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AlDar M, Almaa A, Alturki H, Alkhalifah HS, AlSaeed WH, Alkhalifah AS. Cardiac Complications in Trisomy 21 Patients in a Secondary Hospital: A Descriptive Study. Cureus 2024; 16:e58058. [PMID: 38738149 PMCID: PMC11088443 DOI: 10.7759/cureus.58058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 05/14/2024] Open
Abstract
This retrospective study addresses the intersection of Down syndrome (DS) and congenital heart defects (CHD), including the prevalence and characteristics of CHD in trisomy 21 patients at a secondary hospital in the Eastern Province of Saudi Arabia. The study investigated the electronic medical records retrieved from the Qatif Central Hospital database, specifically targeting individuals diagnosed with DS (identified by the International Classification of Diseases, Tenth Revision (ICD-10) code Q90.9) between March 2012 and March 2022. The primary aim was to detect cardiac anomalies diagnosed via echocardiography performed at the hospital, along with subsequent follow-up assessments and documented patient outcomes. Among the 161 patients reviewed, the study revealed a significant prevalence of diagnosed heart defects through echocardiograms, constituting approximately 72.7%. Notably, patent ductus arteriosus was the most common condition, found in 29.81% of cases, followed by atrial septal defect (27.95%) and atrioventricular septal defect (17.39%). Among the study participants, 22.98% required surgical intervention. Unfortunately, mortality impacted 32.3% of individuals, while the majority (60.87%) remained alive. In addition, a small percentage (6.83%) discontinued follow-up within our center. This study contributes significant data on cardiac anomalies in DS patients in Saudi Arabia, highlighting a high prevalence of CHD with specific patterns of anomalies. The need for early diagnosis, timely surgical intervention, and ongoing management is evident. These findings provide a foundation for improving clinical practices and shaping public health policies tailored to the needs of this population in Saudi Arabia and similar regions.
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Affiliation(s)
- Mohammed AlDar
- Pediatrics and Neonatology, Qatif Central Hospital, Qatif, SAU
| | - Ali Almaa
- Pediatrics, Qatif Central Hospital, Qatif, SAU
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John ST, Gayathri K, Sahasranam KV. Cytogenetic Patterns, Congenital Heart Disease, and Thyroid Dysfunction in Children with Down Syndrome. J Pediatr 2022; 245:196-200. [PMID: 35114288 DOI: 10.1016/j.jpeds.2022.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 01/16/2022] [Accepted: 01/25/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To study the cytogenetic patterns, congenital heart disease, and thyroid dysfunction in children with Down syndrome. STUDY DESIGN This was a retrospective observational study of children with Down syndrome over a period of 20 years, from a major referral institution in Kerala state, South India. The cytogenetic patterns, echocardiography reports, and thyroid profiles were analyzed using SPSS, version 20, software. The prevalence of heart disease and thyroid status in the various cytogenetic patterns also were analyzed. RESULTS The prevalence of translocation (9.45%) was high compared with the reported 4% in the literature. More of the younger mothers had translocation with a greater, but not statically significant, incidence of heart disease. Mosaic karotypes (3.04%) were also greater than reported (1%) in the literature, with female preponderance. Heart disease was seen in 58% of cases, with atrial septal defect being the most common lesion, compared with atrioventricular septal defect noted in literature. Hypothyroidism was noted in 31.2% with no difference among the cytogenetic groups. There was no case of hyperthyroidism. CONCLUSIONS The high prevalence of translocation and mosaic Down syndrome stresses the need for routine karyotyping in children with Down syndrome. The need for routine screening and regular follow up of heart diseases and thyroid status should be emphasized.
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Affiliation(s)
- Shaji Thomas John
- Down Syndrome Clinic, Baby Memorial Hospital, Kozhikode, Kerala, India.
