection,Pathogens, Antibiotics ,Susceptibility
    (University of Khartoum, 2015-04-09) Hassan, Amira ; El-Tigani Mohamed Ahmed ; Paediatrics and Child Health
    The aims of the study were to determine the pattern of pathogens causing acute UTI in children, their antimicrobial susceptibilities and the associated risk factors and renal tract anomalies. This prospective, hospital-based study was conducted in Gaafar Ibn Auf Emergency Children Hospital in the period from July to November 2007. A total of 400 children aged 15 day – 16 years, suspected of having acute UTI, were screened using dipsticks urine tests. Dipstick was positive in 221 children (55.2%) from whom urine samples were sent for culture and in-vitro sensitivity testing. One hundred out of these 221 patients (45.2%) had significant bacteriuria. Their mean age was 3.4 + 3.6 SD years and males constituted 53%. Most of the patients were below the age of 5 years (74%) of whom 35 percent were infants. E. coli was the commonest isolated pathogen (60%) followed by klebsiella, enterococcus faecalis and staph. Aureus in 12%, 10% and 9%, respectively. proteus spp., streptococcus and pseudomonous aeruginosa were the least common organisms (6%, 2%, 1%, respectively). The in-vitro sensitivity tests showed that the bacterial isolates were highly sensitive to gentamycin (96%), ciprofloxacin (94%), ceftriaxone (90%), cefixime (85%) and cefuroxime (75%). Sensitivity to nalidixic acid, nitrofurantoin and cephelaxin was 74%, 70% and 51%, respectively. Pathogens were highly resistant iv to co-trimoxazole, amoxicillin-clavulanate and ampicillin in which sensitivity was 29%, 19% and 14%, respectively. Ultrasound scan (US) was done in 89 patients of whom 29 children (32.6%) had (US) abnormalities. Six out of there 29 children had renal calculi and the remaining 23 had different US abnormalities. VCUG was done in 15 out of 28 children in whom VCUG is indicated. The result showed low grade (I-II) Vesicoureteric Reflux (VUR) in 5 (33.3%) of them. Risk factors, with the exception of uncircumcision were not significantly related to occurrence of acute UTI. In conclusion; - E-coli is the commonest pathogen causing acute UTI in Sudanese children with acute UTI. - Urinary pathogens are highly sensitive to gentamycin, ceftriaxone, ciprofloxacin cefuroxime and cefixime. Therefore we recommend all these agents, except ciprofloxacin, as first line drugs for empiric therapy of acute UTI. - Isolates showed high to moderate sensitivity to nalidixic acid and nitrofurantion, therefore we suggest these drugs for less - acute cases or for prophylaxis because of their low serum therapeutic levels. v - Conventional drugs like cephelexin co-trimoxazole, amoxicillin – clavulanate and ampicillin showed low sensitivity results, therefore we do not recommend their use in empiric treatment of acute UTI. - Renal tract abnormalities were not common in Sudanese children with acute UTI. The detected abnormalities namely VUR are likely to be acquired due to infection rather than congenital. - Therefore we suggest MCUG for UTI cases only in whom this test is indicated.
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    Growth and sexual maturation in children and adolescents with type I diabetes mellitus in Khartoum State
    (UOFK, 2015-04-09) Ibrahim, Samia ; Dr. Yahia Shakir Abdel Gadir ; Paediatrics and Child Health
    Over the last 50 years the prognosis for growth and pubertal development in children with type one diabetes mellitus has improved. Considerably, however growth failure can occur in diabetic children with long standing poor glyceamic control. The aim of this study is to assess physical growth and pubertal Development in a group of children with type 1 DM of diabetic children and to evaluate the effect of duration of illness, and degree of glyceamic Control on growth and sexual maturation. Anthropometric measurement of height, weight, body mass index, pubertal status, as well as bone age were assessed in 138 children with Type1 DM aged, 1 – 17 years, treated in two diabetic centers, Thirty eight patients (27.5%) had stunted growth, defined as height for age < - 2 SD, fifteen of these patients were in age group 9 -17 years, growth failure was positively correlated with level of glycosylated hemoglobin (HbA1c) (P = 0.001), there was no gender predilection shown. Twenty four patients (14.4%) had moderate under weight defined as weight for age < -2SD, nine patients (6.5 %) had sever under weight, defined as weight for age <- 3SD. , under weight was positively correlated with level of glycosylated hemoglobin (P =0.002). V Thirty-two (23.2%) patients had delayed bone age, twenty nine of these patients were in age group 9 – 17years. Ten females (20%) and nine males (16.9%) of adolescents, shown delayed sexual maturation with positive correlation with poor glyceamic control. This study revealed growth retardation and delayed skeletal and sexual maturation in young Sudanese patients with insulin dependent diabetes mellitus, and emphasized the importance of strict glyceamic control.
