Sa'ad Hijazi

Effectiveness of iron therapy on breath-holding spells

OBJECTIVE The objective of this study is to investigate the effect of iron therapy on breath-holding spells (BHS). METHODOLOGY Sixty-seven children with BHS were enrolled in a clinical trial to evaluate the effect of iron therapy on BHS. At the beginning of therapy, the clinical, laboratory, and demographic characteristics of the patients in the treatment group (n = 33) and placebo group (n = 34) were comparable. Patients were assessed weekly for the first 8 weeks and then every 2 weeks for the next 8 weeks. Response to therapy was assessed by the change in the frequency of BHS. RESULTS Children treated with iron showed significant reduction in the frequency of BHS (88%) compared with the frequency (6%) in the placebo group. As expected, the treated group showed a significant improvement of a number of blood indexes compared with the placebo group. Baseline mean levels of hemoglobin and total iron binding capacity were predictive of a favorable response to iron treatment. CONCLUSION Results of this study indicate that iron therapy is effective in the treatment of BHS and that iron-deficient children seem to be more likely to benefit from such therapy. Response to iron therapy was strongly correlated with improvement in blood indexes.

Iron status: A possible risk factor for the first febrile seizure

Summary:  Purpose: We conducted a controlled study to investigate the relation of iron status and first febrile seizure (FFS).

Cryptosporidium. A cause of gastroenteritis in preschool children in Jordan.

In this case-control study, we investigated the role of Cryptosporidium in gastroenteritis in children < 6 years old. Six hundred fresh stool specimens were examined for various pathogenic parasites, bacteria, and rotaviruses. Wet-mount preparations, formaline-ether concentrations, and Sheathers floatation techniques were used to recover the parasite oocysts. Permanent stained slides using acid-fast stain and trichrome stains were prepared. Of 300 children with gastroenteritis symptoms, 20 (6.7%) had Cryptosporidium oocysts; seven of the 20 had concomitant infections so they were excluded from the counts. This infection rate is significantly different (Z = 2; p < 0.05) from that found in the control group (1.7%) of children who reported no symptoms. The most frequent symptoms reported beside diarrhea were abdominal pain, cramps, anorexia, nausea, vomiting, and fatigue. Contaminated drinking water is suspected to be the source of infection; other possible factors are discussed.

Serum Ferritin in Evaluation of Iron Status in Children

The value of serum ferritin in assessing iron status was studied in 192 preschool age children between the ages of 3 and 60 months. Children were considered to have iron deficiency if the transferrin saturation was less than 16% and the peripheral smear revealed microcytosis and hypochromia. Anemia was present when hemoglobin level was 10.5 g/dl. According to this criteria, 46% of children screened had either iron deficiency (11.5%) or iron deficiency anemia (34.4%). Mean serum ferritin for the iron deficiency anemia group was 39.1 ng/mg as compared to 41.7 ng/ml for the iron deficiency group and 84.7 ng/ml for the normal group. Even though the serum ferritin level was lower in the iron deficiency group, the difference in the means did not reach statistical significance. Furthermore, only 30% of children who had either iron deficiency or iron deficiency anemia had serum ferritin level of less than 12 ng/ml, the level considered diagnostic for iron deficiency. It can be concluded that serum ferritin cannot be used alone for iron status determination. Multiple parameters will make the assessment more reliable.

The duration for which exclusive breast-feeding is adequate. A study in Jordan.

ABSTRACT. The object of this study was to determine the length of time for which exclusive breast‐feeding supported adequate growth in a cohort of infants from families in and around Amman, Jordan. The infants were described as “faltering” if their incremental growth over 4 weeks fell below 2 standard deviations of the increments reported by Fomon in the USA. The infants were examined every 2 weeks until they faltered, or, without faltering, were started on supplementary foods. In general, up to the time of faltering, growth was satisfactory by international standards. The median time of faltering was 6 months. The results support the view that, at least in this relatively well‐nourished community, exclusive breast‐feeding is satisfactory for 4–6 months. However, further examination is needed of the risk factors that lead to early faltering in some breast‐fed children.

Seroimmunity to rubella virus in Jordanians

Abstract Sera of 985 Jordanians from 1 to 36 years of age and 115 cord blood specimens werescreened for rubella haemagglutination-inhibition antibodies. The percentage of seropositivity increased with age, 73–76% of the younger group were positive, while 80–91% of the older group and 95% of cord blood specimens were positive. Analysis of the results according to the age group and geographical distribution isdiscussed.