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Saquib N, Al Sarraj AN, Oubaied BTZ, Rajab AM, Agha BN, Hossain J, Almazrou A, Saquib J. Gain in growth after surgical repair of congenital heart disease among children with Down syndrome. Am J Med Genet A 2021; 188:24-30. [PMID: 34496118 DOI: 10.1002/ajmg.a.62483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/29/2021] [Accepted: 08/16/2021] [Indexed: 11/12/2022]
Abstract
Down syndrome (DS) is a common genetic disorder among Saudi children, for which limited data is available on growth for those who undergo surgery for congenital heart disease (CHD). We assessed the magnitude of growth over time following surgery and the factors associated with growth change. Eighty-eight children with DS and CHD who underwent surgery between 2009 and 2017 at the tertiary children's hospital in Al-Qassim, Saudi Arabia, were eligible. Information on gender, height, and weight (at surgery, 6 and 12 months), age at surgery, and type of CHD were abstracted from the medical records. Repeated measure analysis of variance (ANOVA) was used for data analysis. The sample's mean age (SD) was 16.2 months (20.1); 47% were male. Height, weight, and body mass index (BMI) increased significantly at both follow-up points. There was a significant interaction between age at surgery, type of heart disease, and time for all three physical indices (p-values <0.001). The increase in height, weight, and BMI was significantly greater for children ≤8 months old with acyanotic CHD compared to children >8 months with cyanotic CHD. Overall, the gain in growth was greater for the children with DS who had had surgery at a younger age.
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Affiliation(s)
- Nazmus Saquib
- College of Medicine, Sulaiman Al Rajhi University, Al Bukairyah, Saudi Arabia
| | | | | | - Ahmad Mamoun Rajab
- Calderdale and Huddersfield NHS Foundation Trust, Calderdale Royal Hospital, Halifax, UK
| | - Bana Nasser Agha
- Prince Sultan Cardiac Center at the Maternity and Children's Hospital, Buraydah, Saudi Arabia
| | - Jesmin Hossain
- Department of Paediatric Cardiology, National Heart Foundation, Dhaka, Bangladesh
| | | | - Juliann Saquib
- College of Medicine, Sulaiman Al Rajhi University, Al Bukairyah, Saudi Arabia
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Amin RE, Abdel-Meguid IE, El-Refaie NM, Fakher W, El-Tabie D, El-Gindy HA. Clinical Profiles, Congenital Heart Disease, and Other Comorbidities Among Egyptian Children with Down Syndrome: A Tertiary Center Study. JOURNAL OF CHILD SCIENCE 2021. [DOI: 10.1055/s-0041-1735537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Introduction Down syndrome (DS) is the most common chromosomal disorder. It is accompanied by several comorbidities, which could lead to severe morbidity and mortality. Congenital heart disease (CHD) is one of the most commonly described condition.
Objective This study aimed to determine clinical profiles, dysmorphic features, CHD, and DS associated comorbidities in a tertiary center (Cairo, Egypt).
Patients and Methods This descriptive study included 290 patients diagnosed with DS, who presented to the Clinical Genetics clinic, Cairo University Children Hospitals, from February 2018 to December 2019. The patients' ages ranged from 2 to 4 years old. All patients were evaluated by full history, clinical examination, anthropometric measurements, and assessment of developmental milestones. Patients' diagnostic investigations including karyotype, thyroid function, and echocardiography were checked.
Results The study population consisted of 290 children with DS of which 196 (67.6%) were male, 115 (40%) had CHD, the most prevalent atrial septal defect (ASD), patent ductus arteriosus (PDA), and ventricular septal defect (VSD) accounting for 10.7, 7.1, and 4.2%, respectively. Common dysmorphic features were upward slanting palpebral fissures (98.6%), hypertelorism (97.9%), and sandal gap (60.7%). Thyroid dysfunction was the second prevalent comorbidity, found in 35 patients (12.1%). Global developmental delay was reported affecting language (99%), motor (94.8%), and social (92.8%) domains.
Conclusion The prevalence of CHD among children with DS was 40% with ASD, PDA, and VSD being the commonest. Thyroid dysfunction was the second most common comorbidity. The most prevalent dysmorphic features were upward slanting palpebral fissures, hypertelorism, and sandal gap. Developmental delay was very common, language being the most affected domain.