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    The Blood Pressure In Primary And Secondary School Children In Aden Governarate
    (University of Khartoum, 2015-04-08) Taher, Mariam ; Mohamed Sir K. Hashim ; Paediatrics and Child Health
    The objective of this study which is a cross sectional community based ii study, was to provide the basic information on the normal pattern of blood pressure and the underlying causes of hypertension in school children in Aden Governorate. It also endeavors to identify the magnitude of the problem of hypertension ( suspected and definitive ) and to explore related demographic and socio-economic factors . The study aimed to examine and determine the association of high blood pressure with possible potential risk factors among school children aged 6 – 16 years . Ten thousand and eighty two students were enrolled in this study during the period from November 2002 to April 2004 in different schools in Aden Governorate. They filled one questionnaire which involved all the demographic information, physical examination chest, CVS, abdomen, CNS and ophthalmologic. Anthropometric measurements were done for all students and BMI calculated . Blood pressure was measured and BP percentiles determined as well as BMI percentiles according to age, gender and height . The age of the students ranged between 6-16 years with mean age 11.6 ± 2.94 S.D. Males constituted (47.3 %) and females constituted (52.7 %) with female to male ratio 1.1: 1 . The prevalence of hypertension in the first screen was ( 4.4 % ) while in the second screen was (2.0 %) . High BP and hypertension is higher in females than males and in age group 13-16 years . Hypertension is more iii frequent in Mansora (3.6 %) followed by Khormakser ( 2.3 % ) . In males the mean SBP ranged from 92.8 ± 8.08 to 104.5 ± 11.15 and the mean DBP from 54.16 ± 8.27 to 64.53 ± 10.82 . In females, the mean SBP ranged from 92.38 ±8.36 to 105.17 ± 10.59 and the mean DBP ranged from 51.35± 9.96 to 65.80 ± 10.29. Prevalence of hypertension increased with increase of the BMI from less than 5th percentile, 5th-85thpercentile, >85th-95th percentile and > 95th percentile, 0.32 %, 1.39 %, 7.05 % and 13.43 % respectively . Stage 1 hypertension was detected in 133 students ( 66.5 % ) while stage 2 hypertension, was in 67 students (33.5%) . Rate of male students (73.1%) in stage 1 was higher than female students (62.3%). In stage 2 hypertension, female students (37.7%) were higher than male students (26.9%) . Isolated systolic hypertension (51.0%) was more frequent followed by the systo-diastolic (45.0%) while the isolated diastolic was (4.0%) . Hypertension was more frequent in children of hypertensive parents (7.8%) while in children of non hypertensive parents was only (1.4%) . Consequently hypertension increased with increase in parents' education level, occupation and family income due to change in lifestyle . Also incidence of hypertension increased in families with more number of children due to overcrowding and stress. Students who smoked or chewed Kat had more incidence of hypertension . 35.2 % of students had renal problems which is iv considered to be a cause of secondary hypertension while 64.8 % of students without clear underlying causes were considered as essential hypertension . The mean hemoglobin was 10.82±1.46g/dl, blood leukocyte 4,064 .12 ± 1056.26 cells /m3 and the blood ESR was 30.29 ±14.40 mm/ 1st hour (Wastergren) . The serum urea 28.36 ±5.79 mg/dl, serum creatinine 0.55 ±0.20 mg/dl, serum uric acid 4.66 ± 0.97 mg/dl, serum sodium 134.07 ±9.31 mg/dl and the serum potassium was 3.31 ± 0.71 mg/dl . The serum cholesterol 170.84 ± 22.32 mg/dl, serum triglyceride 103.90 ± 24.04 mg/dl, and serum sugar 91.50 ± 11.20 mg/dl. Urine culture was positive in 28 (57.1%) of students with renal problem while abdominal ultrasound showed chronic glomerulonephritis in 23 students (46%) with renal problems . Students with hypertension were referred for further assessment and management in certain clinical centers .