Preeclampsia in Jordan: incidence, risk factors, and its associated maternal and neonatal outcomes

Abstract Objectives: To estimate the incidence of preeclampsia among Jordanian pregnant women, determine its risk factors and its associated neonatal morbidity and mortality. Methods: The study is a part of a comprehensive national study of perinatal mortality that was conducted in Jordan. This study included all women who gave birth in the selected hospitals during the study period. Maternal and medical conditions during pregnancy and neonatal outcomes were compared between women who developed preeclampsia and who did not. Results: This study included a total of 21,928 women. The overall incidence rate of preeclampsia was 1.3%. Obesity (OR = 2.6) and high blood pressure (OR = 11.9) were significantly associated with increasing odds of preeclampsia. The risk of preeclampsia was 2.3 times higher in first pregnancies than that in second or more pregnancies. The rates of low birth weight (LBW) delivery (32.5% vs. 8.3%), and prematurity (30.8% vs. 7%), and the neonatal mortality rate (81 vs. 12 per 1000 live births) were significantly higher among women with preeclampsia. Conclusions: The overall incidence rate of preeclampsia was 1.3%. Preeclampsia was significantly associated with maternal and neonatal morbidity and mortality as well as increasing vaginal operative delivery, cesarean section, LBW, and birth asphyxia.

The Nutritional Impact of School Feeding Programme in Mafraq Area

The impact of a school feeding program on the nutritional status of school children in Jordan is assessed. Students from 8 governmental schools were studied: 4 of the schools were in the generally poorer Mafraq area and participants in the program. The other 4 were from Madaba did not participate in the program and thus served as controls. Almost all children were from low to middle income groups. 1608 children belonged to the study group and 946 to the control group. Subjects were primary and preparatory school children with ages ranging from 7-15. Results of anthropometric measures show that weight and mid-arm circumference values were significantly and generally higher in the Mafraq area especially among females and younger age groups who are more sensitive to nutritional changes. Height retardation was common in Mafraq and could indicate the presence of past or chronic malnutrition. The average values for height in both areas were far below the US standards. The impact of the school feeding program on the personality characteristics of the students in Mafraq and Madaba indicate higher grades and achievements in Madaba in almost all fields. This finding could also reflect long standing higher social economic cultural and educational standards in Madaba. Because school feeding in Mafraq is less than 1 year old it would be difficult to draw precise and definite conclusions from the data presented for this short period of time.

Incidence of hepatitis B antigen among Jordanian volunteer blood donors.

Abstract Blood samples of 2500 healthy volunteer donors attending the Jordan UniversityHospital Blood Bank were screened for HB S Ag by the R.I.A. and R.P.H.A. methods and revealed the presence of 111 HBP S Ag positive samples (4·4%). A higher positive rate was present among elderly donors from crowded poor areas with low income, education and hygiene.

Rate of teenage pregnancy in Jordan and its impact on maternal and neonatal outcomes

Abstract Objective Research regarding the adverse outcomes of adolescent childbearing has suffered from many limitations such as a small sample size and non-representative samples. This study was conducted to determine the rate of teenage pregnancy among Jordanian adolescents and its associated adverse maternal and neonatal outcomes. Methods The study is a part of a comprehensive national study of perinatal mortality that was conducted between 2011 and 2012 in Jordan. All women who gave birth after 20 weeks of gestation in 18 maternity hospitals in Jordan between 2011 and 2012 were invited to participate in the study. Consenting women were interviewed by the trained midwives in these hospitals using a structured questionnaire prepared for the purpose of this study. Additional information was also collected based on the physical examination by the midwife and the obstetrician at admission and at discharge. Data on the newborn were also collected by the pediatric nurses and the neonatologists in these hospitals. Results The overall rate of teenage pregnancy [95% confidence interval (CI) was 6.2% (5.9%, 6.5%)]. Of the studied maternal and neonatal outcomes, women aged <20 years were more likely to deliver prematurely compared to women aged 20–35 years [odds ratio (OR)=1.5, 95% CI: 1.2, 1.9; p < 0.005)]. However, the two groups of women did not differ significantly in low birth weight delivery (OR = 1.2, 95% CI: 0.9, 1.5; p = 0.167) and neonatal mortality (OR = 1.2, 95% CI: 0.8, 1.3; p = 0.491) in the multivariate analysis. Conclusion Teenage pregnancy was associated with increased risk of premature delivery, apart from the effects of socioeconomic factors.