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Affiliation(s)
- Radwa Ezzat Amin
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | | | - Walaa Fakher
- Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dina El-Tabie
- Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hala Ahmed El-Gindy
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
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Alhuzaimi AN, Alotaibi NM, Alsuhaibani GI, Alanazi RK, Temsah MH. Congenital Heart Defect and Pulmonary Hypertension in Children With Down Syndrome: Clinical Profile Over Two Decades. Cureus 2021; 13:e13212. [PMID: 33585145 PMCID: PMC7872499 DOI: 10.7759/cureus.13212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives: To describe the frequency and spectrum of congenital heart defects (CHD) and pulmonary hypertension among pediatric patients with Down syndrome (DS) in Saudi Arabia. Methods: A cross-sectional, retrospective study of the cardiac anomalies among pediatric patients (0-18 years) with DS had been seen and evaluated in one center from August 2001 to October 2020. The demographic data, the reason for referral, echocardiography data including presence and type of CHD, systolic function, atrioventricular regurgitation, and pulmonary hypertension (PHTN) were analyzed. Results: Among the 468 pediatric patients with DS, 275 (58.8%) had one or more congenital heart defects (CHD). The most common types of CHD among DS pediatric patients were ventricular septal defect (29.45%), atrial septal defect (ASD) secundum (26.9%) and atrioventricular septal defect (AVSD) (22.9%), and moderate to large patent ductus arteriosus (PDA) (9.1%). Pulmonary hypertension analyzed in children older than two months of age and was present in 21.5% of patients with CHD and 2.2% of patients with no CHD. Multivariate logistic regression showed the presence of AVSD, large PDA, and ASD secundum which all independent predictors of pulmonary hypertension. Conclusion: Almost 60% of DS patients have CHD with pulmonary hypertension which affect almost one-fifth of patients with CHD. AVSD, hemodynamically significant PDA, and ASD secundum were the most common lesions associated with pulmonary hypertension.
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Affiliation(s)
- Abdullah N Alhuzaimi
- Pediatric Cardiology, Department of Cardiac Science, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, SAU
| | - Najoud M Alotaibi
- Pediatric Cardiology, Department of Cardiac Science, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, SAU
| | - Ghadah I Alsuhaibani
- Pediatric Cardiology, Department of Cardiac Science, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, SAU
| | - Reem K Alanazi
- Pediatric Cardiology, Department of Cardiac Science, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, SAU
| | - Mohamad-Hani Temsah
- Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, SAU
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Santoro SL, Steffensen EH. Congenital heart disease in Down syndrome – A review of temporal changes. JOURNAL OF CONGENITAL CARDIOLOGY 2021. [DOI: 10.1186/s40949-020-00055-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract
Background
Congenital heart disease (CHD) is a well-known co-occurring condition in Down syndrome (DS). We aimed to review the literature to evaluate the current evidence to address key questions.
Methods
A series of key questions were formulated a priori to inform the search strategy and review process. These addressed the topics of prevalence, type of CHD, severity, and screening. Using the National Library of Medicine database, PubMed, detailed literature searches were performed. The quality of available evidence was then evaluated, the existing literature was summarized, and knowledge gaps were identified.
Results
Fifty-six relevant original articles were identified which addressed at least one key question. Study details, including: research design, internal validity, external validity, and relevant results are presented. The total prevalence of CHD reported in DS ranged from 20 to 57.9%. In later decades, the prevalence remained constant at 40—55%. The types and classification of CHD varied considerably between studies. Some studies indicate a trend towards a milder phenotype, but this was not consistent. Over time, some studies observed an improved prognosis for CHD in DS. Studies investigating screening for CHD by physical examination, chest X-ray, and electrocardiogram report sensitivities of 71–95%.
Conclusion
To further improve knowledge on CHD in DS, we suggest that future studies cover a wide range of nations and regions, with a longitudinal design, and account for potential confounding factors.
