الفهرس 
COVEROnly 14 pages are availabe for public view
 |  | from | 141 |  |  |
| | | from | 141 | | |
Abstract
Rheumatic fever remains a major public health problem in developing countries. It is still the most common cause of acquired heart disease in many developing countries as in Egypt, India and South America (El Said et al., 1998). Physician awareness of rheumatic fever is generally high in developing countries but little is known about the accuracy of diagnosis of RF by physician in these countries, so there is overdiagnosis of rheumatic fever in children in certain developing countries (WHO, 1992).
The aim of this study was to demonstrate the possibility of over diagnosis of RF among school aged children based on signs and symptoms and elevated Antistreptolysin of titre (ASOT) and not fulfilled by Jones criteria.
The study was conducted on 100 children between 5-15 years previously diagnosed as RF and compliant to LAP.
All Patients Were Subjected to the Following:
Full history taking laying stress on application of modified Johns criteria.
Thorough clinical examination laying stress on the cardiac examination and detection of signs of RF.
Plain chest x-ray.
12 lead surface basal ECG for assessment of Heart rate( HR) ,rhythm, detection of any rhythm disturbances or evidence of chamber enlargement.
2D, color Doppler and M-mode echocardiographic examination to asses cardiac structures, functions and presence of any valvular abnormalities or pericardial effusion.
Laboratory investigation including:
a) Complete Blood Count (CBC).
b) C-Reactive protein (CRP)
c) Antistreptolysin O Titre (A.S.O.T).
d) Erythrocyte Sedimentation Rate (ESR).
The results of the study revealed that only 26% of cases fulfilled Jones criteria. While 2.7% of those who didn’t fulfilled Jones criteria were diagnosed with rheumatic heart by echo.
The study showed also that ASOT was high in 11 cases, 50% of them came with the same symptoms inspite they were compliant with LAP, which denotes that they were misdiagnosed as RF.