Drowning in children: Aseer Central Hospital experience, Southwestern Saudi Arabia

To study the reasons, magnitude and outcome of drowning following submersion in water of children admitted to the Pediatric Intensive Care Unit in Aseer Province, Saudi Arabia. A retrospective cohort study of all pediatric patients [0-13] years old who drowned and were admitted to the Pediatric Intensive Care Unit, Aseer Central Hospital, Southwestern Saudi Arabia, between January 1[st] 1999 and December 31[st] 2009. A total of 19 cases were admitted following submersion in water. The mean age was 5.2 years +/- 3.8. Majority of victims [94.1%] were from the highland areas. Events most frequently occurred in the summer [46.7%], followed by spring and winter, 33.3% and 20%, respectively. Home events constituted 44.4% of submersion cases. Of these, 55.6% drowned in a washing container, while 53.4% submersed in swimming pools. Twenty-two percent of these accidents occurred in the sea and in wells while 11.1% occurred in a lake. The mean duration of submersion was 4.04 minutes +/- 5.35. Cardiac arrest was reported upon arrival at hospital in 42.1% of the victims. There were seven deaths [36.8%] and in one patient [5.2%] there was severe brain injury. In all deceased cases, no adults were watching the children when the accidents occurred. Drowning is a significant risk factor facing our children and can claim lives. The media as well as the authority should play a major role in increasing the public awareness to minimize or prevent such a problem

relation of age to the severity of Type I diabetes in children

To study the relationship between the age and severity of Type 1 diabetes in children 0-5 years and more than 5 years of age admitted to Aseer Central Hospital, Southwestern Saudi Arabia over a 7-year period. A retrospective review of children less than 13 years of age with Type 1 diabetes admitted to the Pediatric Department, between 1st January 2000 to 31st December 2006. A total of 181 children with Typel diabetes were admitted to the hospital during this period. Of these, 27.6% were children 5 years or less, while 72.4% were more than 5 years of age. The duration of symptoms was longer in younger children compared to older patients. Diabetic ketoacidosis was present in 31.4% of the younger children, and in 15.3% of the children more than 5 years old. Hospital stay was also longer in children less than 5 years of age. Most significant differences were in the younger children's group and affected the biochemical test results. The present study showed that more younger children present to the hospital late, and in a state of diabetic ketoacidosis compared to older patients. Efforts should be directed at improving the knowledge and skills of the primary health care personnel to be able to diagnose and refer these cases earlier

Antibiotic resistance pattern and empirical therapy for urinary tract infections in children

To study the type of bacterial pathogen causing urinary tract infection in children at Aseer Central Hospital, southwestern Saudi Arabia, and their antimicrobial resistance patterns. A retrospective study of all the urine cultures carried out on children in the period from January 2003 to December 2006, for a total of 4 years were reviewed at the bacteriology laboratory, Aseer Central Hospital, southwestern region of Saudi Arabia. Their antimicrobial resistances as well as sensitivities were also analyzed. A total of 464 urine cultures were identified. Escherichia coli constitutes the most common pathogen isolated 37.3%, followed by Klebsiella 16.4% and Pseudomonas species 15.7%. In general, there was a significant increase in the resistance rates of different bacterial pathogens to different antibiotics. In spite of an increase in the resistance rates of bacterial pathogens causing UTI, ceftriaxone, imipenem, and to some extent Azactam are appropriate for initial empirical intravenous therapy in UTI. In patients with uncomplicated UTI not requiring hospitalization, Nalidixic acid, and Nitrofurantoin can be used as oral treatment

Intensive insulin treatment versus conventional regimen for adolescents with type 1 diabetes, benefits and risks

The aim of the study is to compare the frequencies of complications among adolescents with type 1 diabetes [age 12-18 years] treated with either intensive insulin regimen [4 injections per day] or conventional regimen [2 injections per day]. The study was carried out at the Childrens Hospital, Quebec, Canada during the period 1997 to 1999. This retrospective survey involves a chart study of type 1 diabetic children aged 12-18 years. The frequency of retinopathy, nephropathy [albuminuria], diabetic ketoacidosis [DKA] and hypoglycemia were determined among the children on 4 insulin injections per day and those on 2 injections per day. The 2 groups were matched for age, sex, body mass index, insulin dosages and glycosylated hemoglobin levels. The frequencies of DKA [25% versus 30%] and hypoglycemia [25% versus 30%] were comparatively less among the intensive therapy group compared with the conventional therapy group. The incidence of retinopathy was approximately the same [8% versus 7%] in the 2 groups and nephropathy did not feature in any patient in the series. Intensive insulin therapy appears safe and advantageous over conventional regimen in the age bracket 12-18 years as has already been proven for individuals above the age of 18 years and adults. It can be recommended for this age group to forestall the morbidity of childhood diabetes