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Ghmaird A, Alrashidi TN, Alqahtani YS, Alanazi AH, Alaenzi YA, Almohammadi AM, Alzahrani HA, Alomrani NF, Altabbish W. Types and Distribution of Congenital Heart Defects in Pediatric Patients with Down’s Syndrome: A Retrospective Study. Cureus 2020; 12:e11133. [PMID: 33133793 PMCID: PMC7586367 DOI: 10.7759/cureus.11133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Congenital heart disease (CHD) is common in patients with Down’s syndrome (DS), rendering them at risk of significant mortality and morbidity. However, all patients with confirmed DS must undergo further investigation for a cardiac anomaly early in their lives. Objective To define frequency and patterns of CHD among children with DS in Northwest, Saudi Arabia (SA). Methods A five-year chart review study was conducted in Northwest SA between January 2015 and June 2019. We included all children referred to the pediatric cardiology clinic with a confirmed diagnosis of DS and CHD. Children were identified in the clinic’s database, and charts were reviewed retrospectively. Results Among 851 patients with CHD, 53 were identified with DS. Male patients represented 62.3%, while female patients represented 37.7%. The median patients’ age at the time of diagnosis was two days, with most patients diagnosed before 28 days old (67.9%). This study found that atrial septal defect (ASD) and patent ductus arteriosus (PDA) were the most common isolated lesions (37% of isolated cases), while the most common combined lesions were ASD, ventricular septal defect (VSD), and PDA, as well as combined ASD and VSD. Female gender was significantly associated with higher percentage of VSD (p = 0.031) more than male. While male patients had significantly higher percentages of ASD and valvular anomalies than female patients (p = 0.019 and 0.033, respectively). Conclusions The patient’s gender was significantly associated with some types of CHD. Both ASD and valvular lesions were more common among males, while VSD was more common among female patients, no gender differences were detected regarding the other types of CHD.
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Alsuhaymi ZS, Shihata MS, Alsuhimi SS, Alharbi HB, Khoshal SQ, Syed AU. Outcome of congenital heart surgery for patients with Down Syndrome. Chirurgia (Bucur) 2020. [DOI: 10.23736/s0394-9508.19.04992-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abduljawad EM, AlHarthi A, AlMatrafi SA, Hussain M, Shawli A, Waggass R. The Prevalence of Congenital Heart Diseases in Syndromic Children at King Khalid National Guard Hospital from 2005 to 2016. Cureus 2020; 12:e7891. [PMID: 32489745 PMCID: PMC7255536 DOI: 10.7759/cureus.7891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/29/2020] [Indexed: 12/30/2022] Open
Abstract
Background Congenital heart diseases (CHDs) are abnormalities that present in the heart since birth and are one of the leading causes of infant mortality in the world. CHDs are more common among children with dysmorphic syndromes. The current study aims to estimate the prevalence of many CHDs in different dysmorphic syndromes. Methods This was a retrospective chart review study conducted on all dysmorphic syndrome patients who attended genetic clinics at King Khalid National Guard Hospital in King Abdulaziz Medical City (KAMC), Jeddah, Saudi Arabia from 2005 to 2016. Dysmorphic pediatric patients less than 14 years old who had genetic testing to confirm their diagnosis were included in the study. Patients who did not have any previous echocardiography were excluded. Results A total of 212 individuals (47% males and 53% females) were included. Eighty-five percent of Down syndrome patients had CHDs, and the most common CHD was an atrial septal defect (ASD) (51%). In patients with Turner syndrome, 45% of them had CHDs, and bicuspid aortic valve (BAV) (40%) was the most common defect. In DiGeorge syndrome, 81% of patients had CHDs, and ventricular septal defect (VSD) (41%) was the most common. In Williams syndrome, 83% of patients had CHDs. All patients with Noonan, Edwards, CHARGE (coloboma, heart defects, atresia choanae (also known as choanal atresia), growth retardation, genital abnormalities, and ear abnormalities), and Rubinstein-Taybi syndromes were found to have CHDs. In Patau syndrome and Joubert syndrome, 50% of patients in each had CHDs. Patients with Prader Willi syndrome had normal findings in the echocardiogram. Conclusion The highest prevalence of CHDs was found in Down syndrome. This study has a significant impact on the future of managing and directing the resources to improve the quality of life for syndromic patients. Further studies are needed to confirm these findings and to increase the local data in the field of CHDs in Saudi Arabia among syndromic patients.
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Affiliation(s)
- Elaf M Abduljawad
- Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Ahad AlHarthi
- Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Samah A AlMatrafi
- Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Mawaddah Hussain
- Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Aiman Shawli
- Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, SAU
| | - Rahaf Waggass
- Pediatric Cardiology, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
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Saleh NY, Salem SS, Abo-El Fotoh WM, Soliman SE, Abo-Haded HM. Angiotensin-converting enzyme insertion/deletion (ACE I/D) gene polymorphism in Egyptian children with congenital heart disease. Birth Defects Res 2020; 112:963-969. [PMID: 32343056 DOI: 10.1002/bdr2.1700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/16/2020] [Accepted: 04/04/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Congenital heart diseases (CHDs) are the leading cause of infant deaths worldwide. The relationship between angiotensin-converting enzyme (ACE) gene polymorphism and CHDs is not clear. The aim of this work is to assess the presence of an association between ACE I/D polymorphism and CHD in Egyptian population. SUBJECTS AND METHODS Seventy CHD cases and 70 controls were incorporated in this study. DNA was isolated from their peripheral blood, and then ACE I/D gene polymorphism was tested by polymerase chain reaction (PCR). RESULTS There was no significant difference among the frequencies of the DD, II, and DI genotypes in patients and controls (26 [37.1%], 37 [53.3%], and 4 [5.7%], 5 [6.7%]), 40 (57.2%), 28 (40%), respectively (p value = 1 and OR [95% CI] = 1.1). There was no significant difference between D allele (DD + DI) and II genotype distribution among patients and controls (p value = 1 and OR [95% CI] = 1.2 [0.3-2.9]). Moreover, there was no difference between I allele (II + DI) and DD frequency (p value = 0.2 and OR [95% CI] = 0.6 [0.3-1.2]). CONCLUSIONS ACE I/D gene polymorphism might not be a risk factor of CHD in Egyptian children. Additional widespread studies are needed to affirm these data.
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Affiliation(s)
- Nagwan Y Saleh
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt
| | - Sherif S Salem
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt
| | - Wafaa Mm Abo-El Fotoh
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt
| | - Shaimaa E Soliman
- Department of Medical Biochemistry, Faculty of Medicine, Menoufia University, Shibin el Kom, Egypt.,Medical Biochemistry Unit, Pathology Department, Faculty of Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Hany M Abo-Haded
- Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Khoshhal S, Al-Harbi K, Al-Mozainy I, Al-Ghamdi S, Aselan A, Allugmani M, Salem S, El-Agamy D, Abo-Haded H. Assessment of quality of life among parents of children with congenital heart disease using WHOQOL-BREF: a cross-sectional study from Northwest Saudi Arabia. Health Qual Life Outcomes 2019; 17:183. [PMID: 31842888 PMCID: PMC6915919 DOI: 10.1186/s12955-019-1249-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 11/22/2019] [Indexed: 11/10/2022] Open
Abstract
Background and aims Health-related quality of life (HRQOL) has garnered increasing interest especially for health care providers and researchers. The study aims to evaluate the HRQOL in parents of congenital heart disease (CHD) children, and to clarify the effect of the disease severity on the outcome of the HRQOL perception. Also, to analyze the internal consistency of the Arabic version of the World Health Organization (WHO) QOL-BREEF tool in order to determine whether the tool had good validity for the target population. Methods A cross-sectional study. The HRQOL perception was evaluated using WHOQOL-BREF questionnaire, and the internal consistency of the tool was tested using Cronbach’s alpha (α-C), Results The study sample consisted of 200 individuals, 120 parents of CHD children, compared to 80 parents of children with minor illnesses (mean age of participating parents = 35.1 ± 9.8 years). While evaluating the HRQOL, the group of parents of children with minor illnesses had higher scores than the total group of parents of CHD children in all domains, indicating a better HRQOL. Class-IV subgroup of parents of CHD children showed the most significant lower total score of domains between all classes (44.47 ± 12, p < 0.001). With respect to the internal consistency of the WHOQOL-BREF, estimation of α-C values were 0.84 points for the group of parents of CHD children, and 0.87 for the group of parents of children with minor illnesses. Conclusions This short-term study emphasized that, HRQOL scores among parents of CHD children are compromised, and the severity of their children illness significantly affect the total score of domains in their HRQOL perception. Furthermore, the tool showed to be practical and efficient to evaluate the QOL of parents of CHD children in our population in future researches.
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Affiliation(s)
- Saad Khoshhal
- Pediatric Cardiology Team, Department of Pediatrics, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Khaled Al-Harbi
- Pediatric Cardiology Team, Department of Pediatrics, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Ibrahim Al-Mozainy
- Pediatric Cardiology Unit, Department of Pediatrics, Maternity and Children Hospital (MCH), Al-Madinah Al-Munawarah, Saudi Arabia
| | - Saeed Al-Ghamdi
- Pediatric Cardiology Unit, Department of Pediatrics, Maternity and Children Hospital (MCH), Al-Madinah Al-Munawarah, Saudi Arabia
| | - Adnan Aselan
- Pediatric Cardiology Unit, Department of Pediatrics, Maternity and Children Hospital (MCH), Al-Madinah Al-Munawarah, Saudi Arabia
| | - Mohammad Allugmani
- Pediatric Cardiology Unit, Department of Pediatrics, Maternity and Children Hospital (MCH), Al-Madinah Al-Munawarah, Saudi Arabia
| | - Sherif Salem
- Pediatric Cardiology Department, Madinah Cardiac Center (MCC), Al-Madinah Al-Munawarah, Saudi Arabia.,Department of Pediatrics, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt
| | - Dina El-Agamy
- Department of Pharmacology, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Hany Abo-Haded
- Pediatric Cardiology Team, Department of Pediatrics, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia. .,Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt.
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Kotb MA, Draz I, Basanti CW, El Sorogy ST, Abd Elkader HM, Esmat H, Abd El Baky H, Mosallam DS. Cholestasis In Infants With Down Syndrome Is Not Due To Extrahepatic Biliary Atresia: A Ten-Year Single Egyptian Centre Experience. Clin Exp Gastroenterol 2019; 12:401-408. [PMID: 31695469 PMCID: PMC6815214 DOI: 10.2147/ceg.s216189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/03/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose We aimed to define the clinical presentations, course and outcome of cholestasis in infants with Down syndrome (trisomy 21) who presented to the Pediatric Hepatology Clinic, New Children Hospital, Cairo University, Egypt. Methods Retrospective analysis of data of cohort of infants with Down syndrome and cholestasis who followed up during 2005-2015. Results Among 779 infants with cholestasis who presented during 2005-2015, 61 (7.8%) had Down syndrome. Six dropped out. Among the 55 who followed-up for a mean duration +SD = 12.1 ± 16.7 months, none had extrahepatic biliary atresia (EHBA), 37 (63.3%) had neonatal hepatitis and 18 (32.7%) had non-syndromic paucity of intrahepatic biliary radicals. Fourteen (25.4%) had associated congenital heart disease. Only 35 (63.3%) cleared the jaundice. Twenty-nine (52.7%) received ursodeoxycholic acid (UDCA); of them, 13 cleared the jaundice, one improved, 14 progressed and one died, compared to 22 who cleared the jaundice of the 26 who did not receive UDCA. Only three of those who did not receive UDCA progressed and none died. UDCA carried a 3.4-fold risk of poor prognosis (p= 0.001). UDCA use was associated with more complications (p= 0.016) in those with Down syndrome and cholestasis. Conclusion We did not come across EHBA among neonates and infants with Down syndrome in 10 years. Non-syndromic paucity is associated with favorable outcome in infants with Down syndrome. UDCA use in cholestasis with Down syndrome is associated with poor outcome.
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Affiliation(s)
- Magd A Kotb
- Pediatrics Department, Faculty of Medicine, Kasr Al Ainy, Cairo University, Cairo, Egypt
| | - Iman Draz
- Pediatrics Department, Faculty of Medicine, Kasr Al Ainy, Cairo University, Cairo, Egypt
| | - Christine Ws Basanti
- Pediatrics Department, Faculty of Medicine, Kasr Al Ainy, Cairo University, Cairo, Egypt
| | | | - Hesham M Abd Elkader
- Department of Pediatric Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Haytham Esmat
- Department of Pediatric Surgery, Cairo University, Cairo, Egypt
| | - Hend Abd El Baky
- Pediatrics Department, Faculty of Medicine, Kasr Al Ainy, Cairo University, Cairo, Egypt
| | - Dalia Sayed Mosallam
- Pediatrics Department, Faculty of Medicine, Kasr Al Ainy, Cairo University, Cairo, Egypt
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El-Gilany AH, Yahia S, Wahba Y. Prevalence of congenital heart diseases in children with Down syndrome in Mansoura, Egypt: a retrospective descriptive study. Ann Saudi Med 2017; 37:386-392. [PMID: 28988253 PMCID: PMC6074196 DOI: 10.5144/0256-4947.2017.386] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The pattern and risk factors for congenital heart diseases (CHD) in children with Down syndrome (DS) vary over time. OBJECTIVES To update knowledge of the prevalence, types, trends and associated factors for CHD in children with DS in the Egyptian Delta. DESIGN A retrospective hospital record-based descriptive study. SETTING A tertiary care center in Mansoura, Egypt during a period of 14 years from 2003 up to 2016. PATIENTS AND METHODS We studied children with genetically proven DS. Relevant sociodemographic factors, medical history, clinical examination, karyotype and echocardiographic data were statistically analyzed. MAIN OUTCOME MEASURES Prevalence, types and risk factors of CHD in DS. RESULTS The prevalence of overall, isolated and multiple CHD in 1720 children with DS were 36.9%, 29% and 8%, respectively. Isolated defects accounted for 78.4% of all CHD. Ventricular septal defect, atrioventricular septal defect and atrial septal defect were the most frequent isolated defects. There was a downward trend in the prevalence of overall CHD (from 56.2% to 25.0%) and isolated CHD (from 56.2% to 19.8%). The logistic regression model predicted 65.7% of CHD and revealed that passive maternal smoking, lack of folic acid/multivitamin supplementation and parental consanguinity were the independent predictors of CHD in children with DS with adjusted odds ratios of 1.9, 1.8 and 1.9, respectively. CONCLUSION More than one-third of children with DS have CHD with ventricular septal defect, which is the most common. Avoidance of passive maternal smoking and consanguineous marriage together with maternal folic acid supplementation could contribute to further reduction of CHD in children with DS. LIMITATIONS Single-center study and retrospective.
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Affiliation(s)
| | | | - Yahya Wahba
- Correspondence: Dr. Yahya Wahba Department of Pediatrics (Genetic Unit), Faculty of Medicine, Mansoura University, Mansoura 002, Egypt , ORCID: http://orcid.org/0000-0001-7479-7866
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Al-Mendalawi MD. The spectrum of congenital heart diseases in down syndrome. A retrospective study from Northwest Saudi Arabia. Saudi Med J 2016; 37:1294-1295. [PMID: 27761573 PMCID: PMC5303812 DOI: 10.15537/smj.2016.11.16359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Mahmood D Al-Mendalawi
- Department of Pediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad, Iraq. E-mail.
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